“Peace and Ease” (Egg freezing cycle 2, Blog entry 2)

This morning I had my second monitoring/ultrasound appointment. It’s my first time seeing how my body has been progressing in terms of the egg follicle growth since Saturday, which was 4 days ago.

I was anxious to see how things were moving along since that first appointment revealed 12 healthy egg follicles, 6 in each ovary. All were at normal growth rates. Today was especially exciting; those 12 have now measured in what is considered ‘healthy range’ of close to 15mm – with a few more days these will certainly be viable eggs for retrieval. Moreover, there were quite a few more egg follicles that had appeared since the last ultrasound…quite a few actually! All were measuring well and looked healthy. The technician said my uterus lining and walls were also looking very clean and strong. This is encouraging news.

When I asked during my first round of egg freezing what my numbers looked like, I was reminded that the number of egg follicles was quite high; 34 to be exact but we were only able to retrieve 12 eggs, with 7 mature enough to freeze.

So while the probability is always good to have in my favor, I am also very much aware that how they are measuring is also a strong indicator of their viability. So it is reassuring that the OVA staff is taking me slow and steady and these are measuring strong already. I also asked when I might be having my retrieval and because of the results of the first round and knowing what we do now about how easily my body responds to the stimulating hormones, but not necessarily the maturity of the eggs, we may push and go a bit longer to really get those mature eggs over the threshold to ensure their survival.

That being said, physically I feel much different than the first round. Earlier than what I can remember, I have had a bloated feeling all over, especially in my belly and my lower abdomen sometimes cramps a bit, especially at night. I also noticed last night that I occasionally have ‘butterflies’ or what feels like fleeting flutters in my stomach, almost like you were nervous or adrenaline. It is a different feeling than I have ever felt, but I understand the changes that are going on and trying to stay healthy, get enough sleep, water, healthy foods/fats and salt intake.

I thought it might be worth mentioning too, the last 5 days I would take long walks by Lake Michigan early in the morning before the hustle and bustle of the city woke up. It is a very peaceful time of day and when I usually workout, but since I cannot throughout this process, I have used this time of day to walk (to clear my head) and also reflect on this process. In my videos excerpts I have conveyed this is emotional, yes, but it is also a beautiful thing. Having a child is the most natural thing in the world since the beginning of time and having this peace and quiet the last few mornings have made me feel at ease that while this process is at the hands of capable OVA doctors and nurses, engineering every step of the way – the result, should these precious eggs need to be used, will be the very natural thing a woman, myself, contributes to in reproduction.

That philosophy – which initially gave me conflict until I came to understand it the way I have – has put me at such peace and ease that this is a wonderful thing to be doing for myself…and I am fully participating in it just like I will if and when the time comes to use these eggs. That is a beautiful miracle, just like human life is.

 

“My Future Self Will Thank Me” (Egg freezing cycle 2, Blog entry 1)

So….back for round 2! I have just started my second go at freezing my eggs with OVA and have found this time surprisingly different in more ways than I realized.

When I first met with the OVA staff who would guide me through this process, I was not as intimidated by the daily regimen I would need to follow over the course of 2 weeks. I had been here before; administered shots to my abdomen, felt the changes in my body, began daily blood draws and ultrasounds, ultimately bringing me to my retrieval date.

As I just completed my first ultrasound after giving myself hormone injections this week, the differences have become apparent. I understand when the ultrasound technician explains that he sees 6 follicles growing in each ovary, totaling 12. I understand what the measurements mean for viability and keeping an eye to help them grow to the size needed for retrieval. As the saying goes, sometimes ignorance is bliss and knowledge is power….however this knowledge has also stirred a bit of anxiousness in me.

Whereas during my first round of egg freezing, I wasn’t quite sure what I was seeing during my ultrasounds but knew growing follicles meant a positive outcome, that wasn’t exactly the case. I was stimulating quite well, with 23 I believe at the appointment just before my retrieval, only to pull 12 mature and 7 eggs to freeze. That number, as explained to me, is equivalent to just about 1 round of IVF, oof. My body had just gone through quite a bit and seemed well-positioned to provide so many eggs for the future and the outcome was a bit disappointing. Flash forward to now, looking at that 12, my ultimate focus is working with the OVA team to ensure we are dosing properly and encouraging my body through these hormones in a slow and steady pace.

