Everything Egg Freezing Part 5: The Cycle Continues
In part 4, we covered my initial visit and the first week of my treatments. As I said in the previous entry, while the first week went fairly smoothly, the second week was quite a bit rockier for me for a variety of reasons. In this entry, we will cover week 2 and everything leading up to the day of the retrieval, which happened on day 15 of my egg freezing cycle.
Disclaimer: I am always attempting to be as gender neutral as possible when writing and talking about parenthood! Also, I will try to put up a content warning whenever fertility-related things are getting heavier in my posts so that you can skip along if you are not feeling like that kind of content would be good for you to read right now.
Week 2:
My mom left on Sunday, right before week 2 began. The day that she left, I had a cycle visit. I actually had a couple of Sunday visits during my cycle. The cycle visits, just as a refresher, include an ultrasound and lab work, which checks estrogen levels to ensure that they are increasing as expected. At that cycle visit, a little over 80% of my follicles that were counted on day 1 appeared to be growing gradually. While I was a little more tired than usual, generally I was feeling pretty good and ready to kick off week 2.
*CW: unexpected results*
I had an appointment the following morning, and I showed up anticipating more of the same news. Unfortunately, this was not the case. Only a few of my follicles were growing in the range that they should have been, seemingly overnight. Hearing that was super upsetting to me. I began to feel so anxious and disappointed, wondering if this whole endeavor was a waste of my time and money. I also had been feeling like my treatment at this particular clinic was pretty impersonal for the few months leading up to the cycle initiation, so I was questioning whether or not I made the right decision in selecting it for such an expensive and demanding undertaking. The ability to hide my feelings is most definitely not a skill that I have ever possessed, so I was visibly upset (read: crying) in the clinic at this news.
The ultrasound technician had relayed these results to me, so I asked to speak one on one with a nurse on the team. While the nurse that came to speak with me was not my primary nurse, who was in a procedure, she was so kind and patient. It meant a lot to me to be able to voice my concerns and my uncertainty about whether or not it was worthwhile to continue with the process with so few follicles at the appropriate size. She let me know that she would relay everything to my doctor, who would call me in the afternoon once my lab tests were in to chat more about what I wanted to do.
I went home and had about an hour before my work day began. I used that time to call my boyfriend and my mom and get myself into a calmer state of being. While I was definitely dealing with some intense emotions, seeing patients was actually super helpful to get my mind off of things. Focusing on someone else’s needs and putting some space between myself and my feelings allowed me to come back to them after my work day was done feeling calmer and more grounded. I also almost canceled my acupuncture treatment that day, but I ended up keeping it, and we focused on grounding, calming my mind and supporting my body. My doctor called the second I walked out of acupuncture, and I was thankful that I was in a more relaxed head space to speak with her.
My doctor confirmed that my results were not as robust as expected at this point in the cycle, including my estrogen levels. She validated my concerns and acknowledged that it would be reasonable at this point to even cancel this cycle and to come back and try again with different medication doses in the future. She said that we could also increase the medication doses immediately and continue on, seeing if we could recruit a few more follicles on the way. We discussed that I had taken the time away from my home, taken some time off of work, and already paid for the place to stay and medications. I let her know that I was willing to stay and try the increased medication dose route, if she thought that was reasonable, and she said she did think that this was a reasonable plan.
We increased one of my medications that night, and the following day I had another cycle visit. Happily, double the amount of follicles appeared to be growing with the increased dose! My care team all were genuinely thrilled, which was so sweet. From the amazing ultrasound tech to the extremely kind nurse (who actually cried while speaking with me on this day), I felt so supported by my team from that point forward. I was relieved with this news, but it was such a rollercoaster of emotions that it still felt pretty overwhelming. That night, we increased the other medication. My estrogen levels started to significantly increase from this point forward, and I stayed at that increased number of appropriately growing follicles for the remainder of my cycle. More on that in the retrieval post.
