A cycle of In Vitro Fertilization and the Story of my Pregnancy with Sarah
When you decide with the doctor at the fertility center that the right approach is In Vitro Fertilization and Embryo Transfer this is the process you go through.
First you both must have a meeting with a nurse where she explains a lot of the procedures and terms. We had our meeting with two other couples and all were quite nice. Then you both have a series of blood tests to go through.
What they look for is FSH, follicle stimulating hormone that is present, your LH (luteinizing hormone) level, estradiol, and rubella antibodies. Then you undergo a ultrasound. What they look for is normal ovaries that look smooth with visible follicles and not wrinkled. Also, they do a through scan of your uterus, making sure it's all okay. Then a cervical test for Chlamydia and a pap smear to test for cervical cancer. You both must have a hepatitis and a HIV test. Luckily we were both free of those. Tim had to give a sample of semen for analysis. The motility (movement), morphology (shape), and content and consistency is all evaluated.
Then you're given prescriptions for a drug called "Lupron". It's a synthetic hormone (GnRH analogue). A drug that prevents ovulation essentially. You start taking that about mid-way through your menstrual cycle. What that involves is each morning, drawing the correct amount up and then injecting yourself in the stomach area (the fleshy part). Not for the squeamish, indeed. You use a sterile needle and wipe with alcohol on the injection site, pinch up the skin, stick it in, pull back a tiny bit to see if there's blood, and if not, push it in. Then discard the needle and record your treatment. Always had a chart handy during this.
You are monitored every week with another ultrasound. Gets pretty routine after a while. Then on the first day of your period (first day of heavy, red bleeding) you call and report that. Then you are told to start injecting yourself with the FSH (follicle stimulating) drug. I had Puregon. Expensive stuff. I also had Humegon. This is injected with a needle that goes in your thigh. So each morning you are injecting yourself with 2 needles. Then in the afternoon, for the Puregon, Tim had to inject me in the hip area with a long needle, to reach beyond the fat level into the muscle. That needle hurt as I recall. For this, we were told to draw a circle shape on my hip with a pen. Then each day, you inject at a different hour of the clock alternating sides.
For this stage, you are monitored every two days by ultrasound. They want to see the number of follicles on each ovary and see the size of the ovaries. The normal occurance for the ovary is that once each month one follicle ripens and then at ovulation bursts open releasing the egg, hopefully with the sperm waiting there for it. In this case, you are super-ovulating with about 20 to 40 follicles, all ripening at once. As a result your ovaries suddenly become noticeable for once and you feel as though you've got two grapefruits there. Very strange, bizarre feeling indeed for me.
As the days pass and you are at about 12 days past the first day of menustration, the follicles are nicely ripening. They then evaluate your blood test numbers and then tell you to take the important shot. This drug is called Profasi or Pregynl (same thing). This is the pentultimate drug that tells your ovaries to ripen the follicles for release. Because of the drug Lupron, they don't actually release. So, within 12 hours of taking this drug you go into the clinic for egg retrieval. This involves changing into a gown, having an IV attached for pain control then walking into a operating room and climbing onto the table. Then they extract the ripened eggs with the longest needle you have ever seen. They measure you ahead of time at an office visit to find out the correct length of needle to reach your ovaries. This, in itself, is painful as you lie on an examing table, legs in stirrups and the doctor inserts a thin measuring tool and finds your cervix and gently measures your uterine length. So, in the operating room for the retrieval, your husband is there holding your hand. The doctor inserts the needle through the wall of your vagina and using the ultrasound, finds the ripened follicle and using suction, plucks it off and extracts it. Very cool machine and equipment and expensive, I'm sure. As they collect each follicle, it truly hurts despite the pain medication. I'd say one of the most painful things I've undergone and that included root canal on my teeth.
I was pleased to hear they'd gotten about 24 eggs from my two ovaries. You then rest for a few hours then get dressed and go home and rest some more. Then the next day you get the call to say how many eggs have fertilized in the petri dish. Thankfully, about 5 eggs fertilized and started their precious divisions. You pray at this point for it to continue. The problems involved can include no fertilization at all which means the sperm lack the necessary chemical to dissolve the cell wall of the egg and work its way into the egg. Or the egg can fracture, meaning not the normal cell division.
After 3 days of culture and nuturing you go back to the clinic for transfer. This time the operating room is soft light, there's music, your husband is there holding your hand and it's very nice. I actually got to view the embryo in the microscope before transfer. They transferred 3 embryos into me and we christened them Joe, Flo, and Mo. It was a very emotional time for me and I cried buckets afterwards as I recall. Then you dress and go home and begin the awful 2 week wait. Toward the end of it you are constantly evaluating yourself. "Do I feel pregnant" "AM I PREGNANT?" "Please God, I want this SO BAD" "Please let my dream come true!" are the thoughts. Every single time you go to the washroom you check the toliet paper for blood, I swear. As the 2 week mark passes and I get no menstrual period and my breasts ache I begin to believe it's true. Then the blood test at the lab. What they are looking for is the presence of beta hcg - the pregnancy hormone being there. They want a quantitative level as a good level of it indicates a healthy pregnancy. They also check progesterone levels. Progesterone is the necessary hormone to maintaining a healthy pregnancy. It is first produced by the ovaries then produced by the placenta after 10 weeks or thereabouts.
