Our Embryo Transfer

This is one of the hardest posts that I have ever written. There is potentially triggering topics such as miscarriage and early pregnancy loss. Please take care when reading.

November 2020…

After waiting for what seemed like forever, we started prepping for our frozen embryo transfer. This process is difficult, but is much easier than the egg retrieval process. Before the actual embryo transfer, I had to make three trips to Denver for ultrasounds and labs to make sure everything was looking good. The two primary goals of the ultrasounds were to make sure that my uterine lining was thick enough for a transfer and to make sure that I didn’t have any ovarian cysts. We had also opted to do an “everything but the kitchen sink” protocol, meaning that we would do everything we could to ensure success of the transfer. With this, I would have two intralipid infusions in the hopes that it would diminish any sort of immune response my body may have against the transfer and potential pregnancy.

During this whole time I was also on various medications: oral estrogen, estrogen patches, and progesterone in oil (PIO). I definitely had some emotions on occasion but I feel like the worst part was a sore booty. The PIO is a bit rough after you’ve done it for a while. It is an intramuscular injection that is taken once a day starting five days before my transfer. Even today I am dealing with effects of the injections, primarily hip and leg numbness.

On November 19th, 2020 we got the green light! Everything looked good. We would have our first embryo transfer on November 25th, 2020.

Our transfer…

Jeremiah and I came up the day before the transfer just to make sure we didn’t have any traveling hick-ups. For the day of transfer, we opted to do acupuncture before and after the procedure to improve blood flow and promote relaxation. After completing the initial round of acupuncture we were taken to a procedure room. The embryologist projected an image of our embryo onto a television that was in the room. We had been given an image of the embryo before going into the procedure room and by the time we were seeing it on the television, it had already changed so much and had made a lot of progress with hatching.

Our Embaby!

My cycle was delayed a bit so we ended up having a different doctor for the transfer. She was super sweet and explained everything as she went. In order to complete the transfer, a speculum is inserted followed by the catheter that is connected to a syringe which holds the embryo. After the transfer, the embryologist went back to the lab to confirm that everything was “all clear”. I was told to lay down for about five minutes and then I would go do my last acupuncture session for the day.

Waiting for our transfer!

After the transfer I felt fine. I had some mild cramping off and on but that was it. Now it was time to wait to see if the transfer worked; two weeks to be exact.

Waiting…

During our two week wait, I felt optimistic. Several times I had experienced some twinge-like pain and cramping so I felt good about the transfer. Because my clinic uses HCG boosters, I was not able to do home pregnancy tests initially because they would produce false positives. I decided to wait until there was a high likelihood that the injected HCG was out of my system before trying a home test. At first I didn’t know if testing at home was the right call, but I decided that I wanted to prepare myself before the blood draw at my clinic. I tested at home two days before my clinic visit and it was positive! Tested again the next day and it was positive again.

Although I felt somewhat reassured of the positive tests, I knew I needed to wait until the clinic tested to be sure. I have met so many girls who have had positives at home and when they did their clinic testing, they found out that they had a chemical pregnancy.

On December 7, 2020, I drove to Denver for my blood HCG test. When I was about two hours from home, my nurse called from the clinic. I ignored the call since I was alone and I wanted to wait until I was with Jeremiah. She left a voicemail and let me tell you, that was the hardest two-hour wait of my life.

When I got home, Jeremiah was in a meeting and I told him I had the results. He got off the meeting and we sat down in the bedroom and hit play. My nurse said, “I have good news for you, you’re pregnant”. Finally! What we had been dreaming about was finally coming true. We still had another confirmation test on December 10th, but so far my numbers were good.

December 10th came around and it was confirmed, we were pregnant! Our due date was August 13, 2021!

Ultrasounds…

On December 23, 2020, just shy of seven weeks pregnant, we saw our nugget for the first time. Everything looked good and the heartbeat was strong. During this appointment I received another intralipid transfusion. Next appointment was set to be at nine weeks pregnant and we would “graduate” from Conceptions at that time.

