Cycle 2 Trigger Time

I slept pretty poorly last night, which isn't a terrible surprise given my nerves, and didn't get to take full advantage of the time change and extra hour of sleep. I think I got up three times to pee (thanks hormones) and finally gave up on going back to bed around 7:30am. I had been worried about how I was going to take my morning meds since my appointment was at 8:45am, I usually start prepping my shot at 9 and inject around 9:25am, but I neglected to take into account the time change. With the extra hour, my shot clock was moved up to 8am and I was able to finish both injections before I had to leave.

My view from the ultrasound table

The clinic was pretty much empty with only a couple other people there for monitoring and I got in to do my blood in a flash. The lady tech was working today and she was able to get my arm vein in one go, giving my poor bruised hand a much needed break. She's gotten pretty darn good at finding that vein, I know certain techs have better luck with different patients, it's too bad she only works over the weekends.

After bloodwork it was on to the ultrasound, where I got to spend a few minutes waiting for the tech and admiring the fake sky ceiling tiles. When all these cycles are done and I'm good and pregnant,  I'd like to go back to Hawaii with E and enjoy some real tropical skies. I think we've definitely earned it and as long as it's safe to fly, I can't see any reason why a little bean couldn't bake just as well on the beach in Hanalei Bay as it can here at home.

The tech for this ultrasound was really thorough, I think she knew I was disappointed with the results we've been getting and she checked and double checked to make sure she wasn't leaving out any potential follicle that could be hiding. I'm still waiting to hear back from Dr. D with the results of my lab work, but from what the nurse said, it looks like we're going to be taking a stab at 4-5 follies - the 17, 20, 22, 22 and 26. Unfortunately the 26 is likely too mature to fertilize and the 17 is probably too immature but I'm not giving up on them just yet. We could still get 4 good eggs that turn into 4 good embryos to add to our batch.

12.6mm lining, nice and thick

My lining has also finally picked up which should be another sign that the follies are putting out a good amount of estrogen and it's time to trigger. I don't have the grapefruit sized ovaries feeling since I have so few follicles but I am still feeling bloated with the same weird temple pressure head ache I've had for a week. S says the pressure is dampness in my body so I'll probably ask her to put those needles in again when I go for my acupuncture appointment before retrieval.

Day 4: Acupuncture and Patience

Today, I'm finding it difficult to be patient. We don't get an update on our embryos and I know they're in the most difficult phase of growth where many embryos are often lost. Last we heard, four were doing very well with 7-8 nice, even blastomeres (cells) and two were growing nicely but a little slower with only 6 nice, even blastomeres.

On day 4, we need those embryos to be in the Morula stage, the last phase before they grow into blastocysts, form the blastocoel (fluid filled cavity) and start differentiating cells. Today, and possibly tomorrow if they're slow growers, they should have between 10 and 30 cells.  They might even have begun compacting like the embryo below, which is where the cells start squishing together like the embryo below.

Nice quality Morula

Hopefully they'll make it through the morula stage and grow into nice blastocysts tomorrow. If they're not quite there yet it's still okay as long as they're progressing. They'll be allowed to grow to day 6 when plenty of embryos are frozen and I probably won't sleep until we get the call. As blastocysts, they should be dividing into the inner cell mass (ICM), the Trophectoderm (TE) and the blastocoel (fluid cavity), which gets bigger as the embryo expands.

Nice Blastocyst

We need good cell differentiation to get a clean biopsy of the embryos for PGD. They need to sneak some cells out of the TE on the side there, the cells that will become the placenta, so we can test the fetal DNA for abnormalities.

Since there's nothing I can do to help my embryos grow, my distraction for today was a much needed acupuncture appointment. I haven't been since my retrieval and it's supposed to really help with recovery and the symptoms of OHSS. I laid down on the table, S took one look at my belly and said "Oh boy, you're definitely hyper stimulated". Clearly other people think I look 6 months pregnant too.

