Wednesday, December 14, 2016

Egg Freezing (It's Happening!): Retrieval and Results

The RE's office called Monday afternoon to confirm that the "trigger" shot worked and that we were a go for the retrieval surgery the next morning. I was elated--by Monday afternoon I was in a fog of hormones, couldn't concentrate, felt fairly crummy, and just wanted it to all be over with already. Got my wish!

The RE's office told me to arrive at the surgery center by 7:30am on retrieval day. You're supposed to have a family member or friend drive you to the appointment and back (because, anesthesia), but everyone local that I knew that would have been up for the task was coincidentally out of town or had important work commitments that morning. So, I ordered up a ride using one of Austin's Uber-equivalents. This made me nervous--ever since Uber and Lyft left Austin the remaining ride share programs have proven a bit... unreliable--but I made it to the surgery center on time.

Once at the surgery center, they confirmed my identity, asked me to sign various releases and other forms, had me gown up, checked my vital signs and started my IV. The anesthesiologist came in to ask some screening questions. The embryologist also paid me a visit to confirm the plan for any retrieved eggs. Finally, the RE stopped by to say hello (the first and only time I saw him that day). I texted my family to let them know I had arrived at the surgery center and that I'd text them again once surgery was over.

At 8:30am on the dot we were rolling towards the operating room. They had me walk in and get on the table on my own. In short order, there was an oxygen mask over my face and I could feel the anesthesia running through my IV and up my arm. That's the last thing I remember before waking up in the recovery room.

I woke up to one of the nurses checking my vital signs. I texted my family to let them know that I was out of surgery. A nurse confirmed that the RE had been able to retrieve 25 eggs. By 9:59am I was in a cab on my way home.

Later in the afternoon, the embryologist called to confirm that of the 25 retrieved eggs, 18 had been mature and all 18 froze successfully. My family is full of questions about how many frozen eggs are needed to achieve one pregnancy. I don't have a clear answer to this, but at my age and thinking forward to how old I'll likely be when I can use these eggs, I'll be lucky to have one child and hopefully 18 frozen eggs will be enough to achieve that.

Yesterday, similar to when I went through the process as a donor in my early 20s, I felt fine after surgery. There was some abdominal cramping, but nothing debilitating. If the anesthesiologist hadn't told me that I wasn't allowed to drive all day or make any significant decisions, I would have returned to the office. (As it was my out of office autoreply telling clients that I was in surgery and would not respond until the following day was not a success... I ended up joining three client calls yesterday.)

Today, I feel even better. The mental fog from all of the hormones has subsided and I'm ready to get back to life as usual.

Often, when I read an article about egg freezing, women who have completed the procedure say that they feel like they now have the luxury of time to find the right partner and focus on their career. I can't say that I have those feelings. The weight that has been lifted is the worry over whether I should even try to freeze my eggs. It seems I've been debating the question for years. I'm happy to take "freezing my eggs" off my to-do list.

I'll post one more time under the "freezing my eggs" tab to discuss the cost of the process, but am waiting for all of the final bills to roll in before doing so.

Monday, December 12, 2016

Egg Freezing (It's Happening!): Fifth and Sixth Appointments

Happenings from the weekend related to the egg freezing cycle:

  • Blood drawn at hospital before 8am.
  • Inject myself with Ganirelix in the car in the parking lot at the hospital.
  • Ultrasound appointment at RE's office at 9:30am to measure ovarian follicles.
  • Pick up additional Ganirelix at pharmacy since stimulation is taking a little longer than originally planned.
  • Inject myself with Gonal-F at around 7pm.
  • Inject myself with Menopur at around 7pm.
  • Blood drawn at hospital before 8am.
  • Inject myself with Ganirelix in the car in the parking lot at the hospital.
  • Ultrasound appointment at RE's office at 9:00am to measure ovarian follicles.
  • Inject myself with a "trigger" shot. The "trigger" causes eggs to start meiosis prior to egg retrieval. This injection needed to occur at a very precise time, which fell in the middle of dinner with clients. So, I excused myself to go to the restroom and administered the injection in a stall in the ladies room. Whatever it takes!
This morning (Monday) I was back at the hospital for what will hopefully be the final blood draw of the cycle. Then, I had to call and prepay the anesthesiologist who will attend my retrieval. Next, I'm finishing some paperwork for the pharmacy, which charged me the wrong amount for my medications. Finally, I'm waiting for the RE's nurse to call and confirm that my blood work showed that the "trigger" shot was effective so that we can move forward with retrieval, which should occur tomorrow.

Thursday, December 8, 2016

Egg Freezing (It's Happening!): Fourth Appointment

At this point in the cycle the crook of both my arms are bruised from blood draws and my abdomen is freckled with the memory of nearly 20 injections.

