Egg Retrieval (Oocyte Retrieval)

We arrived at the Victoria Fertility Centre a bit ahead of our scheduled 8:45 AM arrival time for my egg retrieval (oocycte retrieval) during my first IVF cycle. I was hungry and thirsty (fasting since last night).

Please feed me. Or can I at least have several glasses of water?

We checked in and were sent down the hall to the Victoria Fertility Centre lab. This is where the lab where embryos are created is located, the surgical unit for extracting eggs and transferring embryos, and a room for men providing specimens.  We checked in there and waited for a few minutes. Dr. Hudson and a nurse both checked to see if we were comfortable and how we were doing. We both felt nervous.

The lab is down the hall from the normal examination rooms of the VFC.

In the waiting room of the lab.

Eventually a nurse came out to review my past surgeries, my pseudocholinensterase deficiency, and to put hospital bands on me, one for ID and one for allergies. She then gave me a thimble of water (I want more!) to take a cup full of pills including extra strength acetaminophen (Tylenol), gabapentin, Celebrex, and Ativan. This mix was supposed to relax me and reduce pain and inflammation.

My breakfast consisted of only tablets and capsules.

An embryologist who would be extracting eggs from the fluid aspirated from my ovaries today then pulled us into her office. She explained that the fluid aspirated from the ovaries is passed through a window from the operating room to the lab and that the egg count we hear in the operating room is not final, because they double check it in the lab. They would confirm with us before we left if we want half fertilized by mixing the eggs with sperm and half by ICSI (one sperm is injected into one egg) still as we are currently down for. They want us to be comfortable with our decision and sometimes the number of eggs is odd, so choices must be made. Today is day 0 she explained, so tomorrow day 1 for embryo counting purposes. They will call us tomorrow morning to tell us how many were fertilized. Then they will call us daily to tell us how the embryos are faring and their "grades" from day 2 onward.

My husband was then pulled aside to a room to give his specimen.

The room where my husband was sent to give his specimen.

A cup of coffee beans? A strange item in the room where men are sent to give their specimens.

I waited in the waiting room for a while and then was shown to a room to change into a hospital gown which was more of a cotton nightie with lace trim. I was instructed to put a heating pad on my abdomen and lie down while I waited for my procedure and for my husband to return. The heating pad was really nice.

The room where I was to wait before being sent to the operating room.

Two new bracelets!

My husband returned bearing tales of a room with assorted magazines, a specimen cup, and strangely a cup of coffee beans (a fetish we haven't heard of before?). He changed into scrubs provided for him. I wished I had scrubs instead of a cotton nightie. I tried to relax on the bed with the awesome huge heating  over me, but it was getting near to the time appointed, 9:45 AM, and I was nervous. My husband pulled my warm rainbow coloured alpaca socks onto me (courtesy of my sweet parents-in-law). Psychedelic baby!

In my cotton nightie.

Resting with a heating pad over my abdomen as instructed.

My husband had actual scrubs to wear. I was envious.

Psychedelic socks to keep me warm in the operating room.

Waiting for the egg retrieval.

Our egg retrieval was scheduled for 9:45 AM. As the time drew nearer, we felt more nervous.

At almost 10:00, the emergency room nurse, who also works at Victoria Fertility Centre reviewed allergies with me. She said the IV sedation would be done with fentanyl (a synthetic opiate) and midaz or midazolam (a benzodiazepine). She was warm, funny, and encouraging. All the staff at the VFC seem to have a way of putting you at ease. The private clinic setting is a lot more relaxing than having a procedure done at a hospital, that's for sure.

I was taken to the operating room and an IV line was started. They couldn't get a vein in my hand, so they had to use my arm. The nurse was amazed by my low blood pressure too. I told her that was nothing. Once in emergency my blood pressure was 60/40.

Yes, they give you Crocs to wear to the operating room (my husband had to wear a pair too). What a stylish look.

In the operating room with a blood pressure monitor and oxygen on.

My blood pressure was on the low side.

Dr. Hudson joined us a few minutes later and the IV sedation was started by IV. I didn't feel that sedated, so more midazolam was added.