Everything was going well. I definitely was experiencing some nausea and some serious food aversions. My friend Fallon had bought be some ginger gummies and they saved my life on so many occasions.

On Christmas day, Jeremiah and I were in the kitchen and I felt a gush of fluid. I immediately went to the bathroom and saw that I had bled quite a bit. I sat there for about ten minutes and it eventually let up. I sent an email to my nurse to let her know what had happened, but I knew exactly what it was; a subchorionic hemorrhage (SCH).

When a person undergoes IVF, one of the most common issues that can occur is an SCH. Most of the time it doesn’t cause pregnancy loss, but it can scare the hell out of you.

A couple days after the SCH, I had one of the local providers do an ultrasound to make sure everything was okay and it was! Thank God!

At the start of the new year, I started feeling a bit different. All of my food aversions and nausea were gone. I spoke with the girls in my support group and many of them had experienced heavy fluctuations in their symptoms so I felt reassured that nothing was wrong.

January 8, 2021…

On January 8, 2021 we headed to Denver for our nine week follow-up. I was a bit worried due to my change in symptoms, but I remained optimistic. The appointment started with a blood draw to make sure my hormone levels were looking good. Next, our ultrasound.

We were led into an ultrasound room and were greeted by one of the techs. I had several ultrasounds with her and she is very sweet. I felt good. She proclaimed that she really enjoyed doing ultrasounds at nine weeks because the babies look more human-like.

The ultrasound started and I immediately saw the head which was followed by the body. It really did look like a little person now. It really is amazing how fast everything develops. I had my eyed glued to the monitor and did a quick evaluation. No heartbeat. I said out loud, “I don’t see a heartbeat”. The tech said that she was going to check again on the doppler setting. Next thing she said was “I am so sorry”. I broke down. The tech had to still get measurements so I laid there crying and silently begging for it all to be over with.

After the ultrasound, we were led into a consultation room where we waited for the nurse practitioner to come see us. After waiting several minutes, she entered and gave her condolences. She explained that the baby measured perfectly at nine weeks and one day, so the loss was recent. I then asked what the plan was. She said that at this gestation, they strongly encourage a dilation and curettage (D & C). She went on to explain that I could have the procedure done at the clinic the next week, but I declined and said that I would have one of the local providers manage me. I was instructed to continue my medications (estrogen and PIO) until the morning of the procedure in order to prevent bleeding.

That meeting was surreal. I reflect on it now and I can’t remember half of what was said. Jeremiah was silent. He didn’t say a word. One thing that really frustrated me when I stopped and thought about the meeting is that she never asked him if he was okay or if he had any questions. He was just a prop in a room. When we left the clinic, I told him that “you matter too”. He didn’t even realize what had happened.

The drive home was painful. One of the first things I did was call one of my friends who is also an OB-GYN. I spoke as best as I could through all the crying. He spent several minutes telling me what my options were. He explained that I could take misoprostol (medication to induce passage of the baby) at home if I preferred but there is a chance that it could be painful and drawn out. I remember being in a panic and just thinking that I needed it all over with. I requested that we do the D & C; it would be on the 11th.

The rest of our drive home was silent and full of tears. I think the only time we spoke was when I saw Jeremiah was getting tired so I offered to drive. Once home, there was more crying and silence. I also had a beer in the hopes that it could relax me, it didn’t.

I spent most of the weekend crying. The only time it didn’t hurt was when I was sleeping so I tried to do that as much as possible. Other difficult things were on the horizon; we had to tell our close friends and family. The hardest people that we had to tell were our parents. It felt like we had let them down since they had wanted grandchildren so badly.

Surgery day…

We arrived at the hospital about 11:30am that day. I felt sick, sad, defeated, and angry. Jeremiah and I were definitely experiencing the “denial” stage of grief. I called my doctor and asked if we could have one last ultrasound to make sure that the initial exam was correct. We arrived at the clinic and went in the back door. He came in and did the ultrasound. There was our baby, our lifeless baby. I asked for pictures from the ultrasound. Why? Because we loved that kid more than they will ever know and wanted any sort of memory that we could get. I also needed it as a reminder to keep going and that I can make miracles, beautiful little miracles.

