It’s one thing to read a summary of what happens during egg freezing or IVF, but we’ve found it’s often more helpful to read an honest, personal account of what every day of a treatment actually feels like. When Ovally founder Kathy froze embryos in Spain, she blogged about it every day – below is an unedited version of what the “stimulation period” was like for her, when she was giving herself daily injections of follicle-stimulating hormones. Even though everyone’s experience is slightly different, we hope that this will make the procedure more tangible:
Day 0 – the first appointment:
Greetings from Madrid! I’ve made it and had my first appointment yesterday a few hours after landing from San Francisco. I met with my doctor in person for the first time (I’d already talked to her over video chat), and we went over my treatment plan and some remaining paperwork. She did a “transvaginal” ultrasound to make sure my ovaries and follicles are looking good to go (these are similarly uncomfortable to pap smears, except without the scraping), and I gave some blood for a few last tests. Luckily everything looked fine, though I’m nervous about having enough eggs to mature. I also got a tutorial on how to inject myself with the hormones, and picked up the medication at a nearby pharmacy. I’ll start giving myself injections tonight.
Everything went smoothly at the doctor’s office, and luckily it was easy to find by subway in my jetlagged fog. I definitely had a moment of “what have I done, doing this procedure in a foreign country?!”, but as soon as I actually arrived at the office and met with the doctor, I calmed down. I was expecting to be rushed more during my appointment, and it was nice when the doctor took her time to learn more about me. The jetlag hit me harder than expected after landing at 7am and not sleeping much on the plane, but I did get to wander around the old town a bit and have some really tasty tapas. Below is the view of my Airbnb.
Day 1 – the first injection:
I did it! There was definitely some trembling with clammy hands, but injection #1 went in two hours ago, and so far I’m really relieved to be feeling fine. I injected the follicle-stimulating hormones close to my belly button (you want to pinch a bit of fatty tissue around there), and it hurt a little when the needle first pierced my skin and then for about 30 seconds right after I pulled it back out. There’s only a tiny red dot visible at the site of the injection now. I’m feeling no effects so far and hope it stays that way.
The other exciting part of my day involved a trip to Segovia, a historical town just north of Madrid with a surprisingly well-preserved Roman aqueduct from 50 A.D. (!) that used to transport water from a river 11mi away in the mountains to the town.
Day 2 – no news is good news:
Didn’t feel any effect of last night’s injection today and hope it stays that way as the daily shots continue. The second injection went in even more easily and painlessly tonight. Wandering around Madrid in December has been surprisingly beautiful.
Day 3: Everything’s still calm
I’m still not feeling any negative effects of the injections and am not experiencing any bloating at this point. I hope everything’s going well, and my eggs are growing despite me not feeling anything. I’ve been exploring different neighborhoods and parks in Madrid.
Day 4: More shots
I did injection #4 tonight at the usual time (it has to be at the same time every day) and am still not feeling any effect. We’ll see what the doctor says tomorrow about my follicles – hopefully they are growing. I’m wondering how much expectation setting plays a psychological role. I’m typically sensitive to medication and expected to have some level of negative side effects.
Below is a picture from my day trip to Toledo, another UNESCO World Heritage site and the “City of the Three Cultures”, where the cultural influence of Christians, Muslims, and Jews is reflected in much of the architecture.
Day 5 – appointment #2, the egg reveal
Had my second doctor’s appointment this morning and was much more awake for this one compared to the last (thanks, jetlag, for disappearing!). We did the second ultrasound to see how my follicles are responding to the stimulating hormones and reviewed the results of my blood tests. Apparently a few values that strongly correlate with stress and lack of sleep were off but acceptable under the circumstances. Phew.
I was nervous about the ultrasound, but when the doctor turned the monitor my way during the ultrasound, I could actually see the follicles! They were little black blobs that had indeed been getting bigger since last week. We counted 8 enlarged ovarian follicles on one side and 9 on the other, so there are 17 eggs maturing right now. Since it’s only day 5, there’s a chance even more will respond to the stimulating hormones.
I’m happy with 17 eggs and had been hoping for at least 10-15 eggs to freeze given the statistical likelihood that an egg will turn into a baby is about 5-10%. Of these 17 eggs, only a small number will turn into viable embryo(s) that we’ll freeze: Once they’re retrieved from their follicles, some eggs may turn out not to be fully mature, some may not be of good enough quality to become fertilized, some may not survive the first few days of development to become blastocysts, and others may not have the correct number of chromosomes, which we’ll detect through genetic testing.