Looking over me to the screen where the ultrasound images will show the follicles.

The egg retrieval was then commenced. The 18 inch needle was inserted into me using ultrasound guidance. Through the vaginal walls, the needle aspirate fluid and eggs from the follicles in both ovaries. I wasn't paying attention to the screen, but my husband took lots of pictures of follicles on the ultrasound screen (dark black masses on the ultrasound screen) and the needle inserted into them, draining them of their fluid and egg (the needle looks like a silvery white point in the middle of a follicle). After the draining was complete, the follicle would largely disappear from view on the screen, no more big blackish spot.

Follicles are visible on the screen as the dark masses.

Follicles in my ovaries.

The follicle on the left has the tip of a needle in it, draining it of its fluid and egg.

The follicle on the left has been drained and is no longer visible as a large dark mass on the ultrasound. The needle tip is still visible as a silvery white mass.

The follicle on the left middle has the tip of a needle in it, draining it of its fluid and egg.

The follicle on the left has the tip of a needle in it, draining it of its fluid and egg.

The follicles are no longer very visible, having been drained.

I was uncomfortable several times during the procedure and Dr. Hudson  gave orders without hesitation for the emergency room nurse who was watching my every move, to add more fentanyl (more was added about three times) so that I would be as comfortable as possible. At the end of the procedure was the most uncomfortable and the fentanyl just didn't seem to be doing it and then suddenly it was over. Dr. Hudson was done the whole egg retrieval process in about 15 minutes.

After the egg retrieval was complete.

I was walked back to a recovery room and alternately drank gingerale, ate cookies, and slept off the midazolam and fentanyl.

I devoured the cookies and gingerale faster than they recommended (and kind of like a drunken wild animal) but I was hungry and thirsty!

I was ravenous.

The embryologist, along with Dr. Hudson, came to tell us that they had managed to aspirate 10 eggs from my ovaries during the egg retrieval, a number that they were pleased with. We confirmed half will be fertilized with ICSI (one sperm injected into one egg) and the other half by traditional mixing of an egg plus sperm in vitro. They will call us tomorrow to tell us how many eggs were actually fertilized.

In the recovery room waiting until I could leave the VFC and get some actual lunch.

I was allowed to dress. Yes, I'm really high on midazolam and fentanyl in this photo.

The nurse checked me over, before deeming me well enough to be discharged. I was groggy, but not feeling too bad (just really hungry and thirsty). The nurse walked with us all the way down to the car to make sure that I was fine. She said that she was impressed. Well, I'm a beast when it comes to drugs and alcohol (not that I drink anymore- ten years sober this coming New Year's Day). As I told them before, I can process a lot way faster than others can and I keep on ticking.

I was ravenous and it was lunch, so we picked up a burger and fries at a drive through on the way home and then ate at home. After, I passed out for a few hours with the cat beside me. No one provides nursing care like Lamont.

Yet another cotton dressing for my right arm, this time from the IV.

My bracelets are so beautiful.

After lunch I passed out with the cat beside me to keep me company.

The cat then migrated to my pillow and rested his cheek and chin on my forehead as he often does. It was a fuzzy way to wake up hours later.

I awoke ravenous again and had a snack. I couldn't sleep more, so I went to the living room to write. I felt a slight twinge of pain earlier after my nap, but had some Tylenol and so far I'm fine. All in all it's not as bad as I thought (but I did get four helpings of fentanyl and two helpings of midazolam so . . .). I'm bleeding only slightly, certainly less than with the hysterosalpingogram (HSG) or sonohysterogram that I had done leading up to this first IVF cycle during the diagnostic stage when they were confirming that we have Unexplained Infertility. In any event, another stage in this first IVF cycle, the egg retrieval, is complete.

Now we must wait on pins and needles to find out if any of the ten eggs fertilized successfully. The lab at the Victoria Fertility Centre will call tomorrow morning probably between 10-12. After that, we will be getting daily phone calls from the lab to tell us the grade of each embryo and if they have survived until it is time for an embryo transfer if there are any that survive  into the day 2-5 range when embryo transfers are done.