Tag Archives: eggs

Alas, poor embryos. I knew them …

My quest for motherhood is like looking for red Skittles, i.e., good-quality eggs, in a bag of many colors. They're there; we just have to find them.

With the number of steps involved in the in-vitro process, I was bound to forget at least one. This would be the call from the andrologist on the status of the remaining five embryos.

I first Googled the phone number as I always do with unprogrammed calls and saw that it came from the hospital’s lab, my hospital. Neither the Mr. nor I could figure out why they were calling. Then, the message on “the status of your embryos” freaked me out even further. I figured it’d be about cost or storage options or how long we thought we wait before tapping into the frozen reserve. I called back immediately to find that neither assumption was true.

It was about the status of our embryos.

Retrospectively, it felt like what would happen in the hospital when a nurse would call family members about their loved ones. They never say, “Mrs. K died.” Instead, they talk about the status of Mrs. K’s condition and how the family should come in. If you’ve ever experienced the activity surrounding someone’s else death in a hospital bed, you can always tell what you’re in for just based on the cryptic language used when they call you. But this was no nurse; the woman is an andrologist. She was compassionately matter-of-fact but obviously not a patient-care practitioner. I don’t hold that against her. I appreciated the information and her willingness to repeat it until I was sure I understood.

Essentially, there are no longer five embryos. Before the transfer, there were seven. The best two of those — the ones dividing evenly with proper cell shape and most likely to implant — were transferred last week, three days after fertilization.

Three more simply didn’t reach the blastocyst stage, meaning they “failed to progress” to Day 5. (Blastocysts are more likely to survive the freezing and thawing process for a another transfer than “younger” embryos.) Another embryo became a blastocyst but then began dividing unevenly and soon “arrested” as well. These are the types of fertilized eggs that never would’ve implanted in the first place. Yet, it’s still feels a little bit a little bit depressing that they didn’t make it and that there aren’t more additional mini-me possibilities.

Yet there is room for rejoicing because one survived to the cyropreservation (freezing) stage and is expected to be there when we need it. Also, in perspective, the loss of three embryos makes sense. Embryo survival is closely linked to egg quality, and my unexplained infertility is blamed on a diminished ovarian reserve. That means that of all the eggs I have, I only have a few that are of good quality. The majority of them probably aren’t as likely to undergo fertilization and endure a full term. The in-vitro route makes the existence of those eggs more apparent.

Imagine it this way: you have a bag of Skittles, and only the red ones count. You could blindly stick your hand in the bag for one at a time, hoping for a red one. However, the more efficient way would be to grab a handful and pick out the red ones while avoiding the rest, which would likely be the majority of the bag. In-vitro fertilization is my efficient handful into motherhood.

The quest feels a little more daunting right about now with just one backup, but I’m trying not to let it shake me. I will not buy a home pregnancy test to try to get an early result. I will not obsess about any twinges or odd feelings. I’m just gon’ ride it out and pray for two more days.

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Fentanyl is your friend

This is a 2-cell embryo on Day 2.
So much for “conscious sedation.” I was out almost as soon as the nurse injected it into my IV. (We won’t talk about the collateral damage done to both arms to get the IV going in the first place.) Right before then, I’m told I started singing “Nowadays” from the musical “Chicago.”

“… You can live the life you like. You can even marry Harry but mess around with Ike. Good, isn’t it grand …” I vaguely remember that. And I can recall turning on my side for the rump shot of progesterone. Sade’s greatest hits played in the recovery room. I remember hearing it, but I don’t remember singing along. A nurse said she wanted my autograph, so I must’ve done a decent job. I was hazy but soon awake enough to walk. At home, I slept the rest of the day — the whole day.

I think I’m done with the abrupt sleepiness from the fentanyl, but the Mr. keeps reminding me that it hasn’t been 24 hours since the procedure (it’s 8 a.m.). That’s the recommended time before I can operate heavy machinery. I didn’t think of it like that, but I guess it is a good idea that I’m working from home today editing printouts from last week. Even with uncomfortable bloating and a literal pain in the behind, I find it hard not to be celebratory.

