Everything Egg Freezing Part 6: The Retrieval
Welcome to part 6 of my egg freezing journey, where we will cover all things egg retrieval! The retrieval procedure was the culmination of two weeks of medications, physical changes, and emotionally challenging moments, which are covered in the previous posts, if you’re just joining. This post will cover the few days before the retrieval, the retrieval morning and what it involved, and the recovery after.
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.
The trigger shot
We left off at the end of week two of my cycle, with my body really feeling the changes it was undergoing. As you take medication to mature as many follicles (fluid filled structures that eventually will house eggs) as possible, your ovaries start to swell. I really felt that abdominal swelling in the few days leading up to my retrieval. My lower abdomen felt full and a little achy in some places, and I felt quite tired. Rest really was essential in helping me to feel comfortable through the end of the cycle. On Sunday, November 12th, I had another cycle visit which confirmed that I was ready to do my trigger shot that evening in order to have my retrieval on Tuesday, November 14th.
The trigger shot “triggers” your body to ovulate. This helps to prepare the eggs that the follicles are supporting to mature and be ready to retrieve. For my cycle, my doctor used a combination of two injections. One of the medications is the hormone HCG, which is used to confirm pregnancy on at-home and clinical pregnancy tests, and the other is a medication that increases a hormone called GNRH. I found an article here that studied the use of two different medications vs one medication, and it does seem to improve the number of mature oocytes (eggs) that are retrieved. The trigger shot must be done at the exact right time, or the whole process can be thrown off. I was sent detailed instructions by my team later that day for me to complete my trigger shots that evening at 10:15pm exactly. I was to take all of my regular medications as well earlier in the evening. Because the timing was so specific, I prepared the medications in their syringes a few hours ahead of time, when I was preparing my normal medications, to be sure that I would be ready to just go for it at 10:15 exactly. The injections burned a bit when I administered them, similar to the regular medications I had been taking, and otherwise I did not notice any side effects.
The next day, I had to take a pregnancy test, which should come back positive because of the HCG in the trigger shot. The test that the office gave me did not come with any instructions, so at first I was concerned that it was not coming back positive. I waited a little longer, and I did see a faint positive result, thankfully! This was a good sign that the medication had been effective, and I could proceed with the retrieval on my scheduled date. I underestimated how charged with nerves I would be while waiting for the test result, because I was due to go back home one day after the retrieval and return to work two days after the retrieval. I worried that the retrieval would have to be pushed back if my test came back negative, but happily it all came out how it should. Monday passed uneventfully after this, and I did not have to do any injections on Monday night. I was instructed to fast after midnight and show up at the office at 8:30 on Tuesday morning, November 14th, for my 9:15 retrieval time.
Pre-retrieval jitters
The retrieval
I arrived at the office the morning of my retrieval feeling a mixture of many emotions. As an integrative and functional medicine doctor, I have actively worked to minimize medications and medical interventions in my life unless absolutely necessary. Because of this, I had not taken any prescription medication for a few years until this year (when it became necessary for this procedure and other reasons that I’ll save for another blog post), and I had not been under sedation of any kind since my wisdom teeth were removed in 2008. I was nervous about being under sedation and about the success of the procedure. I did some breathing exercises and engaged my five senses before the procedure to calm my nerves. Because I had to fast after midnight and couldn’t drink water the day of the procedure, I was relatively dehydrated and it was difficult to get an IV placed for the procedure. It took multiple tries and finally the nurse anesthetist was able to place one after my nursing team could not. I had a few bruises from this, but ultimately I was just relieved to be able to proceed with the procedure.
I was taken to the procedure room once my IV was placed, and then things happened REALLY quickly. It was a whirlwind. The team helped me get into the right position for the procedure and did a couple of time outs, where I had to say my name, birthday, and procedure that was happening. Then, I was given an initial dose of medication to help me relax and oxygen tubing was placed in my nose. I felt the relaxing medication nearly immediately. I was advised that the sedation medication was being given and then…I woke up! I remember waking up in the procedure room and being told that it was all done. My nurse and nurse anesthetist took me back to the recovery room. I was definitely still feeling the effects of the medication and was effusively complimenting both of them for the next few minutes, which was only a little embarrassing to remember once I was woken up again a little while later. I was ready to leave the office just a little while after the procedure. I felt no pain, just a growling stomach from not having eaten in close to 12 hours. I was told that I had absolutely no bleeding and the procedure was very straightforward. I was advised to take tylenol for pain control, and was sent a small amount of pain medication because I am allergic to ibuprofen and all related medications, which they typically use for pain control. My boyfriend took me back to the apartment to rest and recover more (read: eat a giant breakfast burrito). I was also advised to not drive or make any consequential life choices (i.e. legal paperwork) for 24 hours after the procedure due to the waning effects of the sedation medication.