Physically, I definitely feel the bloating and heaviness that is going on in my lower abdomen, but it now feels different than PMS symptoms. Perhaps it is because I know what’s happening, but it does feel as though I am carrying something more. Interestingly enough, I have noticed (and friends who know I am going through this) that I protectively place my hand on the side of my stomach – without realizing it. I’d like to think this is almost instinctual which makes me smile, almost feels like the closest thing to being maternal 🙂

My mom flies in Wednesday as my retrieval date will be sometime Thursday, Friday or Saturday and I am ever so grateful for her support. I’ve been a bit emotional the last day or so and I can only imagine it will increase as the days go on. This is such an empowering process any woman can do for herself. To use your body as a vessel for what could be your potential children and know that you are ‘freezing time’ – to have your body be in optimal reproductive health should you need to use these eggs later in life. I feel that connection with my body already and it is one that goes beyond the superficial. It truly is a beautiful thing to feel the changes of what is happening.

I am excited about the coming days and watching my progress; staying positive for a great outcome but know that whatever that is, I’ve taken this step in my fertility and it feels good and it feels right and my future self will thank me.

“My Egg Freezing Journey Begins” (Egg freezing cycle 1)

The opportunity to shatter the biological clock wasn’t a possibility for women years ago, but today, women can rest easy knowing that they have never been more empowered to take charge of their fertility. That is exactly what led me to the decision to freeze my eggs with OVA.

I have always been irregular, tried various birth controls over the years in hopes of regulating my hormone levels, minimizing side effects, in an effort to give way to the most ‘normal’ biological function a women could have: her monthly menstrual cycle. After many failed attempts, I decided to give my body a break and went 4 months without taking any oral contraceptive – and without a period resulting. At my yearly appointment with my OBGYN, I was told that while it is acceptable to be somewhat irregular, going that long is not healthy for a woman. We agreed to have some preliminary hormone level testing done, to see what the underlying cause may be. Additionally, I was weeks away from my 31st birthday, single and was wondering if this would impact my fertility and desire to have a family in the future. This thought prompted me to begin researching my options. The hormone tests came back and it revealed small inversions that would contribute to my irregularity. My OBGYN called to explain this to me, but the only thing I heard was “while this isn’t indicative of your ability to get pregnant down the road, you will likely be a woman who has trouble in doing so. This challenge increases with your age.”  So began my proactive journey to reach out to any and all resources.

Connecting with Whitney, a fertility nurse at OVA,  when I did was a prime example of right time, right place. I had so many questions given my research, my reproductive health and history and what my options would be. Whitney was extremely informative; a great resource for so many questions I had, all the while empathetic to the personal challenges in making a decision on what to do next. Knowledge is power. After evaluating all the aspects involved, I made the decision to proceed with freezing my eggs with OVA.

The choice to freeze your eggs is not only one done freely, but one that you fully commit to – from time, money and the emotional and physical capacity that you will experience, all in from Day 1.

I decided to journal everything that I was about to go through both to help other women in their own journeys and to help me make sense of the overwhelming yet empowering experience.

 

Oct 7th, 2015 – 1st Appointment (ultrasound)

Today was the first appointment I had at OVA to get a baseline view into my reproductive health. This would include a blood withdrawal and ultrasound. I didn’t quite know what to expect, but I had never had an ultrasound performed before and knew that this would be very telling in what my fertility looked like going into this process. As one can imagine, I was a bit nervous, but hopeful that I was still fertile despite my menstrual history. I was excited and surprised to see during the ultrasound just how many eggs were in both ovaries. I was told that it is ideal to have 10+ and I was showing 22 total. It was at this time that I was put on a monophasic birth control for 2 weeks in order to regulate my hormones further and I would come back and again have another ultrasound and bloodwork to determine the protocol for the hormones I would receive.

Oct 15th – Results of bloodwork

Whitney called to tell me that my bloodwork came back normal. The anti- mullerian hormone that is tested is to reveal ‘how good’ my ovarian reserve is. Between 1-3 is normal; below 1 is not good but above 3 is fine. Mine was at a 7.4, which is indicative of PCOS or polycystic ovarian syndrome. This could explain why I was having irregular to no periods at all, experience symptoms such as light facial hair and weight gain. However, overall, my hormone levels just looked low in general. We discussed that me being on the monophasic birth control during the following 2 weeks would provide a more normalized, stable view into these hormone levels. The main takeaway was that everything looked overall normal and healthy and the low levels are likely due to the birth control I was on and we’ll know more after the next ultrasound. My ovarian reserve is strong, just elevated due to the PCOS.

