10 Fabulous Follies!

This mornings appointment yielded even more good news - I have ten wonderfully growing follicles! TEN!

ohmyfuckingholyhellmindofficiallyblown

I'm not sure if the ultrasound tech was counting the left over cyst as one of the follies though, I had a new tech today and asked her about it. She was a really nice, positive and gentle tech but she tried to give me a bit of a lecture on how all follicles are cysts -_- I asked again specifically about the SIMPLE cyst, the opaque little circle, not the dark, clear follicular cysts, and she said it might have shrunk down so much that it looks like a regular follicle. I left it there but I just can't believe that I have 10 legit follies after being told I should never expect more than 3. It seems too good to be true.

They seem to be growing more slow and steady this cycle than they did last time. Last cycle they jumped from 13 to 19mm from CD 7 to CD 9, with a decrease in medicine, and this time the largest follie was still only ~16. This means I'm on the hook for at least two more days of stim injections but I think slow and steady growth is a good thing.

As I understand it, a mature follie is 18-20mm and several of mine were still 10-12mm. I know we won't be triggering until as many of them as possible are in that range. When Dr. Danzer called today he said he thought I might be on track for a Saturday trigger and a Monday retrieval, so my next appointment is Friday morning.

I've also read that larger follies are better quality in "younger" women (under 35) but poorer quality in "older" women (over 35). The big question is - do my ovaries make "young" eggs or "old" eggs? Do they act like 27 year old eggs or does the premutation make them older/poorer quality? What is the ideal size for 27 year old, premutation eggs? If they're all committed to growth, they should grow 1-3mm per day so that lead follicle could potentially be 22mm after two more days of stims. I guess we'll just have to see!

Cetrotide, Menopur and Omnitrope

In the meantime, it looks like I'll be enjoying my 4 injections per day for a little bit longer, including the wretched Cetrotide. Every time I inject it I dislike it more and more - this last shot was ridiculous, it wouldn't prime and I wasted a ton of drops and still had a bubble that wouldn't get out. I'm actually thinking of using a different syringe all together for tomorrow and just chucking the glass one that you're supposed to use. Definitely not worth the hassle.

Itchy Sitchy

Today was day two of adding in Cetrotide to my IVF protocol and I have to say it's not my favorite medicine. I've been pretty lucky to only experience a few side effects from the various meds but the Cetrotide is one of the most annoying.

Thus far, I've had:

• Head aches -  I can't tell if these are from the Menopur/Omnitrope or from the insane heat we've been having. I've only had two that were really unpleasant and I'm trying to drink a ton of water in case it's the heat since I can't take Advil
• Cramps - These I think are mostly from my period take two, the withdrawal bleeding you get after you stop birth control, but I've had twinges after every injection as well. They're more in my uterus than my ovaries so who knows what is causing it. My bet is on the Menopur. 
• Numb toe - This one is definitely the Omnitrope. One small section of my right big toe went numb, it was the weirdest thing. I had no idea it was a common HGH side effect.
• Sore joints - Again the Omnitrope. Mostly my right knee and it's only been a couple times, another common side effect.
• ITCHING - ding ding ding, we've reached the Cetrotide! The Menopur burns while you inject it, but the Cetrotide itches for at least an hour after. The problem is the itch is under your skin so you couldn't scratch it even if you wanted to scratch a fresh injection site. Gah. 

Tomorrow is day 9 of stims and I'm hoping these follicles are going to be nice and mature at tomorrows appointment. We only needed 9 days of stims for our last IUI cycle and thus far these follies have been tracking my last cycle almost exactly. Plus, my belly is covered in track marks and despite it's ample and expanding girth, I'm running out of injection sites!