I already knew that I probably had OHSS but it's still a bummer to have it confirmed by a nurse. I also woke up sore this morning, my hamstrings and back felt like I'd worked out, and S said it's because of all the fluid I'm retaining. The fluid is responsible for my bloat, my repeated peeing, the heart burn and now the muscle soreness. Oh the joys of IVF.

Dr. D's nurse also called today to ask us about aCGH testing for our embryos and to see how I'm doing. I told her we'd probably base our decision for chromosome testing on the number of embryos we get, our lab doesn't really need an answer until they have all of our biopsy samples but as long as we get a good amount from each cycle I think we'll probably go ahead and add it on. If we only end up with a couple of embryos from each cycle, I'm not sure if it's worth doing, but if we get six lovely frosties each time I'd say it's worth the extra $2500.

As for next cycle and the crazy bloating, she said Dr. D usually takes a "flush" cycle in between IVF cycles to allow all the hormones to flush out of your system. It would also give me a good amount of time to order my meds from IVFMeds.com so I wouldn't be doing things so last minute. She made a note for Dr. D to chat with me about it tomorrow when he calls with our embryo update, so I'll probably be holding my breath until the phone rings tomorrow morning. I so, so hope our six embryos are doing well, I worked so hard for them and I won't be able to relax until they're safely biopsied and frozen.

Day 1: Fertilization Report

Dr. D called this morning to give us the news that we now have SIX wonderful looking embryos. I was getting kind of starry eyed there for a bit, dreaming about having 11 embryos, but I'm very, very happy with our six.

Out of the eleven, 3 ended up being too immature/small to fertilize, leaving 8 good mature eggs, and 2 of those 8 don't look fabulous after fertilization, giving us the 6. The six all fertilized quickly and easily and are looking really good thus far. Dr. D said getting 80% of the mature eggs to fertilize is very good and I'm really excited for these six. Our next report will be on day 3 when we should be seeing 6-8 cells in each embryo. 

Original Photo came from here

As far as recovery goes, I'm doing better than I expected. I heard all sorts of horror stories about people being in terrible pain after a retrieval and I've been extremely lucky that that hasn't been my experience. I took two Tylenol around 1am and went to sleep with my feet on a big pile of pillows to try and help the bloat go down. Aside from getting up at 1:30, 2:30 and 5:00am to pee, I slept pretty well.

When I finally woke up, it was to the sensation of cramping and stabbing, but in my stomach not my ovaries. My first thought was:

"oh nooooo, is this the god awful constipation everyone talks about??? Noooo do not want!"

Ten seconds later I realized they weren't. Nope. Not even close. They were actually hunger pains! Apparently my body has not caught up to the fact that it's no longer feeding 11 protein leeching follicles and I'm still starving and craving soup. I did end up being a little constipated later but it wasn't anything like people had described, it did not make me feel like my ovaries were going to die and fall out, so clearly guzzling all this water is helping.  I'm averaging somewhere between 100-150 ounces a day of PH/electrolyte water, 2-3 of the big bottles from Whole Foods, and I have a couple more left to get me through today. 

I took two more Tylenol around 9am just in case and Dr. D told me to take it easy today. Since I inhaled all the Matzo ball soup E brought me yesterday, my first trip out of the house was to Factor's Deli to get two more Matzo ball soups. I'm pretty sure E thinks I'm a little crazy but it's nice to be craving the stuff I'm actually supposed to be eating. Clear, salty broth and protein is exactly what the doctor ordered, and as long as it continues to help, who am I to disagree?? 

11 Good Eggs!!!!

I had my retrieval this morning and the doctor was able to retrieve 11 good eggs! Yes! I'm so proud of my ovaries right now, take that FXPOI!

I know everyone's egg retrieval experience is different. Before going in for my procedure I read as many first hand accounts as I could, and I still wasn't sure what to expect. It's a little after 7pm now so it's still early but my good drugs have worn off from the retrieval and thus far I have to saw it hasn't been so bad.