 

Oct 28th, 2015 – 2nd Monitoring Appointment

After having been on the monophasic birth control for 2 weeks, another round of bloodwork and ultrasound was scheduled to get a better snapshot of my levels and ultimately, decide on my protocol for the hormone injections I would start 2 days later. The ultrasound again showed a strong count in both ovaries, which was encouraging. The bloodwork later revealed that I still had low, suppressed hormones that we ended up adjusting my protocol for. At this appointment, it was explained to me the rounds of hormones I would be giving myself for the 10-day window prior to my egg retrieval. Although I am in the healthcare industry and pretty comfortable around medical equipment and its use, it was a bit intimidating to see the actual injection needles and hormones that I would be giving myself. Not to mention, the added pressure to think of how exacting you need to be in order to achieve the optimal results.

Oct 30th, 2015 – Injection Day 1

Today is the first day of giving myself the hormone injections. I received the protocol and Whitney walked me step-by-step on how to administer each. There would be 2 injections into my abdomen, Follistim and Menopur. The needles were very small and did not hurt. I don’t know what I was expecting at that time, but I didn’t feel any different, just mentally prepared for this to take its course on my body in the days to come.

 

Nov 1st, 2015 – Injection Day 3

Tonight is the first time I administered the shots on my own, without walking through with Whitney’s guidance. I feel like it is becoming more routine but have definitely experienced some early symptoms. I have felt a little bloated and crampy, as if I were about to start my period. I’ve also been much more emotional (crying to an Adele song on the radio!) and craving chocolate. Typical PMS symptoms that I expected.

 

Nov 3rd, 2015 – Injection Day 5

Hormones in full swing! I have definitely felt a daily increase of bloating and cramping as well as an increase in my appetite. I have gained a bit of weight and am thirsty throughout the day, but I am surprisingly enjoying how closely I am paying attention to the changes happening in my body right now. I’d imagine that this is what you experience in the early stages of pregnancy, as these hormones are stimulating my ovaries to produce as many eggs as possible. There are definite off-limit activities during this time: no exercise, sex, heavy lifting or travel. I can see why, you wouldn’t really want to do any of those things feeling this way. I will be going in tomorrow for another ultrasound and bloodwork to see how things are progressing.

 

Nov 4th, 2015 – 3rd Monitoring Appointment 

I was really anxious about today’s appointment, wanting to see how things were looking and how the hormones had affected my ovaries. The ultrasound showed that the lining of my uterus was above average and healthy. The follicles in each ovary were enlarged more so than the baseline observation a week prior, telling us the hormones were working very well. The count also appeared high which was encouraging as at my retrieval we will ultimately want 18+ for optimal freezing.  Bloodwork was also taken to monitor my levels and will likely adjust my protocol once we get the results back later today.

Since I am progressing right along, I will now have a daily ultrasound to check that everything is looking healthy. Tomorrow I will begin the 3rd injection in my regimen that will be administered in the morning, while the other 2 are in the evening. All of these are done during the same window of time each day/night. Feeling bloated but great! I was assured that this swollen feeling would only increase in the days to come as the follicles continue to be stimulated, lucky me – at least I have chocolate stocked J

  

Monday, November 9, 2015- Making Progress

 

This morning’s ultrasound showed that I am still stimulating very well and everything is looking healthy and progressing along. We’ve counted approximately 33 follicles, which is very encouraging. The follicles look like tiny egg sacs on the ultrasound, which essentially they are since they’re ‘housing’ the egg that has the potential for retrieval. This doesn’t necessarily mean every follicle will have an egg, however. We won’t know that until the retrieval but this number gives us an optimistic view that a large number of eggs will be available. My surgery window was going to be set for tomorrow (Tuesday) but because there are additional follicles that could benefit from another day of maturing, surgery for egg retrieval is now set for Wednesday. Nervous, but excited! My mom is flying in this morning and although I know I’d be fine to handle the coming days on my own or with a little help from a girlfriend, I am happy she’ll be here with me. The emotional support is nice to have.

 

Monday, November 9 (part 2)  Trigger Shot Preps

 

At 11pm Whitney walked my mom through giving me the ‘trigger shots’ which must be given exactly 36 hours prior to my egg retrieval. I was intimidated at first because different from the hormonal shots I’ve been giving myself in my abdomen, this one was given intramuscular in the buttocks – with a much larger needle. Eek. All that being said, it was not bad, AT ALL! Whitney was fantastic, taking my mom step-by-step through the process and it did not feel that much different than the other shots…maybe because I have extra cushion on my bum to help 🙂 Now it’s just taking it easy tomorrow and surgery is set for 9am on Wednesday!

 

Wednesday, November 11, 2015 – Retrieval Day

I woke up feeling anxious and ready to go. So ready, we got to the surgery center almost 40 minutes early! I finally got to meet Colleen Coughlin who is head of the lab and it was a very humbling meeting. This woman has dedicated her life’s work to making dreams possible for women (and couples) like myself by creating the most optimal environment for their bodies to prepare for this journey from a scientific and personal perspective. Her warmth was felt immediately and her mission to address independent women’s needs are clearly a priority.