Our protocol now looks like:

CD 1: Nothing
CD 2 - 14: BCPs
CD 15 - 17: Nothing
CD 18 - 22:  600IU Menopur (2 injections), 0.25cc Omnitrope (1 injection) and 1mg Dexamethasone
CD 23 - 24:  600IU Menopur (2 injections), 0.25cc Omnitrope (1 injection), 0.25 Cetrotide (1 injection) and 1mg Dexamethasone

We also need to get the saliva kits shipped out for my mother and sister. They need to be over-nighted there which I'm sure will run us at least $50-$100, and means I need to get them collected and shipped on the same day. This has been a bit more difficult than you'd think since we need to coordinate three schedules and collect samples on the same morning. It's on my to do list for tomorrow so hopefully everything works out.

In the meantime, all my energy is directed at those 9 follicles maturing in my ovaries. Come on follies, grow, grow, grow! I need good, healthy, mature follicles at my appointment tomorrow.

It's Time for Cetrotide

E and I got so much accomplished this morning! We had a really tight schedule and just managed to fit everything in before he had to go off to work but we got to check a bunch of things off our list. As usual, my first task was this mornings injection - 4 Menopur to the right of my belly button and 1 swallowed dexa. Couple that with a shower, feeding the poor starving cats and dogs (2 had been fed only 2 hours previously while the others hadn't eaten since dinner, you know, a lifetime ago) and we just barely made it out the door in time to get to our vial pick up.

Just like last time, CA Cryobank was perfectly prepared. Our vials were waiting for us in their filled transport tank and I was in and out of there in under 5 minutes. We confirmed our donor number, the number of vials we were picking up (3), and signed the paperwork promising to return the tank, a errand I need to remember in the next couple days.

With our pick up complete, we headed straight to SCRC. They were really, really busy this morning but their lab tech D was ready and waiting for me. He took the tank to hold on to so I didn't have to lug it around to different rooms and I went in for my ultrasound first.

Today is day 7 and I had to look back through my notes to compare apples to apples but it looks like we're in almost the exact same place this cycle as we were last cycle. We saw NINE lovely follicles, eight maturing together between 10-13mm and one that was just a bit under 10. I am thrilled to tears with these numbers, even if it's likely the 9th one may not mature in time for collection. It's still way better than I was expecting and I am so hopeful that these eggs turn into healthy, viable embryos. Grow follies, grow!

After the ultrasound I went to get my blood drawn and chat with lab tech D. D is awesome, he had all my paperwork ready for me to read over and sign for SCRC and Reprogenetics, the vials for my estradiol and PGD probe sample ready to be filled and he managed to hit the vein in my arm in one go. I was just resolving myself to do all my blood draws from my wrist but now that I know D is such a rock star, I will be sure to ask for him again. He got a direct hit, perfectly into the vein and had those 3 vials filled within seconds. I am so, so appreciative of good techs.

D is going to be sending out one of our donor vials and two purple topped vials of my blood out to Reprogenetics today. I haven't received the saliva kits for my mom and sister yet, so getting those and sending them out is next on my list of to dos.

I also got my marching orders for my medication and it is time to add in my Cetrotide injection. This brings my daily total up to 4 injections, and since I've already done my morning shot, unfortunately means I'll be doing 3 in one sitting. This messes up the careful balancing act of rotating injection sites that keeps me from getting bruised and sore, I was hoping to balance it out to 2 in the morning and 2 in the evening but once you start at a certain time they prefer you keep it at that time. Ugh.

I've been doing:

• 1 Menopur in the morning to right of the belly button with my dexa pill
• 1 Menopur in the evening to the left of the belly button
• 1 Omnitrope in the evening high and to the right of the belly button, though I have done the left once or twice

I've found that even if I do one shot high and one shot low on the same side, I end up having to pinch over a fresh injection site to get the other site which isn't fun. Since it looks like this injection is supposed to go into the belly as well, I'm thinking of maybe trying it lower, below my belly button and somewhere in the middle.

An injection site diagram. I use both Menopur sites every day and change up the HGH sites. I'm thinking the Cetrotide should go down at the bottom.

