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My journey – The choice for twins, frozen embryos and OHSS

Here is the final part of my IVF journey.  If you missed the previous posts …

The day of my embryo transfer is the day I remember with the most clarity. We met our doctor in a little room off the OR to discuss the procedure before it took place. He told us that the maturation process had been very successful and 11 of our embryos were now healthy, highly graded blastocysts.

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Via

I was overjoyed with the success of it all and high on some serious hormones imagining my little team of 11 blastocysts, my happy little mind was was wandering far into the land of pregnancy when the doctor hit us with 2 questions:

1. How many embryos are you going to transfer today?
2. What are you going to do with the remaining embryos?

I knew these questions were coming, I attended the orientation, I had read my fair share of info on all of this but I also was whirling from the whole process and didn’t have the foresight to talk to VC about it … so it came down to this.

On question 1:
The success rate of a 1 blastocyst transfer was around 50% and the success rate of 2 was 60%. I choose 2 purely based on odds. VC bless his heart didn’t argue with me. The doctor did, he told me that the risks of a twin pregnancy were significantly higher and that I should perhaps do one as my IVF cycle had been so successful, he was certain I would become pregnant. But my mind was made up, 2 embryos. Twins were in our future, God willing.

On question 2:
All I could think was this: Those blastocysts are our children! Preserve them and keep them … take good care of them NYU. I clearly am not going to have 9 more children, I wasn’t even sure I would want more after this pregnancy. But ask a woman who has gone through the emotional and physical pain of IVF what she wanted to do with the “extra” blastocysts and I guarantee you she will want to do anything to preserve them.

Note that I say “I” a lot here, poor VC was stuck between a rock and a hard place on both of these 2 life choices. To argue with me would have been a disaster at this point … but thankfully he felt the same as I on both. Word to the Wise for anyone going through IVF, clearly talk about all of the choices that you will have to make with your spouse/partner. When it comes time to making decisions, you don’t have a lot of time and you are 100% hormonal. Better to have a discussion before and know your game plan.

Ok back to the the transfer. It took place in the fertility center’s OR. I was awake and not sedated so I was able to see the entire thing take place.  VC wasn’t allowed in with me so it was just me, the doctors and my little blastocysts.  The process is non invasive and is done with a long syringe, on the end of the syringe is tiny camera so that the doctors know where they are aiming.  I could see the feed of the camera on a large plasma screen.

One at a time they carefully placed 2 little blastocysts into my uterus, along the wall.

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I spent 30 minutes or so lying down and then was sent on my way … hopefully to cook up a few babies.  And cook I did.  From that moment on I was on the wild 33 (should have been 40) week ride of a twin pregnancy.

The Good:

8 days later on April 2nd, 2010 – Good Friday – I had a blood test confirming my pregnancy.  And of course on October 20th 2010 our twin Gs were born.

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The Bad:

Progesterone Shots:
From the day of the transfer through 12 weeks of pregnancy I took progesterone shots daily. These shots are hands down the WORST part of the entire IVF cycle. They are a super thick, oil based shot with a huge needle that goes square in your bum. They hurt like no tomorrow and leave you with lumps on your bum. I would cry big big tears when VC gave them to me … but here is what I learned about them:

  • Make sure that the solution is warm. Hold it in your hands for a few minutes to make sure its liquified.
  • If you can, take the shot in the morning, its better to walk around all day after the shot than to go to sleep, the solution will disperse and not lump.
  • Ask your doctor for a target. VC was giving them to me a little too high for the first few days, landing it more in my hip flexor than my bum. We asked the doctor to mark the spot he should give it with a sharpie and then kept the mark there … it really helped land the needle and reduce pain.
The Ugly:

OHSS
A few days after the transfer I began to feel extra weird. I was bloated, like can’t button my pants bloated and was feeling a ton of pressure in my abdomen. It was pretty uncomfortable, but I figured that it was a good sign and that the transfer had worked. The bloating continued to increase exponentially over the days. I remember when I received the results of a confirmed pregnancy the nurse said that my hCG levels were really high and that it was likely I was having twins. At this point I was so bloated that I looked about 3 months pregnant, and was already up 10 lbs. I felt like the whole pregnancy thing was “happening really fast”. The next morning the bloating and pressure had turned into a shortness of breath and vomiting. I finally called the doctor … who told me to get into the office ASAP.

It turns out I had a very severe case of Hyperstimilation or OHSS. 1-2% of women undergoing IVF get OHSS and its generally because of a high number of follicles. I had 23 over 10mm follicles, which is a very high number. What happens in OHSS is this: when they extract the egg out of each follicle they made a little puncture with a needle and remove it. If you are experiencing OHSS the follicles fill with fluid, causing extremely enlarged ovaries and in extreme cases like mine, the fluid then leaks into your abdomen and some up to your lungs.

It was terrible, I gained 10-12 lbs of fluid that had to be drained out of me. This process happened 2 times in 10 days until the OHSS was finally under control. By the end of it, they had removed 4 liters of fluid from my body. Yikes. The take away lesson here is this, don’t wait to call your doctor!! I was trying to be tough and stick out discomfort.  Do not do that.  It doesn’t help anyone :) Most of the extremity of OHSS could have been avoided if I went in earlier.

It took a few weeks to go completely back to “normal” or rather my new normal which was pregnant with twins.  The OHSS didn’t affect the babies at all, they were safe, protected, growing and healthy.

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We will chat pregnancy another day, but before that I can’t wait to tell you all about the Frozen Embryo Transfer cycle that I am currently undergoing.  I am 1 week in.  Next post I will give you all the details.

As always, ask me anything … if you are going through this process or looking at the possibility of it, I am here for you.

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4 thoughts on “My journey – The choice for twins, frozen embryos and OHSS

  1. Came across your blog after reading someone else’s… This post couldn’t have come at a better time. After a year of trying, 2 failed IUI’s, a pregnancy, a miscarriage, and several more months of trying we are turning to IVF. While IVF gives me so much hopes, especially after reading this pot… I am also scared to death. Thank you for sharing your story and I hope that mine has a happy ending like yours.

    1. Oh Tracy, I am sorry for the past year. It is a difficult process. Sending you lots of baby dust for your IVF cycle. Please reach out to me with any questions!

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