These are pics of the belly. I really wish I would have done my hair for some of these- but the point was to focus on the belly, not my disheveled ponytail! I love that as soon as Barley realized we were taking pictures, he HAD to be right in there with me- Cooper just wanted to watch. Barley is a big boy and the belly covers his huge head!
I know some people are confused by the specifics of the process, so I will try to explain a few things about the whole process now. For the egg retrieval, the docs needed to get my body to grow as many follicles as they could to their largest possible size- the follicles contain the eggs and the larger they are, the more mature the egg will usually be. Every woman has a different number of “resting follicles” available in each ovary every month- the body naturally grows or matures 1 or more (maybe 2-3) of these each month for ovulation. The older you are, typically the fewer follicles you have available. The number usually drops off drastically after age 35- the eggs are also so much older since girls are born with all the eggs they will ever have and the older they get, the less likely they are to be normal (able to fertilize, able to produce a normal, healthy embryo). There is very precise timing with this process, they can’t let the egg get too mature because it expires quickly if it isn’t fertilized within a certain time of maturation. The docs also have to carefully control ovulation- they cannot let your body do it’s own thing, so while I injected meds to make my ovaries work overtime growing these follicles, I also injected meds to stop my body from ovulating. That’s why I had so many blood tests- to check all of my levels, and internal sonograms to look at my ovaries and measure the follicles. Then, on Sunday night (really Monday morning)- 1:00am I was injected with a “trigger” shot. This is an IM injection- a big 1.5inch needle, injected into my glute. This med causes ovulation to begin (which takes about 36 hours for the follicle to release the egg). They time it perfectly to when they schedule me for retrieval surgery. A nurse came to our hotel room and injected the shot. We paid her $105 for this service and it was totally worth it! She made it fairly painless, was super nice, we were sure it was done properly, and she even hugged me for good luck before she left. I needed that since I woke up at 1am to get a huge shot in the ass.
For egg retrieval (this past Tuesday at noon), I was put under anesthesia, the surgery took 10-15 minutes total. The doc uses a huge syringe (good thing I didn’t see that thing!) and goes into my uterus- through the uterine wall, into the ovaries and sucks out the eggs and fluid- he is guided by ultrasound. When I say he goes in through my uterus, I don’t mean that he injects that syringe through my belly- he goes in through other means I just can’t bring myself to describe! The risk is that my body would go into hyperstimulation- or simply- the ovaries would fill back up with fluid at an abnormal rate trying to get that fluid level back, and then there is a chance they explode (seriously) or that they flip, causing emergency surgery to remove that ovary before it causes major damage to the rest of the reproductive organs. I feel good today- don’t think I have any of those possible side effects, but I have to take it easy for a week or so. I gained 8 lbs in 2 weeks. Yikes.
When they have the embryos in the lab, they are looking to see if they divide normally and do so at an acceptable rate. Each day, each cell should divide. So by Day 5, the embryologists have analyzed each embryo to see which ones are dividing at a normal rate, which are still dividing- just maybe a bit slower, and which ones have stopped dividing. If an embryo hasn’t changed in 2 days, it is a dud. They grade the embryos based on this division and rank them. On Day 6, the ones who made it to Day 5 are all frozen. This is a special freezing process that is supposed to minimize any potential damage to the embryos- not at all like an ice cube tray! The embryologist takes cells from the outer ring of the embryo- this ring will become a placenta in a normal implanted embryo. It has the same genetic make-up of the embryo itself and that is why it is chosen to analyze. Everything is labeled with numbers- embryo 1, 2, etc. The cells are then sent to a lab in New Jersey to be analyzed. This process takes about 6 weeks- they look at all the chromosomes and within 95% accuracy, can tell if there are any major genetic defects that would cause the embryo to not survive pregnancy (cause miscarriage) or would cause a devastating illness that would lead to early infant death. This actually happened to our friends who are also going through this process at CCRM- one of the embryos the embryologists thought looked really good, was determined by genetic testing to have a major defect that would allow the embryo to survive pregnancy but 100% chance of death in the first 6 months after birth- if not within hours. Our friends were so glad they chose the genetic testing- they couldn’t imagine the grief of going through infertility treatments for 3 years, and then having your child die within its first 6 months.