I drove to the hospital this morning to have my blood drawn again. Then, to the clinic to have an ultrasound. Today, the doctor could see both my ovaries (an improvement from the last appointment when one was missing in action) and while the follicles are growing in diameter, we aren't ready for retrieval just yet. This means a refill on some of my medications and an 8am doctor's appointment over the weekend.

I feel exhausted and lonely.

Wednesday, December 7, 2016

Egg Freezing (It's Happening!): Third Appointment

Another early wake up call to get to the hospital to have my blood drawn before 8am and then an appointment at the RE's office to measure the follicles on my ovaries to determine how I'm responding to the medications. My blood work and progress are good, but the RE couldn't find my left ovary on ultrasound. Count me concerned.

As of the third appointment (which was yesterday, actually), my RE started me on a third medication called Ganirelix. This medication, which stops eggs from being released too early, is taken by subcutaneous injection.

For those keeping track at home, this day in the egg freezing process involved:

  • One blood draw at the hospital;
  • One transvaginal ultrasound at the RE's clinic; and
  • Three self-administered subcutaneous injections.

Sunday, December 4, 2016

Egg Freezing (It's Happening!): Second Appointment

Since the baseline ultrasound, I have injected myself with two different medications every night between 7-9pm. Both injections are subcutaneous and administered in the abdomen. The needles are small and the injections don't hurt.

The first medication is Gonal-F. As I understand it (and I don't understand it in any sophisticated way, since I'm not a doctor), this medication contains a follicle-stimulating hormone that stimulates healthy ovaries to produce eggs. The pharmacy gave me this medication in a pen that is pre-loaded with medication. Each night, I "dial" a dose, by clicking the pen to the prescribed number (225 in my case), screw on a fresh needle, and inject.

The second medication is Menopur. It contains a follicle-stimulating hormone and luteinizing hormone that helps healthy ovaries to produce eggs. Preparing this injection is more involved. It requires drawing up saline from one vial, mixing it with the powder Menopur, and then drawing the solution up into a syringe for injection. If you liked chem lab as a student (and I did), you'll find this part almost fun.

After three days of this drill, I was to get my blood drawn before 8am at St. David's lab (since it was Sunday, the lab at the hospital was supposedly the only open lab in town). I was in and out of the lab in less than 10 minutes. Next, I drove up to the clinic, where the doctor used ultrasound to measure the dilation of the follicles on my ovaries in order to assess how I was responding to the medication.

At around 4pm, after my doctor had received my lab results, the clinic called me to confirmed that I should continue with my current dosage of Gonal-F and Menopur and plan for another blood draw and monitoring appointment on Tuesday.

I'm already feeling like a pin cushion and we're just getting started!

Other observations:

  • Feeling a bit nervous about coordinating upcoming work travel with the monitoring appointments (also, will TSA let me on the plane with syringes!?!).
  • Noticing more frequent headaches, but think this is likely symptomatic of a stressful period at the firm and not the medications.
  • Not noticing any other side effects.
  • Spoke with a college friend and learned she's completed two egg freezing cycles and contemplating a third to collect the number of eggs thought to be needed to produce two kiddos (not all retrieved eggs survive the thaw, fertilize, or successfully implant which is why you need more than one egg to produce one pregnancy). This stressed me out a bit. Given the cost, I have never considered completing more than one cycle. For now, I'm putting this out of my mind until my doctor tells me the number of eggs he was able to retrieve.

Friday, December 2, 2016

Egg Freezing (It's Happening!): Baseline Ultrasound

This year, I learned that it's easier when hope is absent. After years of wishing and hoping I'd meet someone special and, by extension, one day have a family of my own, I just... stopped. If you aren't hoping for something, you aren't disappointed when it doesn't happen. Since I had gotten to the point where the disappointment was overwhelming, this approach seemed to help.

But now:

  • I'm at the tail end of 35.
  • My father, who is a maternal fetal specialist, has been pushing hard for me to freeze my eggs before it's "too late."
  • I will be changing jobs soon and don't want requests for time off to attend doctor's appointments and have surgery to interfere with making a good first impression.

That's to say, it's time to stop wringing my hands and just do it already.

I'd completed my initial consultation with the reproductive endocrinologist ("RE") and infectious disease screening months ago. So, the RE's clinic was able to react quickly when I asked to get the cycle started asap. This involved the following immediate steps:

  • Baseline sonogram - This appointment is timed to your menstrual cycle. To put it simply, the RE is looking to confirm that the lining of your uterine lining is thin so that the stimulation cycle can begin.
  • Order medications - Stimulating your ovaries to produce eggs for freezing requires, in my case, $3,500 in injectable medications and related supplies. The pharmacy shipped the medications to my office (since my neighborhood is having a problem with the disappearance of packages delivered to the front door) and I rushed them home for refrigeration.

This drill is nearly identical to the steps that were taken to donate my eggs in my twenties, except, of course, that I'm footing the bill this time. Here's hoping all goes well. The process should be complete and my eggs should be on ice by mid-December.