IVF: The Unnerving Process of an Egg Retrieval

After months of trying superovulation to get pregnant without having to fully enter the world of IVF, we came to the conclusion that IVF was the right path for us. Month after month, the pregnancy tests came back negative. Month after month, hope built up just enough to be crushed all over again. Eventually the pain of failure outweighed everything else, and we decided it was time to officially pursue IVF.

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Beginning IVF was a hurdle in itself. As I mentioned in our previous article, we were handed a packet of programs to sort through, and the moment we settled on the one we wanted, we were told we didn’t qualify. Not because of anything we’d done. Just because my overall egg count came back slightly lower than normal. The doctors brushed past it like it was nothing, like the only real takeaway was that we should get started now. But it meant we didn’t qualify for the covered plan, and we had to go with a secondary option we didn’t want. Another gut-punch on top of a process that was already asking so much of us. Still, in the end, it worked out. We got pregnant on our very first round of IVF.

Prepping for the Egg Retrieval

The first stage of IVF is the egg retrieval. What I didn’t understand going in was that this is an invasive surgery, one that requires you to go under anesthesia, even if briefly. Prepping for it is similar to superovulation, except instead of coaxing your body into releasing two or three eggs, the goal is ten to fifteen mature ones. A great retrieval can pull fifteen to twenty-five. They aim high on purpose, because only 70 to 80 percent of retrieved eggs turn out mature enough to fertilize. Of those, another 70 to 80 percent will actually fertilize. And of those, only 30 to 50 percent will develop into a viable day-five embryo, a blastocyst, the kind that can even be tested for transfer. Then there’s one more filter waiting at the end: only a fraction of those blastocysts come back euploid, meaning genetically normal and safe to use.

So yes. It is a stressful, painful numbers game from the very first step, and every one of those percentages sits in the back of your mind while you wait.

To get there, you effectively become a human pin cushion. For two weeks before the retrieval, Michael injected me with hormones, and I made three separate trips to the clinic to make sure everything was tracking the way it should. Every morning I took a Gonal-f shot along with Menopur, which I had to mix myself, and in the final days before the retrieval, more hormone shots were layered on top. One had to go into my stomach each morning, and my medication schedule was aggressive, exact, with no room for error. Some shots stung more than others. Some left my skin irritated and itchy for hours. None of them were something you get used to.

Then, exactly 36 hours before the retrieval, I was told to take the trigger shot, timed so I’d be going into surgery right as ovulation began and my eggs finished maturing. From that point on, there was no more adjusting. The clock was already running.

The Retrieval

Someone has to drive you to the retrieval and stay with you while you’re under anesthesia. Michael took me in, dropped off his sample, and then I was sent back, changed into a hospital gown and a pair of grippy surgery socks, and settled into a chair to wait.

They gave me a light pre-sedative after I signed the paperwork. Then my anesthesiologist came in. Her name was Coffee. I couldn’t help but laugh at the irony even through the nerves. She asked a few quick questions to figure out my dosage, and by the time they wheeled me back, I was calm enough to go. I hadn’t been under anesthesia as an adult, so I sat there quietly panicking right up until the sedative kicked in. Then, three seconds after I settled onto the table, I was gone.

Waking up was slow and foggy. I barely remember the transition back to my recovery room. My sister, who’d come to drive me home, was brought in to help me get dressed. That’s when the surgeons came to tell me the number: five eggs retrieved.

Five.

We’d seen more than ten in the pre-screens. The target was closer to fifteen. Five felt like a quiet kind of failure, even as the nurses assured me it was completely normal and that they’d call soon with more. I remember feeling hollow. Exhausted. Ready to just close my eyes and stop thinking about numbers for a while. The retrieval is invasive enough that they send you home with oxycodone, and that night, when the pain caught up with me, I took it.

A Semi-Frightening Numbers Game

The next week was its own kind of endurance test.

The day after the retrieval, they called: of the five eggs, four were mature. Right on the odds. Of those four, three fertilized. Also right on the odds. Then came the part I couldn’t control at all: how many of those three fertilized eggs would survive to become a day-five blastocyst? The statistics said 30 to 50 percent, which meant, in theory, one or two. But I’d spent hours on Reddit reading account after account of women with three fertilized eggs and zero blastocysts to show for it five days later. And others where all three made it. There was no way to know which story would be mine. Waiting five days for something completely outside my control felt like standing at the edge of something and not being able to look away.

Then the call came. Two of our three fertilized eggs had become blastocysts, and both were being sent off for genetic testing. If they came back euploid, chromosomally normal, they’d be cleared for transfer.

If the wait for blastocyst results had been hard, the wait for genetic testing was worse. Two full weeks. Two weeks knowing that only 35 to 40 percent of blastocysts from women my age come back euploid. The only thing keeping me steady was that one of our two, graded a 5-day AA, the highest grade possible, gave us a sliver of real hope. But a good grade isn’t a guarantee. Nothing was going to feel real until the phone rang.

After two of the longest weeks of my life, it finally did.

Our 5AA embryo was euploid. The other embryo’s results weren’t definitive, so just like that, everything we had came down to one. One embryo. One shot. The doctor asked if we wanted to know the gender, and told us: a boy. She also told us that from here, the odds of successful implantation were roughly 70 percent.

Here’s our breakdown if it helps to see it this way:

We had 5 eggs retrieved.

Of those 5 eggs, 4 were mature.

Of those 4 mature eggs, 3 fertilized.

Of those 3 that fertilized, 2 made it to day-five blastocysts.

Of our 2 day-five blastocysts, 1 was euploid.

Now, with 1 egg, we had a 70% chance of him successfully implanting in the embryo transfer, though most people I spoke with told me that every other transfer was successful for them, making it seem more like 50% odds.

After all the math, all the waiting, all the shots and appointments and sleepless nights refreshing Reddit for someone else’s story that might predict mine, there was still one hurdle left: the transfer itself. Every hope we had was now riding on this one little embryo, the one we’d already started calling Tristan. As my doctor put it, plainly and without ceremony, “It only takes one.” So we held our breath, I threw myself into researching every best practice I could find for embryo transfers, and we began preparing for the next step.