My doctor extracted 15 eggs. Based on today’s call from the embryologist (how do you even become one of those?), seven of the 15 were mature and all seven were fertilized. Now, it’s a matter of days before the transfer of two embryos and yet another dreaded two-week wait. I’m done with injectable medications. Instead, I’m taking antibiotics twice a day, estradiol twice a day and progesterone inserts three times a day. One is to ward off infection from the procedure and the other two held prepare my body for implantation, the next hurdle.  

Countdown …

One innocent victim of my hormone-induced emotional outburst hours before the egg retrieval

So, just like a magwai, I can’t eat after midnight up until after the procedure Monday. It’s amazing how much you want something when someone says you can’t have it. I think the frustration is really just masked anxiety about whether everything will go as planned. I signed the waiver, but I’m still not worried about the more severe risks like excessive fluid buildup, stroke or death. I’m not sure about many things, but I’m most certain that God wouldn’t allow my last “meal” before meeting Him to be pineapple jelly crescent rolls, doxycycline and candied gummy pre-natal vitamins.

Speaking of God, I imagined laying out on the altar Hannah-style in church today after all because I just didn’t have the words to pray for what I want. We sang a song, “God is sovereign, holy and just and on His word we’ve got to trust. For the at the sound of His voice, the Earth became. When God speaks in your life, you won’t be the same.” Between the singing, ministering and worshiping, I felt my heart praying and the tears fell. It wasn’t a shining moment because I haven’t figured out how to cry and sing at the same time. Nevertheless, it was a moment that I felt like God and I were on the same page on this babies thing. It made worship at the next service that much easier. Even then, the tears kept flowing though. I’m sure it’s the estrogen.

According to the Mr., I’ve also been a little more aggressive in a way more characteristic of me PMS’ing. I never take it out on people — or at least not at people who can hear me — but it definitely comes out at the television, traffic, talking heads on TV. The victim on the way home from church was a squirrel pausing in the middle of the street. A squirrel! Yep, it’s got to be the drugs. And it’s expected to get way worse.

After the retrieval … (I should describe that. Using a transvaginal ultrasound to find the follicles, a doctor will guide a needle to where it’s supposed to go and extract fluid that should include an egg. If it does, the egg goes into an incubator. He or she will repeat that process until all the follicles are aspirated. The eggs will then pair with a fresh sample from the Mr., and then we wait.), I’ll start oral estrogen and, uh, non-oral progesterone. That’s supposed to not only make me sleepy but also edgy. Doesn’t that sound like fun for everybody?

I’ll keep taking the antibiotic to ward off any cooties from the procedure and wait again to hear about the number of eggs and the likely transfer date. In the meantime, at least immediately after the procedure, I’ll do nothing but feel the lovely haziness of good hospital drugs. As always, we’ll see what happens.

“Write this down and repeat it back to me.”

Monday is egg retrieval day, but hold the sparkling cider. I've had too many BFNs to get excited just yet.

“What? Huh? Wait. OK. Um, hold on. OK, I’m ready now. Go.”

That was the beginning of my conversation with the nurse today confirming that Monday will be my retrieval day, also known as the great Christmas Egg Hunt. I worried about the shots, and now I’m the subcutaneous injection queen. I worried about the drugs having no effect, and now I have 12 measurable follicles (right — 19, 17, 16, 14, 12, 12; left — 17, 15, 14, 13, 13 and 11). FYI, follicles grow 2 mm per day and are mature, meaning more likely to have mature eggs, around 18. The number of follicles does not necessarily correlate to viable eggs, and not all eggs retrieved will necessarily be fertilized. My awareness of the fact that there’s no guarantee that they’ll find enough quality eggs for fertilization basically gives me another reason to keep the sparkling cider on ice for now.