We then went to the surgery department and waited. I wanted it all over with but at the same time I felt like if I didn’t have the procedure then I would still be pregnant and all would be well. I knew my OR crew and felt good about that. I requested my drug of choice, Versed, and then proceeded to have a nice nap.

When I woke up, I felt okay and just had some mild cramping. After I was able to void and drink something I requested to go home. I had the best nurse. Taylor was a student that I had taught and she took great care of me. When she gave me the green light to get dressed, I all of the sudden felt awful. I was dizzy, nauseated, and had pain radiating from my stomach around to my back. Taylor had to re-insert and IV in order to give me pain medications. I felt that something wasn’t right. Finally, I had some relief and was able to fall asleep. When I woke, I felt okay and ready to go home.

The next few weeks…

The first few days were very hard. I was adjusting to a new reality; I was no longer pregnant. My sister had bought me some books on miscarriages and that helped some. There were two big struggles that I had in the days following the procedure. For one, I felt that I should have miscarried at home, allowing me to feel the pain that I deserved to feel. My other big struggle was the fact that I didn’t bring my baby home with me. I wish that I would have thought for a moment before the procedure and asked for the remains, but I didn’t. Instead my baby’s remains ended up in a biohazard bag and sent to a hospital incinerator. We should have buried our baby.

A couple weeks after the initial D & C, I started passing a lot of clots. I went to the doctor and my uterus was enlarged and contained several clots. We opted to remain conservative and I took misoprostol in the hopes that it would help evacuate all of the clots. That was painful and all I can say is that I have a new respect for that medication (we give it a lot in L & D). After several hours of pain and bleeding, I felt good. There was immediate relief of the pressure I had been feeling.

I followed-up about a week later and I still had clots inside that were not coming out. I did a second round of misoprostol that didn’t work; I needed a second D & C. Joy…

My second D & C was on January 27th. During the procedure they did an ultrasound to confirm that all “products of conception” were gone. My recovery was simple this time and didn’t have pain like I did the first time.

Starting one week after the initial D & C, I had to get weekly HCG tests to make sure that my levels were going down appropriately. Also, my fertility clinic would not be able to complete any new treatments until my HCG levels were zero. Initially, my HCG levels were dropping appropriately and then they slowed way down.

I went for a follow-up in mid-March at the local clinic and we opted to do a hysterosonogram to get a good visualization of the uterus to see if there were any issues since my HCG levels were decreasing at such a slow rate. Guess what? There was a growth-like protrusion at the base of the uterus. Since my HCG levels were still existent at this point when they shouldn’t be and there was that anomaly, I won a ticket to a hysteroscopy procedure.

On March 15, 2021 I had my hysteroscopy procedure. While I was in recovery, the doctor came and talked to me. Sure enough, there was trunk-like structure that was adhered to the base of my uterus. He said it took some time to get it out but he was finally able to remove it. He ended up doing a third D & C. I asked him if he knew what it was and all he said was “I don’t know”. I then asked if it was anything bad and he said “I hope not”. I then spent the next several days convincing myself that I had cancer that was caused from all of the hormones of IVF. Four excruciating days later I found out that it was placental tissue. What? This late? I had even had a period since the last D & C. It just didn’t make sense.

I did the very thing that healthcare workers despise; I went to Dr. Google. The first thing that came to mind was an accreta. An accreta is a condition in which the placenta attaches too deep into the lining of the uterus. This can cause issues with bleeding and proper placental detachment. It makes sense to me especially since I had a period before the last D & C. In my mind, the period should have swept away any remaining products of conception that would have remained on my endometrial lining. My doctor isn’t completely convinced that this is the problem since he hasn’t seen it at such an early gestation, but he agrees that it is a possibility.

Now what???

We are pushing forward! For my next post I will get everyone up to speed on what’s going on right now.