Part 19.

The morning of egg retrieval I couldn’t sleep.  We needed to leave home around 10 a.m., but I told Ben 9:45 a.m. just to be sure we would leave on time (he’s never on time for anything…including our wedding).  I woke up about 5 a.m. and laid in bed, staring at the ceiling.  At about 6:00 a.m., I decide to get up, take a shower and “get ready”.  By “get ready” I mean throw on some Nike shorts and a t-shirt.  This isn’t a procedure like going to the gyno – where they go in through your cervix snake up your fallopian tube and suck out some eggs – it so much more than that.

I’ll have to be under anesthesia for the short time of the procedure because it requires Dr. Carnovale to go in through my cervix with a long needle.  They take that needle and poke it through the wall of the uterus to bypass the fallopian tubes straight to the ovaries.  As you can imagine, that would be pretty painful while your awake.  The doctor has to do a lot of maneuvering to get the ovaries in just the right place (which he’s able to see via a pelvic ultrasound tool that’s also inserted into my uterus). Again, you don’t really want to be awake for that.

Once the egg is “aspirated” (aka “sucked out”) of the follicle, the needle is removed and each egg is place into it’s own specimen dish and placed immediately into an incubator.  The embryologist takes an immediate look to determine if there was an egg retrieved from the follicle (they just suck all the fluid out of the follicle) and what the initial quality of the egg looks like.  They do this for as many times as it takes to get every follicle aspirated – meaning any follicle that looks like it might  have an egg in it, they suck the fluid out.

The patient wakes up in the recovery room and shortly there after the embryologist is in to let you know how many eggs they were able to retrieve.  Later that day (within about 4 hours), the embryologist fertilizes the eggs.  WHICH MEANS that while I am in the operating room, Ben will be in a room providing the other half of the equation – they like the sperm to be “super fresh”.

I’m not stressed about any of it.  This will be my third time under anesthesia in the last 6 months – and by far the easiest and shortest one.  There’s no incisions or stitches or removal of tissue like the last two – this one should be easy.  What I am worried about is how many eggs they will actually get.  At last report, Dr. Carnovale said that it looks like there is about 3 good sized follicles.  I’d honestly be very happy with three – I’m more concerned that there won’t be three.

Ben wakes up at about 8:30, jumps in the shower and we are ready to go by about 9:30.  Instead of sitting around waiting for 10 a.m. to hit, we leave early for the hospital.  We get there about 10:15 and head into the hospital, check in, and wait to be taken back into pre-op.  We don’t wait long and the pre-op nurse comes to get us.  We walk back to a tiny room in the pre-op area.  As I walk into my room I see Dr. Carnovale and Sarah going through some paperwork in the nurse’s area:  They’re all smiles as they greet us good morning.  I set my stuff down and the nurse takes me to the bathroom to take all my cloths off and put on one of those sexy hospital gowns and a pair of socks that I’ve come to love (seriously I love hospital socks they’re warm and have the grippes on the bottoms, between Ben and I, we’ve accumulated quite a collection).

As I am walking into the bathroom, the nurse is instructing me and says, “We also need to get a urine sample from you Jessica.  We need to test your HcG level and test for pregnancy.”

Pregnancy?  Seriously?  If I was pregnant we wouldn’t be here.  This is nuts.

I change, pee in the cup, and pull the red cord in the room to alert the nurse that I am ready to be escorted back into my room where Ben is sitting waiting on me.  I plop down on the bed and the nurse starts prepping for my IV.  It’s a different nurse than my last surgery and I am hoping that my IV can go into my arm and not my hand.  She inserts my IV into my arm, takes some vitals and then pops out of the room.

Next Sarah pops into the room.  She’s as chipper as ever – and I’ve come to appreciate her positivity.  I guess in her line of work you need to be super positive.  She starts going through what happens after the surgery, “Okay Jessica, you should have received your progesterone.  Did it come?”

“Yes.”