The doctor told me that I could expect some bloating as the follicles continue to grow. My likely retrieval date will be a week from now if the follicles continue to develop at their current pace. I didn’t love doing tonight’s 5th injection – had a mental block pushing the needle in -, so doing this for just another 6 days sounds good.
In other news, my husband arrived from San Francisco today! We’ll be back at the doctor’s office for his appointment tomorrow. The winter weather in Madrid continues to be really nice, so I’m including a snap of the city’s holiday vibes below.
Day 6 – did I do too many sit-ups?
When I was leaning back or sitting down in tight pants today, I started to feel some discomfort around the area where I usually feel cramps. The discomfort isn’t like cramps, but it feels more like slight soreness, as if I’d done a few too many sit-ups. My tightest pair of pants is also feeling tighter than usual.
The likely explanation is that I am starting to feel the growing follicles a little, even if there’s no visible bloating at this stage. Immature ovarian follicles are about 3-4mm in diameter, the size of small green peas that each contain an egg the size of a small grain of sand. During a typical cycle, one of those follicles grows to be 18-25mm in diameter, at which point the mature egg inside of it is released during ovulation. Instead of one of those follicles, I now have 17 follicles growing to be 18-25 in diameter, the size of large grapes.
Our appointment at the clinic this morning went well – we completed some more paperwork (consent forms for genetic screening), and my husband gave some blood as well as a sample for a spermogram. The spermogram will double check certain indicators like volume, chemical makeup, and the morphology of his sperm, to make sure everything’s healthy and will happily unite with my eggs once they’re retrieved. He’ll have to provide a fresh sperm sample once my eggs are actually retrieved.
Day 7 – it’s starting to get real
Ultrasound #3 happened this morning, and the follicles keep growing (the black blobs in the photo below are some of my actual follicles). They’re now at an average of 12-13mm, growing about 2mm per day, with the goal of getting to about 20mm in diameter. This means my egg retrieval may happen as early as 4 days from now. I’ll have another ultrasound the day after tomorrow that’ll tell us how close the follicles are to being fully mature.
Since the follicles are getting closer to their mature size, I’m now doing a second injection in addition to the follicle-stimulating hormones. This second shot contains an antagonist to gonadotropin-releasing hormone, the hormone that triggers ovulation. This antagonist prevents any follicles from ovulating and releasing their eggs – we don’t want any mature eggs to escape! It also looks like there might be even more than 17 follicles maturing – the more, the better, as long as they’re good quality.
I’m still feeling fine physically and emotionally – being on vacation is definitely making me feel more relaxed. I switched from tight pants to wearing a skirt and now don’t feel any discomfort when sitting down. I’m definitely a little bloated, and clothes fit more tightly around my lower torso.
My husband’s blood test and spermogram results came back looking good, which is great news for both of us (though we promise we would’ve written about it here had there been some bad news – there should be no stigma around fertility issues)!
Day 8 – skirts are still my friends
I’m still feeling fine and just sore when I lean back in a certain way or sit down. I’m still wearing skirts, which is way more comfortable given the bloating around my ovaries. I might be a bit more tired, though it’s hard to say if that’s only due to the hormones/growing follicles. The second injection that prevents ovulation stings quite a bit when it goes in and continues to do so for a good 20min afterwards; I’d say that’s been the most uncomfortable part of the treatment so far.
Day 9 – finally becoming a side sleeper
We went in for ultrasound #4 today, and it looks like the retrieval will happen on the original planned date, after all. The doctor thinks more eggs will be fully mature by then compared to only two days from now. I’d hoped for an earlier retrieval but will take a larger number of mature eggs in exchange for another day of discomfort.
Speaking of discomfort, I love sleeping on my stomach, which I hear is bad for your back, and have tried unsuccessfully for years to change positions. Thanks to these grape-sized follicles, I’m becoming more of a side sleeper, as lying on my stomach now puts too much pressure on the bloated areas – trying to look on the bright side. Sometimes the bloating is now associated with a little cramping, but it’s short-lived. With that, I’m off to do my two daily injections. The second one that prevents ovulation typically burns a little according to the doctor, by the way.
Madrid is starting to feel really familiar, which is great – went back to the Crystal Palace today to check out some of the art inside and love the little independent stores all over the city.
Read about the trigger shot and retrieval in the next post.