Where NOT To Inject

When I added Cetrotide to my IVF regimen, I was running out of usable belly space to inject. I made the rookie mistake of starting with one morning injection and two evening injections when my morning appointments take place After my morning injection is done.

This means that any changes, including additions, would need to be made to the evening injections, leaving my meds unbalanced. It wasn't the end of the world doing three injections at once but I did end up picking an injection site you should never touch because I was out of space.

Do NOT inject below the belly button!

I know there are acupuncture points all over the belly but somehow I didn't make the connection between those points and my injection sites. Duh. The second I put the Cetrotide needle in below my belly button, I felt a zing, saw stars and knew it was the wrong place to inject. Ouchie.

I asked the acupuncturist about it the next time I saw her and she told me there's a point you should never touch in women about 2.5 - 3 fingers below the belly button. The location is measured with your individual fingers since everyone's fingers are different sizes.

Fertility Points, I'm not sure if the "Don't Touch" point is one of these

My Menopur sites were good, they fall between the Zigong points and Ren 6 point so they're okay to inject. My Omnitrope points were okay too, they were outside the Ki 16 points so also in the clear. The Cetrotide injection might have been okay if I'd done it a little lower but there's a meridian line that runs straight down those points and I should have just avoided the whole area entirely. I somehow managed to hit a point twice and it hurt each time, definitely not worth it. 

For next cycle. I'll take my Omnitrope in the morning with my first Menopur injection so I can use the other Omnitrope site for the Cetrotide when it comes time to add it. This should keep things more balanced so I won't have to do so many injections at once and I shouldn't run out of injection sites.

I Can Wear Pants Again!

Yes! I woke up this morning and the water retention in my abdomen has gone down enough that I can wear pants with buttons again! At the height of the water retention it was really firm like I had swallowed a balloon and was about to explode. It's now much more squishy, like my regular belly chub, and it seems to be going down in sections. My lower abdomen is now squishier than my upper abdomen which looks a little weird but when it comes with pants with buttons I'll take it. I don't have a problem with wearing yoga pants every day but it's nice to have other options.

It's been a full week since the retrieval and I'm feeling pretty good. I don't need any painkillers, have no immediate appointments scheduled so I'm basically just siting around waiting for my period to show up. She always shows up when I don't want to see her but when I need her so I can get a move on with next cycle, she's nowhere to be found. It's still early, my luteal phase is on the short side at 11-12 days and it's only been 8 if you count retrieval day as ovulation. Le sigh, another exercise in patience.

One symptom that is sticking around and took me forever to figure out is the metallic taste in my mouth. I just had my teeth cleaned, I have no cavities or fillings, I'm brushing like 3 times a day, flossing and using mouth wash and it still tastes like I've been sucking on coins. This one didn't show up until a couple days ago and it's been driving me nuts ever since. It finally clicked for me that a metallic taste is a pregnancy symptom, which means its the HCG trigger. Damn that thing, still screwing with me over a week later.

In the meantime, I decided to celebrate my pants fitting by making them tight again with an absolutely delicious apple crumble with french vanilla ice cream. Oh man.  I used this base recipe because it's easy and delicious and then made a couple tweaks.

Their pretty photo

My version involved the following changes:

Ingredients: 

• 10 cups all-purpose apples, peeled, cored and sliced - about 8 apples for me. I only had Galas and a couple Fujis but would prefer Granny Smiths.
• 1 cup white sugar - I didn't use sour apples so I cut this down to 2/3
• 1 tablespoon all-purpose flour
• 1 teaspoon ground cinnamon - doubled this to 2 teaspoons
• 1/2 cup water - halved this to 1/4
• Add 1 tsp Vanilla
• Add 1 tsp Nutmeg 

• 1 cup quick-cooking oats - doubled to 2, Bob's steel cut oats
• 1 cup all-purpose flour - doubled
• 1 cup packed brown sugar - doubled
• 1/4 teaspoon baking powder - doubled
• 1/4 teaspoon baking soda - doubled
• 1/2 cup butter, melted - doubled
• Add 1 tsp Cinnamon 

Directions:

1.	Preheat oven to 350 degrees F (175 degree C).
2.	Place the sliced apples in a 9x13 inch pan. Mix the white sugar, 1 tablespoon flour and ground cinnamon together, and sprinkle over apples. Pour water evenly over all. - I tossed the apples in the sugar mixture to evenly coat them
3.	Combine the oats, 1 cup flour, brown sugar, baking powder, baking soda and melted butter together. Crumble evenly over the apple mixture.
4.	Bake at 350 degrees F (175 degrees C) for about 45 minutes. - Mine needed about 50-55 min

Yumbly Crumbly. Notice the caramely filling

The topping comes out extra crunchy and delicious while the apples are soft and cinnamony. You can throw it together pretty easily with things you already have in the house and it is absolutely delicious topped with vanilla ice cream. The only issue is I'm going to need to hit the gym asap if I keep cooking and eating like this and I'm not supposed to go for another week. Oy.