She continues, “Okay, you’re going to want to start that injection tonight.  This is also a bottom shot.  How did the HcG shot go yesterday? (as she looks at Ben)”

I reply, “It went fine.  I gave it to myself.”

Sarah, looking a little shocked says, “In the leg?”

“No, in the butt.” I respond.

“Wow, okay, I’m impressed.  Well, you’re going to need to continue to do that every night until we do your blood pregnancy test two weeks from today,” she says as she hands me the paperwork for the pregnancy test and continues. “You’ll want to go the lab by our office and we will call you as soon as the results are in – it only takes a couple hours.  Now, if you remember, the progesterone is in oil so you’re going to want to probably rotate cheeks each day.  You’ll be sore from the oil that the progesterone is in.  Tenderness at the injection site is normal, but if you start to bruise really badly, let us know.  When you come in to have the eggs implanted in 3-5 days depending on how today goes, we won’t give you any of this information and you won’t hear from us unit the pregnancy test, unless you need anything or have a concern you can call us. Any questions?”

Ben and I both shake our heads no, then Sarah’s out the door.

A few minutes later, Dr. Boldt, the embryologist walks in.  I like him.  He’s outgoing and talkative and funny.  He brings energy to the room.  He sits down in the chair next to Ben, leans back up against the wall, crosses his legs, and starts chatting – not chatting about the medical stuff, just chatting with us, trying to get to know us.  Less than 5 minutes later we’re laughing and carrying on and I feel completely at ease.  Dr. Boldt then shifts to explaining what he’ll be doing, “Okay you guys, in about 20 minutes we’re going to take Jessica back and start getting her prepped for surgery in the operating room.  Jess, there’s going to be a bunch of gadgets and weird looking vials and stuff in there.  It will look like Dr. Jekyll’s lab – it’s all normal.  When they take you back, Ben, I’ll take you to a room right around the corner where you can provide us a sample.  Then you can go out to the waiting room or come back into this room and wait for Jess. They will bring her back into here for recovery.  Up to you.  They’ll page you.  Jess, Dr. Carnovale is the best.  He will aspirate every possible follicle he can visualize on your ovaries and try to get as many eggs as he can – even the follicles that are super small that probably don’t have an egg in them, he’ll get.  Each time, I’ll be holding the dish while he injects all of the aspirated fluid into it.  I’ll immediately take that dish and put it under the microscope to see if there’s an egg in there.  If there is, we will place it into the incubator to be transported to the lab.  After surgery, Dr. Carnovale will come in and let you know how many eggs we were able to retrieve.”

“This afternoon, probably around 4 p.m. we’ll fertilize your eggs and I will call you in the morning with an update on how they’re doing.  I’ll call you every morning with an update on how they are doing – which ones fertilized, which eggs are dividing at the rate we’d expect, which ones haven’t advanced, etc.  On the 3rd or 5th day we will implant.  If there are only one or two viable eggs left on day three, we’ll implant then.  If we have more than 2 we’ll wait until day 5 to pick the best of what’s left.  We’re going to take great care of you.  Any questions?”

Just then, a nurse pops in, “Okay Jessica, you ready to go?”

Do I really have a choice?

I smile and nod, kiss Ben goodbye, and stare at the ceiling as I’m rolled into the OR.  When we get in there it does look like Dr. Jekyll’s lab.  There’s Dr. Carnovale, Dr. Boldt, Sarah and a handful (yes a handful) of other nurses.  I slide from the gurney onto the operating table – there’s a big hole in the table in-between my legs.  My feet go into stirrups and my arms lay on these planks that make me feel like I’m running through the finish line of the Olympic marathon – they’re spread straight out from from my body.  They’re strapping my arms down as I feel the anesthesia hit my IV – three, two, one…

The next thing I know I’m waking up back in the room I started the morning in.  Ben’s already sitting there in the same chair he was when I left.  I crack my eyes to see him and say, “How many?”

Ben replies, “Five.”

I close my eyes and fall back to sleep thinking…”Five.”