Round 2 (IVM): Step 3 and 4 - Collection and ICSI!

I had my collection done this morning at 10AM. Not my favourite experience throughout this whole process, but certainly not my worst (hysteroscopy without any pain medication takes the cake)!

First, they attached me to a regular IV drip to hydrate me. Then, a couple of hours later we were in the operating room. I was given Ativan to calm my nerves and relax me as well as Fentanyl for the pain. I will spare you all the details, but let’s just say that more Fentanyl will be requested (demanded) if I have to do this again and next time, I think DH will have to give me something other than his hand to hold because I nearly broke his fingers. Sorry! After this, I went to recovery for an hour or so and then waddled my way to the car. I am still in pain, having trouble getting up from the couch and such, but all in all I am fine. I have started taking all of the other prescribed medications as well: Doxycycline, Medrol, Estrace, and Prometrium. Oh, and lots of Tylenol! So far so good!

In the end, they collected 10 immature eggs and 1 mature egg from my right hand side only. The left ovary was not co-operating as it was hiding behind my uterus. The decision was made that 11 eggs were plenty and the additional punctures (which would have gone through my uterus), pain, and work to get to the left side were not going to be worth it. I was SO happy when I heard this! I was in a lot of pain and cramping like crazy at this point.

I was not told, but as far as I can tell the mature egg has already been fertilized using ICSI (which you can read up on here) and the others are being incubated to hopefully be fertilized tomorrow. The hospital should keep in touch daily to keep us up to date.

Transfer of the best embryo will be done within 2-5 days if all goes well and any remaining embryos will be frozen for future use.

Round 2 (IVM): Step 3 - Collection Scheduled!

Since the last time I posted I have been back and forth to the hospital and pharmacies all over again. I took the 3 days of Repronex as prescribed and returned to the hospital Boxing Day morning for my fourth ultrasound only to find that it hadn’t done very much at all. I was then given 2 more days of injections (totalling 620$ at this point - covered by insurance) and asked to return today for a fifth scan.

And... success! I still have a number of smaller follicles ranging from 6-8mm, but enough larger ones (10mm or larger) that we are going ahead with step 3! I have to take my HCG injection this evening and we return to the hospital 38 hours later for collection. Thursday morning here we come!

So, once again, things did NOT go as smoothly as hoped for but at least we are getting somewhere this time!

Round 2 (IVM): Back to Step 2...

I went for my 3rd ultrasound today expecting things to be growing nicely and ready for the next step by Friday. HA! My follicles have hit a brick wall again and need yet another push. I will be on 150 IU of Repronex starting tomorrow for 3 days and back for another ultrasound on Sunday. This injection is scaring the crap out of me right now because it requires mixing and such but I will get through it. I've come too far now not to!

Body... make up your mind and work properly!!! Hopefully things will straighten out by early next week and we can go back to the next step.

Round 2 (IVM): Step 3 - Egg Retrieval / Collection

I have had 2 ultrasounds already, and a third is scheduled for tomorrow and things are going extremely well this time around. So, the time has come! I should be going in for Step 3 within the next few days; probably Christmas Eve or Christmas Day from the looks of things. Must be all those fingers and toes crossed around the world for us!

When I first heard the terms “egg retrieval” and “collection” all I could think of was the Easter Bunny for some reason (I know... my head doesn’t always think right). However, once I found out that the more technical term for the procedure is “follicle aspiration” I became quite content with the term “collection”.

So now that we have settled on a term... what is it?

Inside the ovary, there are numerous fluid filled follicles in which eggs develop – also known as cysts. With ultrasound, each follicle can be seen and measured. Once a follicle reaches around 18mm, it is considered to be a mature follicle – one which will release an egg for fertilization. In my case, I have trouble reaching this size so my eggs will be collected (at around 10-12mm) and further matured in a lab rather than inside my body. This is where IVM begins. When doing IVF, matured eggs are collected.

Where I go for treatment, women are mostly awake for this procedure. An IV drip is given but it does not nearly knock you out from what I have been told. Great if you want to watch, horrible if you cannot handle the pain. A thin needle attached to a catheter with a test tube on the end is passed through the top of the you-know-what (ask me if you don’t) and, with help from ultrasound, is guided to the ovaries. The needle pierces the ovary at each follicle and the fluid is aspirated (drained) through the needle. The egg also detaches from the follicle wall and flows with the fluid into the test tube. It seems to take about a minute or so per follicle from what I understand. It doesn’t sound like long, but when you have PCOS you have multiple follicles which means I could be there for a good half hour or so. Thankfully, DH should be with me this time around!

The fluid with the eggs is passed to the lab where the eggs are taken out and placed in small dishes kept in special incubators to continue growing and maturing. Repronex (hormones) will also be added to help the eggs mature (which cost 340$ for one dose I just found out – yikes!).

If you are interested, you can find some pretty detailed information about this process as well as images here. This is not where I go for treatment but I liked the amount of information they give.

Also, during this time, the lab is supposed to contact you daily to give you a progress report on how your eggs are doing. If all goes well, ICSI should be preformed within a couple of days. More information about ICSI and the following steps to come once I know more about what is going on!

Round 2 (IVM): Step 2 and Good To Go!

Well, good things come to those who wait apparently.

I just had my first ultrasound (step 2) for my second attempt of IVM and everything is clear and good to go! No more pesky, random, 20 mm follicles in the way anymore. The medication I took for the last 3 weeks did exactly as it was supposed to and now I am waiting for a call back from the doctor to let me know when I go in for my next ultrasound and to get a better idea of how the steps will play out in the next few weeks.

No more "Bad News 2010"... bring on "Good News 2011"!