Day 6: FOUR FROSTIES

We have FOUR frozen embryos!!! FOUR potentially healthy embryos that could grow into four potential babies! The two early blastocysts from yesterday continued to grow beautifully overnight and they were able to biopsy and freeze them this morning.

Original Photo came from here

I am so over the moon! The doctor said I responded so well that you can barely tell I'm a DOR/FXPOI patient :D It took a whoooole lot of meds, but it will be so, so worth it if these embryos are healthy. I need good chromosomes without Fragile X or trisomy problems.

Our breakdown for our first IVF cycle:

• 12 days of BCPs
• 3 days off
• 11.5 days of 600iu Menopur, 0.83mg Omnitrope, 1mg dexamethasone, 5 days of Cetrotide
• Novarel trigger - 10,000 HCG 

 This protocol resulted in:

• 14 follies
• 11 eggs retrieved
• 8 mature eggs fertilized
• 6 embryos
• 4 frozen day 5/6

My mild OHSS symptoms are starting to resolve today as well. I still got up to pee three times last night, but I think the swelling in my abdomen has gone down a little this morning which means the HCG must finally be leaving my system, I didn't test out the trigger since there was no reason but it would have been interesting to see how long it sticks around. Maybe I'll test it out next cycle to see if it really takes 10 days to get rid of it. The horrible acid reflux is also starting to go down, I don't feel like I'm going to throw up stomach acid, which is awesome. I know I got off a lot easier than many people do  so I'm not complaining.

Now, we need to do the whole thing alllll over again. The big question is, do we take a month off or start right back up with this upcoming period? I've been looking into it and research has shown there's a definite synergistic effect in back to back cycles, especially in really low AMH/DOR/Advanced maternal age patients.  The cumulative effect of both cycles ends up being greater than the sum of both cycles - if the med effect from cycle one is 2 and the med effect from cycle two is 2, the cumulative result is 5 instead of 4 in the second cycle. I think that's why Dr. D was leaning that way until I got 4 awesome embryos.

The wild card here would be cysts, last cycle I had the most stubborn follicular cysts on the planet that took two periods and two weeks of birth control to resolve. I don't know if I'll have them again this time since they aspirate the follies during my retrieval, which you'd think would mean no more cysts but who knows. It would definitely make the decision for me though, if I have cysts hanging around on my next CD2 baseline ultrasound, I have to take a cycle off.

Day 5: TWO Frosties!

It's only 11am here but we've already had a crazy, stressful morning. My phone apparently rang at 7am but E and I were both sound asleep and I didn't hear it. Waking up 3 times a night to pee is exhausting -_- Then E's phone rang a minute later, and we woke up just in time to hear the end of the call vibrating on the night stand. Fully awake now, I jumped out of bed and recognized the number as belonging to the ART center currently in possession of our embryos. Our updates come from Dr. D at a different number so it was really unusual to get contacted directly by the lab.

I called them back right away and got a somewhat frantic woman on the phone - apparently they never sent us the correct paperwork to sign for PGD consent! They can't biopsy our embryos without this paperwork, we're holding up the embryos and she was worried we might be on vacation or might not have a scanner or printer and she wouldn't be able to get a hold of us. Ahhhh!

Luckily we do have a printer/scanner and we've been waiting on tenderhooks for embryo updates so there's no way we'd be far from home right now. She emailed me the paperwork straight away and E and I quickly signed and initialed another 20 pages, scanned them in and emailed them back to her. Phew. This was not the start I was hoping for this morning but I'm glad she caught the oversight in time.

Knowing that we now had at least one embryo to biopsy (!!!) I carried my phone around with me all morning until 9:30 rolled around and Dr. D called! He said that out of the 6 embryos at our last update, TWO were now hatching blastocysts that were being biopsied and frozen! YESSS!!! Two more are early blastocysts this morning so baring any problems, they should be ready to biopsy and freeze tomorrow! Ahh!!!  I know we're not supposed to count our embryos before they're hatched, but we have a very real shot of having FOUR embryos on ice to test!