Symptoms & supportive treatments:
After we increased my doses, my estrogen levels really picked up and I started noticing more of the symptoms that I had previously expected and not had. This included fatigue, constipation, abdominal bloating (my ovaries were growing with the expanding follicles), some fogginess (thankfully I did not work during this time), and some tenderness over my ovaries. The ovarian tenderness really did not occur until a few days before the retrieval, and it was after a day of increased walking at altitude during a day trip to Breckenridge to celebrate a friend’s birthday. I was worried that the increased activity was what triggered the tenderness, but an evaluation the following day was reassuring and showed great blood flow and no fluid around my ovaries. It was just my body responding to the medications and a call to be restful until the retrieval. It was interesting to see a graphical representation of my estrogen levels rising throughout the cycle (see below).
I managed my symptoms by listening to my body and resting a lot towards the end of the cycle. I would still get up and move (i.e. go run errands and eat good food out of the house) but spent a lot of time the day or two before the retrieval just being horizontal and allowing my body to do its thing. I think if I lived and worked near the fertility office, I could have worked probably for the first 10 days of the cycle and then would ideally take the few days before the retrieval and after the retrieval off. I also was eating plenty of protein and fiber and balancing eating an abundance of micronutrients though fruits and veggies with also eating some comfort foods that just tasted good. I did acupuncture a few times throughout the cycle for support, which was relaxing and helpful. My acupuncturist was thankfully extremely receptive to my requests for comfort (warm blankets, heat lamps, not staying on my stomach for too long) and being cared for in that way made a huge difference in my life during that time. I also did some smokeless moxa and acupressure treatments on my own during that time. I am trained in acupuncture, but the fertility office provided this extra remote service that sends you all of the materials and does a video visit to review how to use them (which costs about $200 out of pocket, full disclosure) and I jumped at the chance to offer myself a little extra TLC. It’s worthwhile to ask your fertility team what services they recommend in the community, like acupuncture, to support you through the process.
Coping with the process:
As I’ve said before, it has been very difficult to predict the emotional impact of this process. Fertility is such a charged topic, and getting results that you don’t expect or find disappointing can bring up really difficult feelings, such as inadequacy and guilt. On top of this, your hormones are surging, which can create mood and physical changes that are difficult to handle at times. The feelings of inadequacy that arose for me and may arise for others are NOT based in reality. There is nothing in actuality that I could have done differently to impact my results, despite what my brain was trying to tell me. I hope that if someone is having similar feelings from a past or present cycle or struggle with fertility that this can serve as a reminder that you are doing everything you can, you are doing your best, and unexpected or unfavorable results are not your fault.
I coped with my fluctuating results and emotions by talking and visiting with trusted loved ones, working with the therapeutic offerings I’ve found helpful in life (acupuncture, energy healing with a trusted and previously established practitioner), and writing about my experience. It was comforting to focus on the health of the follicles that were growing, rather than the loss of the follicles that weren’t. I did meditative exercises to check in with myself physically, emotionally, and spiritually periodically throughout the process. Doing all of these things helped me to feel empowered, which was my key to remaining in a stable and positive headspace. I also felt empowered in being truthful with my medical team. Explaining my feelings to them (in particular to the two nurses that cared for me the most in this process) allowed them to step up and care for me in a way that I had not expected and was touched to receive. I appreciate having been allowed the time and space to voice my concerns and difficult feelings with the team.
As you can imagine from reading this, week two was a doozy. However, my results were improving by the end of the week, and I had the support of my team and my loved ones. As my retrieval approached, I was feeling positive, calm, and ready to get it done and go home to my cats and my own bed! Next up, we’ll cover the trigger shot, the retrieval, and some post-retrieval recovery in part 6.
Please let me know what you think or if you have any questions you’d like me to address in future posts by leaving a comment below or by DMing me on instagram @stephkaroz. Thank you for reading!
