Post Egg Retrieval, How Many Eggs Fertilized Normally, and New Medications

This new stage of the IVF process, post egg retrieval brings new hopes and fears and new medications.

This morning, I didn't feel too bad and I wasn't bleeding at all either. I slept not too badly and was able to go out for lunch with my family and then shop for a short while in the afternoon. All in all, I was feeling better post egg retrieval than I thought that I would be. I also attribute some of this perkiness to not having injectable hormones anymore. I am definitely swollen though and that headache just won't go away. By the end of about an hour of shopping, I had completely had it and had to go home and rest.

Before lunch and shopping I was all smiles, but after I was a snarling creature ready for a rest.

Now for the part you're probably more interested in, what did the embryologist say when she called us this morning? As I mentioned before, the embryologist was going to call us this morning to tell us how many of the 10 eggs extracted yesterday were fertilized. The embryologist called at about 11 AM today and told us that 8 eggs had fertilized normally, four from the mix group (sperm mixed with an egg in vitro as is normally done) and four from the ICSI group (one sperm injected into one egg). She told us that she would call us again tomorrow morning to tell us how many of the fertilized eggs had survived and since it would be day 2 for them by that point (today is day 1), what grade each of the embryos that survives is. She says they grade on a 20 point scale and that they are looking for embryos 17 points and above. Often embryo transfers are done on day 3, so this would be Monday, but it all depends on how the embryos are doing.

With this new stage in the IVF process, comes new medications, the continuation of certain medications, and the renewed use of others. In addition to the prenatal vitamins, folic acid, and vitamin D that Dr. Hudson wants me to continue, there are five medications that I will be taking for this stage of the process (Co-enzyme Q10 has been discontinued at this point as the eggs have already been harvested from me and this cannot be taken while pregnant in any event).

1. Estrace
Estrace is a form of estrogen (estradiol). It is supposed to prepare the endometrium in the uterus to be of an adequate or optimum thickness for the blastocyst/embryo to be successfully implanted. It also helps maintain the endometrium. The side effects listed on the internet are really numerous for Estrace (too numerous to list) and can range from anything related to nipple discharge and crustiness and breast tenderness, pain, and swelling, vaginal excretions and itching, to sore throats, stuffy nose, exhaustion, irritability, gastrointestinal symptoms including nausea and vomiting, bloating, low blood pressure, hair loss, changes to your menstrual period, break-through bleeding, headache, weight changes, to freckles or darkening of facial skin. So, basically anything that can go wrong in your body can go wrong from the disturbing to the downright disgusting and all of them inconvenient.

I was on 4 mg a day before the start of this cycle (until day 1 arrived), but now I'm on 6 mg a day (one tablet, three times per day). This will be continued until 9 weeks gestation if I get pregnant.

Pretty teal pills that will make you hormonal.

We look tiny and innocent, but we're not.

2. Endometrin
Endometrin is a progesterone vaginal tablet inserted with a plastic applicator rather like a tampon. The purpose of the medication is to increase progesterone levels in women undergoing IVF to help them become and stay pregnant. In a woman's body, progesterone prepares the endometrium or lining of the uterus and allows a fertilized eggs or embryo to implant. In a pregnancy, the ovaries will produce progesterone until eight weeks gestation, after which time, the placenta will produce progesterone for the duration of the pregnancy.

Common side effects include nausea, abdominal pain, swollen ovaries (ovarian hyperstimulation syndrome [OHSS- hissssss]), headache, uterine cramping, abdominal bloating, vaginal bleeding, vomiting, constipation, urinary infections, and tiredness. With IVF there is the added side effect of post procedural pain after egg retrieval (pelvic pain). Less common side effects may include vaginal irritation, vaginal discomfort and discharge, vaginal burning sensation, and swelling of the limbs.

I must insert one tablet in the morning and one in the evening every day until I am 9 weeks gestation if I manage to get pregnant.

I have two of these boxes and at a rate of 2 per day, I'll be going through a lot more if I get pregnant.

There are applicators and vaginal tablets to put in the applicators.

The tablet goes on the larger end of the applicator. They call the tablet effervescent. Ooh la la!

3. Low Dose Aspirin (81 mg)
Low Dose Aspirin (81 mg), while not recommended for most pregnant women or those attempting pregnancy, is thought to be beneficial for a small group of pregnant women and women trying to get pregnant through IVF. Aspirin has anti-inflammatory and platelet aggregation inhibition properties and is vasodilatory, which therefore may improve blood flow to the implantation site in women. This could aid in implantation and perhaps help prevent miscarriage, leading to higher success rates. Some doctors dispute this claim.

I must take one low dose aspirin once per day until the pregnancy test.

No frills in these low dose aspirin. "We're boring, but we work."

4. Doxycycline
Doxycycline is an antibiotic that I have been put on to prevent infection during the egg retrieval and embryo transfer process. It is supposed to be hard on the stomach (like Dexamethasone) and should be taken with food. Naturally, as with any drug, there is a list of horrifying things that could go wrong including allergic reactions, jaundice, blurred vision, and severe skin reactions, but those are not common. More common and less extreme side effects of Doxycycline are upset stomach (reduce this by taking with a meal), mild diarrhea, mild nausea, vaginal itching or discharge, and mild skin rash or itching.

I must take one capsule in the morning and one in the evening with food. I will finish taking the course of Doxycycline on the night after the embryo transfer.

The prettiest coloured capsules can make you feel not so pretty.

5. Dexamethasone
Dexamethasone is a corticosteroid hormone (glucocorticoid) used for conditions like arthritis, but for IVF it is used to suppress the body's immune system response to make the body more cooperative in the IVF process. Side effects can include headache, dizziness, stomach upset, insomnia, menstrual changes, and increased appetite and weight gain. Naturally, there are worse things that can happen like infection, irregular heartbeat, mood and mental changes, allergic reactions, and seizures, but these are not common.

I must continue this until a pregnancy is confirmed and then I will be weaned off of it. I must take two tablets in the morning with food.

A pentagon that doesn't indicate a school zone.

Now we wait anxiously to hear from the embryologist tomorrow morning. She will be telling us how many of the fertilized eggs survived, how many embryos we have, and what grade those embryos are. We may also find out when our embryo transfer will be.

The last of summer shines through in this sunflower that my husband gave me. We hope for a fruitful autumn.