Original Photo came from here

I am so, so excited for these embryos. There's a good chance that our baby could be one of those hatching blasts in the freezer Right Now. Now we need to decide if we should take a month off or start our next IVF cycle straight away with this upcoming period. It should be starting in about a week or so, maybe a little more or less. If there is any benefit at all to doing back to back cycles I am ready to go and I will stick myself with all the needles all over again. Dr. D said my OHSS symptoms, primarily the fluid retention that is causing all the discomfort, should start to go away when the trigger leaves my system which is about 7-10 days after taking it. Today makes 7 days so I should start feeling better in the next 3 days which is awesome. If there's any lingering discomfort, the 12 days of birth control should take care of it and by the time I start stimming again, I should be feeling normal.

I have heard before that there may be some benefit to back to back cycles and Dr. D seems to be leaning in that direction as long as I feel good. If that is the case, we're repeating the same protocol and I'll need to place my next order with IVFMeds.com straight away.

Please send good thoughts to my two little early blasts, they need all the positive vibes/thoughts and prayers they can get to grow up and hatch tomorrow!

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 3: Growth Report

We got our growth report this morning and our embryos are still dividing! We have 4 that look really good with nice, even cell division and 2 that look good but are growing a touch slower. We also have 1 that fertilized but is pretty far behind the others with only 2 cells so we're not sure if that little guy can catch up. E is calling it our runt, Wilbur, but I don't think there's any chance of him catching up.

Original Photo came from here

I talked to Dr. D about our next cycle and he thinks we're on track to start in about 6 weeks. I didn't get to really clarify what that means since I later realized it could mean taking a month off or not taking a month off. If I get my period in about 2 weeks, then go on birth control for about 2 weeks, then stim for about 2 weeks, that's 6 weeks right there. I was asking if we'd take 6 weeks off doing nothing before starting the next cycle but I don't think I got that across. I'll have to bring it up again another time.

I also asked about the crazy bloating which he said is probably from the HCG as well as the estrogen. He said I should expect it to stick around in my system for at least 10 days so I don't see this belly going down anytime soon. I have no illusions about the physical side effects of infertility and the IVF process but it would be nice if I could save some growth for a baby.

As far as recovery goes, I'm feeling a bit crappier today than yesterday. I'm still only mildly sore but I have a weird nauseous/imminent cold feeling that probably wasn't helped by the fact that I woke up every 2 hours to pee and didn't get great sleep. I'm not sure where I could have picked up a cold since I've been taking it pretty easy and not going anywhere but I can definitely feel it hovering at the edges of my throat. Hopefully it's just the hormones because I can not get sick right before our next cycle.

Day 2: Recovery

Thus far I think I've been pretty lucky with my recovery. I'm still good with just a couple Tylenol or Advil every 4-6 hours and if I don't take it, there's only a minor ache of discomfort. I never really had any bleeding, nausea, constipation, or serious pain. I know every egg retrieval is different and I don't want to jinx it for next cycle, but I hope I can get off this easy next time. Maybe it's my reward for having such a shot heavy stim cycle :)

The two symptoms I am experiencing at the moment are two I could definitely do without. For starters, I'm still super, super bloated and uncomfortable with a belly the size of a watermelon. Possibly even more bloated now than on retrieval day.  I haven't tried to wear my jeans yet but I doubt they'd button comfortably right now, even my loose jeans would cut right across my ovaries. This is probably still mild OHSS so I've just got to grin and bear it and hope it goes down.

In the same category, my grapefruit sized ovaries must be pushing on all sorts of things because I'm getting awful heart burn. No matter what I eat or how I sit, I have the worst acid indigestion. This is another one of those things you just have to wait out, so I'm popping Gaviscon like candy and hoping that it passes quickly. I just ran through my last bottle so getting more is first on my list of things to do tomorrow.

My secret weapon

For anyone else getting ready for an egg retrieval, I absolutely think that the crazy amount of water I've been drinking has played a big role in why I've felt okay. I drank 100-150oz the day before the retrieval and another 100-150oz the day of. I've been drinking at least 100oz a day since and despite the anesthesia, it's probably physically impossible to be constipated with that much water in your system. I know a lot of clinics push laxatives after a retrieval but I prefer to avoid that stuff if I can. In this case, I think the water is a pretty viable alternative. Plus, peeing every 10 minutes, while also tied to OHSS, helps clear the extra hormones out of your system which should mean less bloat and misery. I'm still sleeping with my feet up on a pile of pillows as well, which is supposed to help all the excess fluid drain.