 

She thanked me for being part of this process but it was all I could do not to express my endless gratitude. She even thanked my mother for being here, but more importantly for her support in me taking the steps to do this. I didn’t realize that most women probably do not have the great fortune of having a surround sound support system on a progressive decision such as this and it made me feel even more thankful to have that of my family, friends, the doctors and my mother’s presence. Before my retrieval, someone asked how I was feeling prior to going in for the 20-minute procedure. I got about 5 seconds in and started to cry. It’s hard to explain the feeling. Being overwhelmed with uncertainty of how it would turn our but excited that you are taking care of what could be your future children in such a way that is like a glimpse through a crystal ball – you carry part of a life inside of you that you only dream to meet one day, should life steer you in that direction. It’s an amazing, heartwarming feeling but one I could not put into words. I was relieved that we were ready to go into surgery right then!

 

The process itself was short and given I was under anesthesia, I do not recall other than a bit of small talk prior. Coming out of it, I was definitely groggy (and apparently was telling the doctors how much I wanted tacos and gingerbread cookies – I don’t recall that!). The pain was not too severe, although it felt like a soreness deep in my belly. I rested for a while, drank some soda to get my sugar level back up and spoke with Whitney and Dr. Kaplan. Amazingly enough, they can tell you the number of eggs retrieved right then and there. What is unknown is the potential for freezing – that will be provided after how many mature eggs can survive the first 24 hours.

 

I was told that of the follicles, 12 had eggs that were able to be retrieved. This was slightly disappointing news, Having counted 33 egg follicles just days before, we were hopeful that more eggs would be retrieved. Less than 50% is how I quickly did the math and knew that this number would likely decline slightly over the next 24 hours. I was actually very emotional about that news. Both Whitney and Dr. Kaplan explained to me that it was not dismal whatsoever, but that they had hoped for more. Every woman is different, bodies are different and the actual timing and hormone protocol can play a role in this number month to month in the same female. I left the surgery that day with my mom to rest at home, grateful she was there for both the physical an emotional support I was needing.

 

Later the next day (Thursday, 11/12), Whitney called me to give me the final results. Of the 12 eggs retrieved, 7 were mature and viable enough to freeze. My heart sank a little, but I was also prepared for that number to drop. She explained to me that if I were to ever need the use of these eggs, typically a round of IVF uses about 6 as they like to create 2 embryos for insemination. Essentially, what I had was enough for about 1 round of IVF. That was a relief – I wanted to think positively that this was better than not having anything at all available. It’s not what we had hoped for, but I was satisfied nonetheless.

 

The greatest learning I had in this whole process was two-fold:

1) Not to put expectations on things – especially those that you cannot control. I tend to be a Type A, strong planner in all things life and business. Heck, this is why I was freezing my eggs! But even with all of science’s advancements and doing everything right, your body is made up in a way that is predisposed to things that are out of your control. Sometimes you just have to be grateful for what you have, the opportunities that come into your life and how you approach them. I am forever grateful for this opportunity and if I ever have to use these eggs, I will know it was all for this reason. And if not, that is because life had other things in store for me 🙂

2) The other learning I had – which I cannot emphasize enough-  was the insight into my personal reproductive health. What a wild ride it is to see how your individual body is at a baseline level, responds to hormones and fertility-wise, how you can prepare for life decisions later down the road. With my irregularity all my life, I always worried I was not fertile. Until now, at 31, I realize that is not the case. So much bloodwork and ultrasounds revealed otherwise, but they also armed me with such robust information that I can now take more of a proactive approach in the future.

Dr. Kaplan explained to me that while I was fertile and did produce eggs, the less than 50% retrieval was revealing. He advised that if I am trying to get pregnant in a few years and it is not working, to not wait on things for a year or so *hoping* something will change. I will likely need more help in that department or may need to look toward IVF.

 

For all this and more, I am incredibly thankful to Whitney, Dr. Kaplan, Colleen and the amazing staff at OVA. What they are doing for women in Chicago and all over the world is nothing short of a miracle. Creating life, giving hope and all the while treating you as though you are the only person going through this and of their utmost priority is simply a wonderful experience. I would do it all over again, in a heartbeat. Many women do in fact. As I mentioned, it was explained that not every round of freezing eggs is the same. I could only be increasing my chances through another round.

 

As for a baby one day, time will tell. That is nothing I have control over, but I will say – the fact that there is way to ‘freeze time’ in a healthy way for the possibility of that dream to come true, is simply the easiest decision I have ever made.

 

Thank you,

Julie