It’s not that I’m trying to be Debbie Downer; it’s just that at this point of trying to have children, I know all too well how it feels to get my hopes up and then let down with a BFN (big fat negative). After peeing on stick or two every month, you learn to take everything as it comes. I used to search for pregnancy T-shirts with funny sayings in anticipation of a positive test amid imaginary symptoms. I’d always feel dumb afterward for thinking too far ahead. Although by God, I’ve managed to accomplish many things and overcome situations that haunt people for life, my inability to get pregnant up to this point has always made me feel like something of a failure and occasionally like God wasn’t listening on this one. I kept praying but then encouraged other people to pray; though, I didn’t tell them about the struggle.

As for being a childless failure, cognitively, I know otherwise. Emotionally, though, it takes some convincing. Being happily married and struggling to have children feels like being the smart girl who isn’t considered pretty. You do a good job pretending it doesn’t matter, but then something happens as a reminder that you do. Some of my Facebook friends are fertile Myrtles; they’ve had two kids in the time I’ve been trying to have one. Stuff like that can get to you if you let it. I’ve tried not to let it, but I’m human. And maybe that was behind my annoyance with having to endure the entire in-vitro fertilization process to have the children I’ve been psychologically preparing for since 2005.

Now, here I am at the critical point — less than 36 hours from the egg retrieval but beyond the hard part — and I’m only thinking as far ahead as drug No. 6, a pre-emptive antibiotic that I’ll take orally starting in the morning.

Ganirelix is the Devil

This Ganirelix acetate shot might as well be a small taste of hell in injection form.

Not that anyone’s grading me, but in my on mind at least, I passed an inital hurdle in the in-vitro fertilization race. Based on results from Tuesday’s ultrasound, I have seven measurable follicles at decent sizes (three at 12 mm, two at 11, two at 10 and a lot of small ones) to keep the cycle going. It’s been my biggest fear that the $350 in prescription drugs and the past five days of shots to the gut would suddenly end in a canceled cycle. But today is cycle day seven, and we’re still on.

About those follicles: Everyone who ovulates does so because of an egg that matures inside a follicle before popping out in anticipation of a sperm hookup. My injectable medications have given me super-powered ovaries that have produced more than the typical one or two follicles that would ordinarily lead to one or two eggs. Mature follicles tend to measure about 18 mm. When I did the intrauterine inseminations, 18 mm meant it was time for a “trigger shot” of Ovidrel, an injection that encourages ovulation. I’ll still get the Ovidrel with in-vitro fertilization; it’ll just be exactly 36 hours before the retrieval.

That would be shot No. 4. But that one, I can handle. It’s that doggone Ganirelix that is most certainly from the devil. It burned after the Mr. injected me and left a bruise that is painful to the touch. I walked around work with my pants down, covered by my jacket. So far, it’s the worst thing that has happened in the process, and it’ll happen again — every morning until … Crap, I don’t know when it’ll stop.

All I can do is follow the advice of a diabetic friend with 15 years of needle experience and consider the pain an offering commemorating Christ’s ultimate sacrifice. It sounded trite when she first said it, but given the hell of this Ganirelix shot, it’s gon’ take Jesus, the 12 disciples and Rufus to take this devil down.

Next ultrasound and blood draw: Thursday.

What if … ? (Ode to @IVFandme)

The ominous BFN, or big fat negative. What if after all of the insemination and in-vitro fertilization attempts, this is all I see? God forbid.

Visiting friends in New York allowed my mind to veer away from that hovering in-vitro fertilization cloud — with the exception of the nightly shots. (Speaking of, it’s almost that time again.)

When we all lived in the same city, we often played the “What if …” game just as we did this weekend. What if I came home and the Mr. had a pet monkey? What if Mrs. Friend told her husband that her name was Ursula when they first met? What if one of us caught another of us cheating on the other of us? It gets deep and sometimes wild and crazy as driven by a double dose of vivid imagination. The possibilities stray so far out of anyone’s mind that it takes a while to decide on the most honest and likely answer. For example, I never thought about what food I’d eat if I could only eat that one thing the rest of my life with no consequences until I had to answer the question.