The acupuncture has probably also played a roll. Even the regular treatments that just keep all your energy and such flowing normally can really help with clearing out your system. The surgery center was a little weird about herbs so I stopped drinking my herbs a couple days before the retrieval and I just started back up again today with my acupuncturist's blessing.

The embryologists try not to bother the embryos on days 2 and 4 so I sadly didn't get an update on my embies growth today. They should be growing and dividing with at least 4 cells so that they can reach 6-8 cells tomorrow. I'm on pins and needles waiting for tomorrows phone call and I'm hoping and praying that all six are still growing well.

 

Original Photo came from here

ETA: I totally forgot to talk about boobs! My boobs are SO SORE. They feel awful if I'm not wearing a bra, which luckily is almost never since they're on the gigantic side and I never go braless. This is probably from all the hormones too and just another thing I have to wait out :(

 

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!

PSA: Ganirelix Totally Has Latex

Both the doctor and the nurse said I would be okay to take the Ganirelix even though I'm allergic to latex. I asked both of them separately, explained again that I'm allergic to latex and they said no worries, it should be fine.

The itchy hives currently covering that injection site beg to differ. It also burns like a mofo and my head and ears feel heavy and clogged. I am so NOT impressed. No more Ganirelix for me. Ugh.

(Source)

If you are allergic to latex, stay far, far away from Ganirelix.  It's not worth the allergic reaction.

Holy Follicles!

I think you could knock me over with a feather right now. 

I have 14 follicles. 

FOURTEEN follicles

Holy Shit!

I am totally and completely in shock. Where did they come from??? I only had 7 antral follies at my baseline, where the hell did the other 7 come from?!?! For someone who was told they'd never have more than 3 eggs to harvest I just can't wrap my mind around 14. Um, have I mentioned holy shit??

As you can see, they range from about 11-19, with one teeny one measuring -3 which is actually 7mm . I think 14/15mm is the smallest size that can contain a mature egg, so they still have some growing left to do before I can trigger. Originally I thought I might get away with only 9 days of stims but it looks like I'm on the hook for at least 12 days.  My poor belly isn't thrilled but I'll do whatever it takes to get these eggs to mature. My lining is also looking excellent, 11.6 today which is wonderful. I'm super hopeful that once we finally make it to transfer, our embryos will have a nice cushy home waiting for them.

Beautiful follies!!

Since I'm out of some of my supplies and meds, my nurse went through the cabinets to try and find some samples. She scrounged up one injection of Ganirelix, which is another brand's version of Cetrotide for me to take tonight. That saves me about $105 so I was really pleased :) The only problem is the packaging. I'm sure I've written before about how I'm allergic to Latex - I'm not deathly allergic, but it does give me a fairly unpleasant rash and I can't take the flu shot or other meds that contain Latex. This package of Ganirelix says right on the box that the "packaging" contains natural rubber latex. I asked both the nurse and the doctor about it and they all said I should be fine to take it but I'm still a little worried. Does that mean the rubber plunger on the syringe is latex? Will I react to the liquid since it's been in contact with the plunger, or will it be no biggie since the plunger itself wont touch my skin?  I'm skeptical but will give it a go since they both said it should be okay. 

My next appointment is tomorrow morning to check in and see how quickly those smaller follies are catching up. If everything looks good, I might be able to trigger on Sunday for a Tuesday retrieval. If they need another day, I'd trigger on Monday for a Wednesday retrieval. 

Come on follies, grow, grow, grow!

Maybe Mature?

Tomorrow morning I'm going in for what is hopefully my last ultrasound and blood draw to check on the follies before I'm cleared to trigger. I was doing a little more research and it looks like Cetrotide can slow down follicle growth, which sort of makes sense since it's designed to prevent premature ovulation. It's probably why these follies didn't exhibit super growth from day 7 to 9, which is also a good thing since slow and steady wins the race in quality follicle development.

As of today I'm officially out of Cetrotide and the Omnitrope syringes as well, so I'm going to need to make a trip to the pharmacy to pick up one more Cetrotide injection and syringe for tomorrow night. If the follies need a couple more days of growth I will suck it up and deal but my poor belly is so, so ready for a break! Four injections is really a lot to do every day and my belly is starting to show the effects. 

I knew yesterdays injection was a bad one as I did it, and as expected it left a nasty bruise. I snapped a gross photo of it for your viewing pleasure in case you were wondering what injection site bruising looks like. In the upper left corner you can see two "good" injection sites where only the needle mark is visible. Then, obviously, there's the big nasty bruise from the shitty Cetrotide injection. Ugh.