The results
I was notified later on in the day by the embryology team that 100% of my eggs that were retrieved were mature enough to freeze. That is pretty uncommon! The amount of eggs retrieved at the end of this cycle was lower than I would have hoped for in an ideal situation and lower than a lot of my friends have gotten with their IVF journeys. However, for my initial numbers, the amount was actually at the upper end of what to expect. This is a good time to slide in a reminder to myself and anyone reading this that comparison is the thief of joy. My hope is that I never need to use them, but it could be the case that 100% of my smallish number of frozen eggs can be thawed to create embryos some day if I do. They are already beating the odds, so why not have an optimistic attitude about the rest of the process? I do not necessarily need to have a lot of eggs, I just need the eggs I have to be healthy. This was what I focused the entire second half of my cycle on. I sent protective energy to my follicles, I meditated on the strength and maturity of the eggs that would be produced. I visualized them all being frozen in a strong and healthy state. These exercises were 100% safe and helped me to ground and calm my mind and body during a difficult process, at the very least. At the most, they helped all of my eggs be retrieved in a mature enough state to freeze.
Resting and celebrating being DONE with the retrieval!
Post-retrieval recovery:
The recovery was honestly the worst part of the entire cycle for me. While the rest of the day after the procedure progressed uneventfully, I developed a little bit of pain despite taking tylenol and did end up taking one dose of pain medication. Then around 10pm as I was getting ready for bed, I developed an intense and unremitting nausea. I had abdominal bloating and mild shortness of breath (because my abdomen was so bloated), and when I got up to be closer to the restroom in case I needed to vomit, I almost passed out. As I was blacking out, I advised my boyfriend to call 911, because I have a blood clotting condition and had not been on my blood thinners for a couple of days due to the procedure, and there is a condition called OHSS to be aware of following your procedure. This is when the ovaries are hyperstimulated and your abdomen can accumulate unwanted fluid, causing rapid weight gain and shortness of breath and sometimes requiring hospitalization for monitoring. I ended up vomiting twice and feeling a lot better, but I was thankful that EMS still came and evaluated me, completing an EKG and vital sign assessment that were both normal and so reassuring. I felt comfortable staying home and trying to get some rest that evening, and I assured the EMS team that I would go to the hospital if anything else happened. The rest of the night passed with a few waves of intense nausea but nothing else, so I felt comfortable staying home.
I called my care team at the fertility clinic the next day, and they reassured me that this did not sound like OHSS. My doctor thought that it was medication-related from the sedation and would improve with some more time. They sent nausea medication to the pharmacy for me that helped me to get through the following day. It was stated at the beginning of my cycle that a fair number of people go back to work the day after their retrieval. There is absolutely no way I could have done that due to the intense 24-hour cycle of nausea that I felt. I returned to work two days after my retrieval and even that felt like I was pushing it a little bit, due to some residual discomfort, bloating, and fatigue. By three days after the retrieval, I was feeling tired but much more like myself again. I’d strongly advise taking at least 2 days off after the retrieval if that’s feasible for you.
About a week after my retrieval, I was feeling well enough to do a serious work out for the first time since my cycle began. I really tried to listen to and honor my body during the recovery period, reminding myself of all that it just did for me. While I do not find weighing myself to be productive or useful and therefore I have not done so in many years, I do think that I gained some weight based on how my clothes are fitting after the procedure. Sometimes it feels difficult to focus on everything my body just did, rather than how I want to feel in my body. I’ve really been working hard to remind myself of the amazing work my body just did every time anxious thoughts creep in about how my body is “supposed” to feel and look. I hope that successive generations are able to enjoy more empowering and joyful relationships with their bodies, as I work to heal my relationship with mine. For now, working out feels amazing, being able to sweat and enjoy the surge of endorphins is something I always have and hopefully always will genuinely enjoy. If it didn’t feel physically good, I would not be doing it. I’d focus on my body’s continued recovery (as I am, workouts included) and exactly what it needs at this moment in time. My recovery happily includes quite a bit of movement, now that I’m nearly two weeks out from my retrieval, and also lots (like, a TON) of sleep and lots of nourishing foods.
I continued the lovenox injections and baby aspirin to prevent blood clots until my first menstrual cycle following the retrieval. Though evidence based supplementation is something I utilize for myself and my patients, I have been holding most of my supplements to allow my body to process and eliminate the excess hormones it has been housing due to this process. Once I feel fully recovered, I’ll return to my previous supplement regimen. Ultimately, I am so thankful that I was able to go through this process. I learned a tremendous amount about this branch of medicine, I have a little peace of mind having some eggs frozen for later in case I need them, and it was a long exercise in listening to my mind, body, and spirit and advocating for what they truly needed at each point in the process.
My final post on this topic will be a short Q&A with anything I have not yet addressed or incompletely addressed in previous posts. As always, I am open to questions I may not have answered in these posts, as well as other topics you’d like addressed in future posts! Please DM me or leave a comment below if you have any.
