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.

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!

Another Win for IVFMeds.com

I woke up before my alarm this morning, worrying even in my sleep about my meds being delivered. I checked the tracking first thing but it hadn't been updated at all since the package landed in New York. Uh oh.

I got everything ready to start prepping my morning shot and got USPS customer service on the phone. The rep was very nice but had absolutely no new information - all she could see was the same tracking page I was already looking at. I told her the package contained time sensitive medication that I needed for the weekend and after a 2 second pause she told me the package wasn't going to make it and I should look into getting my meds locally. Double uh oh.

So here I am, trying to mix my Menopur via needle and figure out what to do. I called Kaiser first since they had a valid prescription on file for me - no answer. I forgot that they changed their pharmacy hours and they're no longer open over the weekend. My next call was to Rox San pharmacy, the pharmacy my clinic deals with most often, where I left the most scattered voicemail ever:

"Hi, my number is...I mean my name is S, I'm a patient over at SCRC and I ordered my medication online but it looks like my package has been delayed. I don't have enough meds to get through the weekend...I'm supposed to take 8, I mean a day...so I need to pick up a couple boxes of Menopur. I should probably get my Novarel too....My name, I mean my number, is blah blah, sorry I'm super scattered today kthanksbye"

It's not easy to use a cell phone and keep your field sterile and I kept accidentally sticking the mixing needle through the side of the rubber stopper. Oy. The next call was to SCRC where I left a message for the weekend nurse since no one was picking up. This one wasn't as scattered but you could probably tell I was freaking out a bit because both the pharmacist and the weekend nurse called back a few minutes later. The pharmacist was calm and kind and told me she could get in touch with the nurse for me and have my meds ready asap. It was about 9:30am now and they closed at 11:30am so we would need to move fairly quickly. A minute after that, the nurse called back and said she was sending over a script for 15 vials of Menopur and the Novarel. I was finally able to take my injection and ten minutes later the pharmacy called to say my order was ready.

Now here is where things got muddy again. I was all ready to go and pick up my Menopur when I get a tracking update that my package has landed in Los Angeles at the big sorting facility. Thus began the debate - do we go and buy the Rox San meds? Do we wait and hope the package makes it to our local post office and out for delivery before they close? The package was running several hours behind the first one which had made it to our local post office by 9ish. It was now almost 11am and it still wasn't there. Do we risk botching the entire cycle and have to cancel? No.

We decided it wasn't worth the risk. Rox San wasn't open on Sunday and this was my only chance to get my medication locally so we went ahead and bought more meds. Three boxes of Menopur,  one box of Novarel and needles/syringes ran us $1250 that I hadn't planned on spending this month. Ouch. But now we were prepared, I had enough meds to get through the weekend and if the package didn't come till Monday I would still be okay.

The pharmacist who packed my order at Rox San gave me this lovely hand carved jade pendent for luck. I'm sure they give them to all their infertility patients but it still made me feel all warm and fuzzy. I can't help but appreciate the little things like this and the way they can brighten up even a crazy stressful day. 

1pm rolls around and our local postman pulls up with no package. He double checked everything and said that he usually receives express packages in the morning. They never make deliveries in the afternoon. He definitely hadn't received anything for me, so I shouldn't expect the package till Monday. Again I felt okay about our decision, we had made the right move, the package didn't come so we'd covered our bases. I bet you can see where this is going.

2:30pm rolls around and there's a knock on my door. Oh hey, look at that.  It's another, different postman. He has my package. Safe and sound and delivered as expected, given that it was shipped out two days later than expected.  Oh man. So now I have the whole IVFMeds.com order, each package was shipped on Wednesday and delivered on Saturday and I just spent $1250 on local meds. Whoops.

I probably would have felt worse if the stakes weren't about 20k high. Cancelling this cycle would mean we were out what we'd already spent plus all the medication, so I'm glad we covered our behinds. I'm also looking into the offer the IVFMeds customer service rep made to reimburse me the difference in medication costs since they knew my package was shipping two days late. I'm not sure if they'll still honor it given the circumstances, but I'll give it a go. I had to bump my protocol two days anyway to accommodate the shipping time which I know not everyone can do and I had 15 vials of local Menopur to offset it. We'll see what they say on Monday.

Day 5 of injections is now complete and it looks like everything ended up working out. I will definitely be ordering from IVFMeds.com again, but with a little more wiggle room for shipping. Four days really does cut things a bit close. Their customer service has been amazing thus far but I'd like to have my meds in hand a couple weeks before my second cycle so I don't have to repeat this crazy stressful process.