We ran a little late in the morning but I still checked in about 50 minutes before my procedure. I had run a wash the night before and apparently E's jeans had gum in them - gum which got all over my lucky rainbow panties. I was not thrilled but opted for a pair of blue starfish undies to match my blow fish socks.

Puffers!

Once there, I turned in my paperwork for SCRC and they had me fill out another huge stack of paperwork for the surgery center. I thought I was coming in fully prepared with my three massive packets but apparently there's always more paperwork!  After signing about a million consent forms and handing over our credit card for ICSI and the biopsy, I made the mistake of going pee. I drank SO MUCH electrolyte water yesterday to try and stave off constipation that I'd been peeing like every 10 minutes. I asked the paperwork person in charge if there was anything else she needed from me and she said no, so I figured great, let's go pee now so there's no chance of my bladder getting in the way of the retrieval. I've hard about people needling a catheter when they go in with a full bladder and I was Not going to be one of them. Apparently, this was the wrong move.  I was supposed to pee in a cup, probably for an unnecessary pregnancy test, but there was nothing I could do at that point. Whoops.

After my potty faux pas, I met the nurse who would be taking care of me during my retrieval. She was very friendly and assured me that the lack of pee wouldn't be a problem. She took me back to the recovery room, took my vitals (my blood pressure was high, I was a bit nervous) and had me change into a gown, which I accidentally put on backwards and had to change. That thing was huge! I met the anesthesiologist, we went over my latex allergy and allergy to all the fun drugs and I decided to stick with Tylenol and later Advil instead of getting a script.  Then the nurse brought in E to sit with me and hold my hand which I so appreciated. I felt a lot better with him there even if he couldn't do anything but provide emotional support. 

A few minutes later it was time for my IV, which came with the usual numbing injection that burns for a second and the large IV needle which aches in spite of the local anesthetic. It wasn't bad though, she got it first try and Dr. Danzer came over to see how we were doing. I had my blow fish socks on, ready to dispense some good luck, and Dr. D decided to take me a little bit early since everything was good to go!

I said goodbye to E and they wheeled me back in to the procedure room. They had me scoot onto the surgery table and I was able to chat with the nurses about the centers preferred method of embryo culture. They must have given me the general around that point because that's the last thing I remember before waking up back in the recovery room maybe 20 minutes later. 

Egg Retrieval!

I've been under anesthesia a couple times before and have never had unpleasant side effects or difficultly waking up. I pretty much pop awake, fully alert, and this time was no different. I chilled for awhile, kind of feeling myself out, waiting for my nurse to come by, and once she saw I was awake she brought me E for company and a couple Tylenol. I don't know how useful Tylenol is for most people, but for me it does nothing. My ovaries were still feeling pretty sore and tender 10 minutes later and they don't like you to take Advil right after the retrieval, so the nice anesthesiologist brought me some Fentanyl for my IV. One small dose did the trick, it dulled the achey soreness to a completely bearable level, and a couple minutes later I was good to go.

E helped me back into my clothes and they brought me a wheelchair to chill in while E brought the car around. We gave him about a 10 minute head start, they wheeled me down, E helped me into the car, and we were home free! I was, as expected, starving so I placed an order for a massive amount of food at our local jewish restaurant/deli. As far as I'm concerned, Matzo ball soup is definitely Jewish penicillin and it was the first thing I wanted.

E dropped me off at home, got me situated in bed and then went to pick up my lunch. Almost immediately, I had to pee AGAIN, for the millionth time. This was another thing I was worried about - a lot of people report that the first pee after a retrieval is really painful but for me it really wasn't awful. My bladder kind of ached for a few seconds in a way I wasn't expecting, almost like the feeling of pressure, but I was basically just peeing out all the water I've been chugging and that was it. I've probably peed at least 8 times since coming home, drank another 100oz of water, and the slight bladder ache is mostly gone.