The same day we hung out, I aimlessly scrolled Twitter to find the following tweet: “No more treatments for me. Moving to childfree, kicking & screaming with a side of crying. #MovingOn” and then “For the twithearts that don’t know my story: 3IUIs, 3IVFs, 1DEIVF, 2FET: all BFN. I truly gave it my all. #MovingOn #Infertility.”

For those who don’t know the lingo, the woman I follow with the Twitter handle @IVFandme has endured:

  • three intrauterine inseminations,
  • three in-vitro fertilization attempts,
  • one in-vitro fertilization attempt using donated eggs and
  • two frozen embryo transfers

… all leading to a BFN, infamously known in infertility circles as a big fat negative pregnancy test result. That’s a whole pharmacy of drugs, a lot of little tubes going you know where and God knows how many, ahem, “private viewings” to go through without a baby to show for it. I wanted to kick something on her behalf, and I couldn’t help thinking: What if that were me?

I don’t think people understand that when you get to the point of fertility treatments, you’ve already tried everything you know to do and that everything else really is a crapshoot. It’s not a sure thing. So, although I look fine with the frequent transvaginal ultrasounds, multiple drugs, blood draws and injections that not only expose my belly fat to the Mr. but turn it red so he can see it better, know that I’m anxious, I’m nervous, I’m occasionally pessimistic and sometimes downright depressed. Fortunately, the worst of it never lingers. But like the darkside, it’s always there. When I explain that I’m “undergoing fertility treatments,” congratulations are not in order. This (group of attempts that may go on for years until I’m tired or bankrupt) feels like my last ditch effort, and I don’t want to jinx it by celebrating what could be a lost cause and maybe a waste of money. “We’ll see what happens” is about all I can politely muster with that weight behind every fertility-related move.

Sorry, Mr. and Mrs. Friend, I’m breaking the rules and sticking by my non-answer: I don’t know what I’d do if it were me.

As for @IVFandme, my thoughts are with you. With a remote understanding of your individual suckage, I know at least part of the road you traveled to this point and send virtual hugs your way. It ain’t much, but tonight’s shots are dedicated to you. Ouch and sugar honey iced tea.

Eggs of a different color

 So these aren’t really mine, but you get the idea.

Here’s a little introductory trivia question, an icebreaker, considering I don’t know you and you don’t know me:

What’s the difference between brown eggs and white eggs? Not much.

The difference lies in the color of the hen that laid the eggs. Brown eggs tend to come from red-feathered chickens, and white eggs come from white-frocked birds. Nutritionally, they’re pretty much the same — just like the chickens. It just doesn’t come up in your everyday conversation.

Neither does infertility among black women. The same problems that white women have with conception and problematic ovaries and wayward eggs are same that black women have. As a group, we just don’t talk about it. Discussing it every day might be overkill, but the silence of it all and resulting isolation is enough to kill the spirit of every woman of color who carries the universal desire to bear her own children.

Wow. That sounded really profound, well beyond what I was going for.

I’m just a brown girl who inherited the genetic reproductive misfortune from the Brown family and finds herself staring in-vitro fertilization in the face. Journalism saved my life once; I figured the foundation of it — writing — might ease the stress of bringing about new life in the form of a round-faced baby or two. Or three. Or eight.

I’m also giving myself and the universe permission to say “black woman” and “infertility” in the same sentence. Part of that will include sharing what I learn about cycles, procedures and shots (oh, my!). There will be flashbacks, observations and blatant use of anonymity to protect the ignorant. You can trust that every raw tale will be true and reflect my most authentic thoughts and feelings about unscrambling my Brown eggs to finally get pregnant.

It’s what all the inquiring mouths are waiting for, after all. So, this is also to shut them up.

On all fronts, wish me luck. — MBE