After we wait the 6 weeks for genetic testing results, our doctor gets my body ready for transfer- about another 4-6 weeks. That means more meds so my body goes through the normal process of getting ready for fertilization and implantation. At transfer time, the lab will thaw the chosen embryos and prepare them for transfer- they make sure that 75% of the embryos cells are active after thaw (to know the freeze didn’t ruin them). CCRM recommends acupuncture 45 minutes before transfer and again right after. They also give you a valium. As you can imagine, anxiety levels are pretty high for patients on this day! Sorry Matt, no valium for you! The doctor will use a trial catheter to make sure he can get past the cervix easily (don’t want to squish the embryos trying to get past the cervix!) then, guided by ultrasound, he’ll use a catheter with the embryos inside, and carefully place them in the right spot in the uterus. They even let you take pics of the embryos if you want- no flash allowed though! Then you lie there about an hour and are released on bed rest for 2 days, followed by very restricted activity for a couple of weeks. No flying in the first 3 months- no hard exercise, etc. Absolutely no caffeine. Patients take a pregnancy test about 8 days after transfer and if positive, repeat in 48 hours and a couple more times after that. A sonogram is performed about a month after that first pregnancy test and if everything looks good, you are released to a regular OB/GYN. So, that’s it!
I can’t wait to try to relay the story to our future kids… Mommy injected herself in the belly with meds, Daddy deposited his sperm in a cup in a really nice room in Denver. Then doctors sucked out Mommy’s eggs, put them in a little petri dish- injected the sperm and then several people watched to make sure you were growing. You were then frozen for about 12 weeks while your cells got tested to be sure you were normal- then we thawed you and the doctor used a long plastic tube to inject you into mommy’s belly. You have a couple siblings still frozen waiting for us to implant them as well in a couple of years. What? That’s not what your friends parents told them? Well, we are a very high tech family. And little Jimmy down the street is far from normal- his parents really should’ve done it the way we did! Oh, and you’ll need to go to practice earlier than the other players and study for an hour longer than all your friends because you’ll need a scholarship of some kind for college- we spent all your college fund money in Denver getting pregnant with you.
Sweet story isn’t it? Really someone should write a children’s book with this premise, they have the ones for adopted kids- why not petri babies?!
In the suburbs of Denver, with beautiful views of the Rocky Mountains, set back from any major roads, is CCRM. There is a garage entrance for the surgery center, or for the famous patients who enter only at night. Here, you give your name and they buzz you into the garage where a few other cars are parked- on Tuesday that included a new Acura, Lexus SUV, and Cadillac SUV- pretty sure at least one of these was a Dr.'s car. We rolled in with Matt’s company car- a maroon Subaru Forester. Not bad- there was another Forester in the garage, so we didn’t feel too out of place. From there, you take an elevator (lined with mahogany walls, a travertine tiled floor and shiny stainless steel buttons), up to the second floor where comfy loveseats await you. Here you wait until someone calls your name. The inside of the building looks like a spa. There are marble floors, huge windows to take in the views, that same beautiful mahogany wood everywhere, and sleek trendy lighting fixtures. I’m envious of the bathrooms- there is a the most gorgeous pale blue glass subway tiles on the walls, and a sink/vanity area right out of House Beautiful magazine. If you happen to just be coming in for a regular appointment, you enter the front door and think for a second that maybe you’re in the lobby of a posh little spa (they do have massage therapy, acupuncture, and a counselor available for patients!) The whole place is calming, serene, comfortable, and just a tad bit intimidating. The staff is a little unbelievable as well. First of all you notice how attractive everyone is- in a very natural, Colorado kind of way: thin, fit, faces fresh from mountain air. Next, you can’t help but be impressed with just how extremely nice and accommodating staff is with all of the patients. From the front desk to the phlebotomists, and don’t even get me started on the nurses, genetic counselor or my doctor!