I was planning on taking it easy on the food since I'm still worried about constipation, but I devoured lunch like a starving person. The entire container of Matzo ball soup disappeared, along with some bagel chips and half a French Dip sandwich. I thought I'd have a little soup, relax some, drink water and maybe have more soup later, but I devoured the whole thing in one sitting like a beast. Then I kissed E goodbye, he headed off to work, and I promptly feel asleep with my full belly, not to be awakened until several hours later by my once again protesting bladder.

This is someone else's soup because I was too busy shoveling mine into my face to take a photo. But it was from Factor's Deli and it was delicious!

I've been up now for a bit and feeling mostly fine, just a little tender. I'm trying to be a good patient this go round so I just took more Tylenol instead of the Advil I'd really like to take. The tenderness feels like an ache as opposed to cramps or sharp pain, but it does make it difficult to bend over and get up. All in all, I'd say I've been pretty lucky so far.

Side Effects:

• Tender, sore ovaries/belly/uterus/lady bits 
• The backs of my hands and the front of my knees were weirdly sweaty, probably from the anesthesia or fentanyl
• Sore throat, probably from the anesthesia, but I wasn't intubated. I hope I'm not getting sick!
• Some really, really minor bleeding, like barely any when I wiped twice, along with some of the gel from the ultrasound probe
• Hungry like the wolf 
• Sleepy
• Bloating - this supposedly wont go away for about a week
• No constipation yet, but who knows with the amount of food I just inhaled ><

Tomorrow morning  Dr. D will be calling with our fertilization report and I am hoping/praying/wishing that all 11 good eggs fertilize perfectly. About 6 hours after the retrieval, while I was snoozing away, one of the SCRC embryologists was fertilizing my eggs via ICSI. Dr. D joked about it being a bit of a beauty contest and said that the embryologist would pick the absolute best looking and swimming sperm he could find from our sample.

ICSI!

It's officially out of my hands now so the only thing I can do is wait and hope and trust in the skill of their embryologist and the quality of my eggs. 

Grow healthy and strong little embryos, you're so, so very wanted!

Getting Ready For My First Egg Retrieval!

According to this mornings blood draw, the HCG trigger was properly absorbed and I'm good to go for a Monday morning retrieval! I'm so excited/nervous/bloated/sore/tender that I don't know what to do with myself. Time seems to be crawling and flying by at the same time and I still can't button the jeans that were falling off my ass a week ago.

I never understood what people meant when they talked about sore ovaries and IVF bloating until now. I guess I never made enough eggs in my previous cycles for my ovaries to swell up like balloons but they're definitely there now. I'm not concerned about serious OHSS (Ovarian Hyper Stimulation Syndrome), it's definitely a mild case, but I look like I'm at least 6 months pregnant, it hurts to bend over and my lower back is tender too. I'm also peeing like crazy since I need to keep guzzling water to ward off OHSS. 

Mild OHSS usually comes with the following, per Mayo Clinic:

• Mild to moderate abdominal pain that may come and go - Check!
• Abdominal bloating or increased waist size - Check!
• Nausea - Check!
• Vomiting - No, thank goodness!
• Diarrhea - No, but I'd take it over the projected constipation O_O
• Tenderness in the area of your ovaries - Check!

Things don't get dicey until the pain and nausea/vomitting turn severe, you get dizzy and you start packing on 10lbs per day. While I probably look like I've gained 10lbs per day,  I'm definitely still in the normal-mild category. I'm ready to get these eggs out though so we can make some beautiful embryos!

Our trigger for this cycle was Novarel, which contains 10,000 units of HCG, way more than the 1,000 units in my last trigger, Ovidrel. Just think of the positive pregnancy tests I could get with this much HCG running through my system!