It's hard to believe that I'm running out of injection sites, especially given how large the injections are making my belly -_- I'll have to give it a shot (ha!) tonight and see if I can pick a good spot that doesn't overlap with any other sites.

Follies Ahoy!

Day 4 of stims and my ultrasound showed at least EIGHT follies! This is the best start to a cycle we've had yet!  And although I'm not getting my hopes up, the tech actually wrote 4-5 for each ovary, but I could only see 4 on each when I looked at the screen with her. Maaaaybe 5 on the right side, but she went pretty quickly. They don't measure each follie individually until they're bigger, mine were all under 10mm. They did all look about the same size though which is wonderful, I didn't see any lagging behind or pulling ahead. I forgot to ask my nurse what my estrogen level was since I missed her call and she left a voice mail, but I will definitely remember to ask next time. Until then, my marching orders are to continue with our existing protocol.

I didn't realize E had snapped this photo :) There are my 8 lovely follies, and my lining is 7.7!

I had the same phlebotomist this time as my last appointment, but I decided not to mess around and went straight for the hand. I told him about the bruising from last time and he agreed he'd rather go for the vein he knows he can get in one go, rather than poking and jabbing and bruising me again. It stung again but didn't leave a bruise and it didn't hurt nearly as much as being repeatedly poked.

Our next appointment for ultrasound and labs is Monday morning when I also do my blood draw for PGD and bring in my donor vial to be sent to Reprogenetics. Our clinic's lab guy said he'd rather all our genetic material go out at once so he asked me to let the clinic send the vial instead of having the cryobank send it directly.

Tomorrow I'm expecting my second package from IVFMeds.com and I NEED that package to come on time. Thus far it's mimicked the same delivery movements as the first package and it should be right on schedule for tomorrow morning. I've posted signs on the door for our postman to Not Leave without delivering the package, and there should be someone home all day. If the package doesn't come, I will be completely screwed and will have to rush to a pharmacy and get vials for the weekend. I don't think the Kaiser pharmacy is even open over the weekend so that package has to come on time.

Thinking positive, I'm so excited for those 8 follies. Sticking myself at least 3 times a day will be all worth it if this works!

Vials Ordered!

Today we were able to check off another thing on our IVF checklist - we officially ordered our donor vials! The doctor in charge of PGD at SCRC has started coordinating with Reprogenetics to get our genetics package ready to go. I was going to ask for a blood draw for PGD tomorrow when the phlebotomist is already doing a draw for estradiol but the PGD doc said no. He'd rather send all our genetic material at once, and since he doesn't want to ship our package on Friday, he asked me to come in and get it done on Monday. 

He's also ready for our donor DNA so we went ahead and placed an order for 5 vials. We're going to pick up 3 of them on Monday morning and hand deliver them to SCRC ourselves when I get the draw done. That way he can send our vial and my blood sample in the same package - I might even try to get my mother and sister's saliva samples in the same box but I don't know if the kits will come in time. The other 2 vials will be stored at CA Cryo in case we need them.

I realized I never got a good shot of the EU Menopur mixing needle so I snapped another shot this morning. This was the first batch I'd mixed entirely via needle and it did take longer than it does via Q-Cap. It also seems to get more bubbly which means I spent more time tapping out bubbles and waiting for each vial to settle. 

EU Menopur and mixing needle

The EU Menopur vials are the slightly larger vials with the blue caps. From left to right, you have the 3ml syringe, the mixing needle and the little injecting needle. The mixing needle is really flexible which means you can get into those corners to get every drop, but you do have to do a lot of wiggling and sucking to get everything.  More than once I ended up with bubbles on the bottom and had to empty the liquid back in, swirl and tap out the bubbles, and then draw everything back up. It takes awhile to mix a lot of vials. 

As for the HGH, I had good luck with the Omnitrope last night and managed to not bruise myself! I did my injection a little closer to my belly button and aside from the heat and soreness that night, there's no other sign of injection besides the tiny pinprick. I'm about an hour away from prepping this evenings injections and will hopefully continue the good luck!