Jenny was my nurse on Tuesday for the egg retrieval- a tall, thin, young blonde who is probably a runner (that conclusion based completely on my prejudices!). She was darling in every sense of the word. Before she started my IV, she gave me a courtesy shot of lidocaine so the IV wouldn’t hurt as much (I have never even had this offered before)! When she had trouble getting the IV started (apparently while I have “big juicy” veins, they roll around)- she told me it was totally her fault and she was going to go get help so I wouldn’t have to suffer. Very considerate. The next nurse, equally adorable, got the IV started on the opposite hand on the first try. It really didn’t hurt much at all, with the numbing shot first- it was the best IV experience I’ve ever had. Jenny was complimentary (“wow you have such pretty hair”), chatty (in that friendly “I’m gonna try to help take your mind off of all of this” kind of way), and helpful (“do you need to sit up? Are you comfortable? Do you prefer graham or club crackers for when you wake up?”). Who wouldn’t love this girl? When I woke up from surgery, she was the first face I saw- smiling at me asking how she could be of assistance and telling me how great I did in surgery (I just laid there really, but I wasn’t going to argue with her). Nice. The anesthesiologist (Dr. Wilson) came in to check on me after surgery and to check to see how my throat felt. The last surgery I had, the hysteroscopy, I had a sore throat afterwards due to a device they had to put in my mouth/throat that helps hold my airways open and prevent my tongue from rolling back. He said he was extra gentle and gave me more numbing medicine this time to prevent that because he was so sorry it was a little scratchy last time. Seriously? He even cared? He is a little weird looking though- I couldn’t help but think he looked like a slightly heavier Johnny Depp version of Willy Wonka. Maybe he has dentures- but there’s something just a little off. Dr. Gustafson performed the retrieval- he’s our little nerdy hero who found my fibroid on my first visit to CCRM. He is a small, thin, very pale YOUNG guy with thin reddish hair (in a sort of dorky, 5th grade kind of haircut). Seriously, if he is one day over 35 I’d be shocked. But he is so nice! Apparently his wife also did IVF, so he’s a little more sensitive and understanding to the situation.
Finally, after I was awake for about 30-45 minutes and Matt had been in my room with me for a while, they brought in the embryologist to discuss the results of the retrieval. Matt and I were praying that they had recovered more than 12 eggs (the number they retrieved in KC). Amy, our very young embryologist walked in. She must be a genius- I think she is about 28, a pretty little brunette, sadly with a personality of a flea. That’s ok- she is obviously smart and she tried hard to talk to normal humans. 20 eggs! Wow- they got 20 eggs!! We were stunned, excited, and now- a little more hopeful. She told us that she’d call us in the morning (Wednesday) as well as on Day 3 (Friday) and Day 6 (Monday) to give us updates on the number of mature eggs, the number fertilized, and reports of growth for the embryos. Day 6 would be to tell us how many made it to Day 5 (the magic day when they would normally transfer fresh embryos back into the uterus) and how many they were able to freeze for genetic testing.
Wednesday morning I had my phone turned up to the highest volume and had it in my sight all morning. Amy finally called at 10:30 (agonizing wait!). Again, in a very forced tone (must be tough to talk to folks of average intelligence) she let us know that 16 of the 20 eggs were mature (better than we thought!) and 14 of those fertilized normally. That is a great starting point! She informed us that the lab used a special PICSI dish for the sperm- to initially sort to find the very best, then used a method called MSI (high powered microscope magnifying 400 times) to choose the right sperm from that sorted batch, and finally a method called ICSI- where they manually inject the sperm into the egg. So high tech! This is definitely not what they teach you about getting pregnant in 7th grade health class!
Now we wait. Wait for the call on Friday, then the one on Monday- that is really the only one that matters. How many embryos made it to Day 5 and they are freezing to send a single cell for testing. It will be a long weekend waiting for that call!
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