Stock photo since I used mine last night

I'm unclear as to why the manufacturer felt the need to include such a huge bottle of diluent. Even splitting it into multiple doses, I can't imagine any circumstance that would require 30mls of liquid. Since I was taking the whole dose, I used just 1cc of liquid with the powder and injected it into my belly at exactly 10:45pm.

Like the Menopur, this one is definitely a stinger. It burned going in and unlike my other injections, has had a lasting effect. My skin is red, hot, and tender even 18 hours later and I can't stand anything touching it.  Major ouchies.

I try to avoid posting photos of my bare flab, especially crazy bloated bare flab, in public places but I figured it was better to be honest about the reaction so other people know what to expect. The photo ended up washed out, but my reaction is red/purple, streaky, raised and hurts like a bitch. But again, it's unfortunately normal.

Since my retrieval is only hours away, I'm trying to get everything ready tonight. You're supposed to drink large quantities of sport drinks like Gatorade or Powerade, but since I'm not super into those, I'm going for PH water and other electrolyte infused waters. They're supposed to help flush the hormones out of your system so the OHSS symptoms don't get worse and go away quicker. You also have to watch out for super constipation from the anesthesia which I'm really, really hoping to avoid. That sounds like the last thing you'd want when you have tons of needle holes in your lady bits and ovaries.  I'm hoping tons of regular water, PH water, watermelon and soup are enough to ward off that unpleasant side effect.

I'm also prepping soft, stretchy clothes to wear tomorrow since my jeans feel awful and tight. I've got my lucky panties, rainbow cheetah print trimmed in hot pink lace that I've worn to all my IUIs and I'm thinking of upping the ante with new blue, puffer fish toe socks with googly eyes and pink glitter shoes. Now that's a lot of good luck :)

Since I'm still crazy hungry despite the incredible bloat, I think E and I are going to get some meaty take out for dinner. I'm craving steak like nobody's business and once midnight comes I'm cut off from food and water. 

Please send all the positive vibes, thoughts, prayers, and energy you can muster my way tomorrow morning. I've got everything crossed for these follicles to contain healthy, mature eggs that fertilize perfectly and turn into healthy, viable, Fragile X free embryos. I know that's a tall order but come on follies, I know you can do it! We need some healthy blasts!

Trigger Time!

I'm so excited, the follies look absolutely wonderful! I woke up this morning feeling bloated, tender and sore so I knew my ovaries must be ready to pop, especially that right one. A quick ultrasound confirmed that I still have 9 follies on that right side so no wonder I'm sore. I took my 4 vials of Menopur before my appointment and immediately felt it, plus I look like I'm about 6 months pregnant and I'm too tender to bend over @_@

There were so many follies there that it took the tech a bit longer to measure each of them, but the scan showed the fabulous fourteen were in prime condition, with 9 synched up, mature and ready to go. They looked like a bunch of overlapping grapes, I was really impressed she was able to keep track of them at all.

Fabulous Fourteen Follies!

Our doctor was really pleased too. He said that day 12 was the best day to trigger for the best quality embryos and we are likely to have mature eggs in at least the nine out of fourteen, 21, 20, 20, 19, 19, 19, 19, 19, 18, 16, 15, 14, 13, 12. Numbers 14, 15 and 16 might have mature eggs as well, but we aren't counting on that since they were later recruits.

My retrieval is going to be Monday morning at 10:45am so I am triggering tonight at exactly 10:45pm. I have my Novarel ready to mix up and I'm so glad I only have one shot this evening. I also have a double check appointment tomorrow to run labs and make sure the HCG was properly absorbed into my system and I'm trying to squeeze in an acupuncture appointment afterwards. You're supposed to do a back treatment on your ovaries before a retrieval, but since my acupuncturist S is out of town, I need to get in and see one of her coworkers. 

After over 2 years TTC I can't believe we're actually getting ready for our first retrieval. I am so hopeful and excited and jittery, I just know these embryos are going to be good!