The day of the blood test they call and say I'm pregnant. You would have scraped me off the ceiling at this point honestly. On such a high that day.
Then the ultrasound 3 weeks later. I started to bleed that morning. Suddenly out gushed heavy red blood. I was so freaked. Tim was so worried as well. We immediately went to the clinic and had a ultrasound and they saw one stubborn little embryo there with a beating heart. As the gurney shook with my crying, Tim and I embraced. The bleeding was caused by the miscarriage of one or both of the other embryos sadly. But I was happy to have one in there, at least. Twins are always more complicated pregancies anyhow.
So, then 2 more weeks pass as I take it very easy and then another ultrasound. The embryo has grown and it is now about the size of a small grape and I can see the little heart fluttering away. Never such a fantastic sight in my life!
Then I was transferred to a OB/GYN for the duration of my pregnancy. I got an amniocentisis done at 16 weeks for checking for genetic anomalies such as Down's Syndrome or Tay-Sachs Disease. Thankfully it was clear. I found out, by asking the lady then it was a baby girl I was carrying. Then the flutters and kicks started. Feels like a butterfly on your stomach from the inside at first.
As she grew and became a fetus, the feelings changed to a fish flopping about. At 22 weeks I had a level 2 ultrasound where they take about 1 hour to closely look at the fetus. Watching it move and twist is a miracle in process. You really "get it" that there's a human baby inside you then. Most of the time you are in a daze, thinking "Nah, can't be true, just too weird to believe" then you get a kick that you feel and you smile and think "having a party in there, are you?" The worst was in the evening just as I was settling down. It was party time in there. Nothing more beautiful than to lie in bed feeling your child moving about inside you and having your husband giving you a back rub or foot massage. My feet grew a size during the pregnancy and never shrunk back!
As the pregnancy continues and you reach the third trimester, beached whale is a term you feel like, don't like to hear, and don't laugh at it if someone dares to mention that term. Instead you shoot them a dirty look as your back aches and you endure more pummelling. But truly inside I was glowing. You know how they say pregnant women glow? I glowed. My hair was thick for once and I just felt so happy. Then high pressure complications crept in and I was put on Labetol for the last 3 weeks of my pregancy.
I spent the last 3 weeks on bed rest. Very hard to do and thankfully my mother helped immensely around the house as did Tim. I had to be induced for labour as they felt it was time. It was 2 days before the official due date. I used the hot tub with the jets to relax. Unfortunately, as the pain was bad, I gave into the offer of an epidural drug. This caused massive itchiness. I was truly uncomfortable. The Phenegan caused a reaction I believe. Tim soothed my skin with washcloths wrung out in cold water. The labour became a 30 hour ordeal as the baby was facing the wrong way at first with face up. She was rotated and then descended. Once she starting coming out, it went fast. But she wasn't breathing. On a scale they (baby doctors) call the APGAR score she scored 2. 9 is the normal. There is a series of 5 points each given a 0 to 2 scale. If the baby meets the 2 level in each of the categories the score is 10. So she was in rough shape. The ped. worked hard on her and it was silent in the room as my tears fell and Tim and I hugged, praying our child would revive. Thankfully, due to the concerted effort of the team, her 5 min. APGAR was 5 and her 10 min. APGAR was 8. She pinked up nicely, was crying lustily, and moving about at the 10 minute mark. When this beautiful pink bundle was handed to me, I cried. Honestly I don't remember much of that day frankly afterwards except that precious pink bundle holding my daughter. She had to spend the night in the nursery as her temperature was down and I felt so lost. I've since heard that "kangaroo care" where the mother and baby are skin to skin is better for both mother and child. This was illustrated in Columbia where there weren't enough incubators for babies. The babies that were left with their mothers did better. Makes sense honestly that the bond created by mother and child over the 9 months would continue. But not knowing that, at the time, I acceded to the nurse. The breast feeding did not go well sadly. But, thankfully, I'd met a wonderful lady at a party while pregnant and she was a licenced lactation consultant. She's a nurse with a strong belief in mother's milk. Thankfully she put Sarah and I on the right track. Breastfeeding is like dancing. The first few times you have no concept of what you are supposed to be doing. Then each time (every 3 hours day and night!) you gain a little more confidence and skill and soon you are breastfeeding like a pro. The sore and aching breasts dripping milk everywhere isn't much fun but that soon cleared up. She was putting on weight well, sleeping well and feeding well. So, there ends the story.
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