Nasty Cetrotide bruise is nasty.

For tonight's Cetrotide injection, I ditched the included syringe and used one of my extras. It was still a pain to mix since it doesn't dissolve well,  but at least I was able to prime it correctly. I'm also not at all a fan of the below the belly button injection site, there has to be some sort of acupuncture point or meridian there since the needle zings and hurts every time it goes in. The lower right/left and upper right/left are much less painful to inject into so I'm definitely changing the site for tomorrow. My belly needs a break!

I've got everything crossed that the appointment tomorrow goes well. Come on follies, I need you to mature! And contain healthy, mature, fragile-x free eggs, that fertilize perfectly and grow into healthy embryos. Positive thoughts!

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.

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.

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!

Day Two of Stims!

Today was day two of my stim injections and I think I'm finally getting back in the swing of things. The first day was a little tough, I felt unexpectedly nervous and my heart was pounding in anticipation of the Menopur burn. It was pretty much exactly as I remembered it though, and by this morning it felt routine again.

Now that I've tried a few of the new medications for this cycle, I'm starting to get a feel for how everything works in practice. Thus far:

• Omnitrope (HGH) - this is one bubbly sucker. The solution is really fragile, you're not supposed to shake it and it bubbles at the slightest provocation. This can be a pain in the ass but since I got the cartridge vials and not the 5.8 vial I'd have to mix like the Menopur, I'm not complaining. I have to draw it back and inject it with the same needle which does dull it slightly, and I do have a small bruise at my first injection site. I also have some heat and soreness at my injection site this evening but I can't tell if its from the Menopur or the Omnitrope since I injected them on the same side. I do morning injections (4 Menopur) on the right, and evening ones on the left (4 Menopur and 0.25 HGH). I might switch things up tomorrow and inject the Omnitrope on the right to give my left side a break.

The cartridge vial is so skinny, but you can still draw pretty well from the rubber stopper at the top.

• European Menopur - I decided not to use the glass ampoules that came with the EU Menopur since I have a ton, like 5 boxes, of the sodium chloride vials left. I tried to give the Q-caps a shot and they do fit on the EU vials, but the rubber stopper in them isn't ideally shaped to extract all the liquid. I have to use the big mixing needles to get every last drop and it takes a bit longer to do. I also had a nervous scare when I combined cold sodium chloride with room temp EU Menopur powder and it turned instantly cloudy. Cloudy Menopur is supposed to be bad Menopur but since it cleared up after about 30-45 seconds, I deemed it okay.

You can see the hole in the rubber stopper is only in the center of the stopper, which means liquid can pool around the sides. The US vials have a long slit to better capture liquid from all sides.

I can already tell my belly is going to be bruised and poked and sore once this cycle is over. Three - four injections is a lot for a day and I'm going to run out of places to stick the needles since they all have to be injected in the same area. I can't rotate between belly, thighs, butt, etc, they all go into the same section of my lower belly. Owie. 

IVFMeds.com had good news, my second package finally shipped! It ended up going out two days later than it was supposed to which necessitated 2 more phone calls to customer service asking why I hadn't received tracking info yet. I would have liked it to go out sooner but if it travels like the first one did, I should have it in time. The customer service rep also said that if my medication didn't come in time, they'd reimburse me the difference between their cost and the cost of the vials I'd have to buy locally. It was a really nice offer but I'm hoping I won't have to take them up on it.

I also got a good convo in with Reprogenetics and they've put my blood and saliva kits into the mail. I have to send in a vial of my blood, a saliva sample from my mother and my sister, and a single premium IUI vial of our donor. They were originally requesting two vials (~$2,000) but their lab agreed we could go with one since these are really high yield vials instead of the low yield kind they'd usually be sent for PGD. That saves me an extra $1000 which is excellent, every little bit helps!

IVF Protocol a bit Clearer

Today I picked up my Omnitrope, needles, syringes and Dexamethasone. Kaiser is usually great about prescriptions but this time they were way off - they gave me Omnitrope cartridges in a weird dosage without the pen to inject them, they forgot my injecting needles and only included the mixing ones, and they only had half the needles and syringes I needed. I ended up spending 30 minutes at the counter while they tried to sort everything out and I still ended up without the pen for the Omnitrope. When I called my nurse to talk over it and find out more about my protocol, she had never worked with Omnitrope in this form before and had to sort out how it's going to work. It looks like I'll have to draw it up and inject it with the same needle, which is going to blunt the needle and make it hurt more -_- I'm not excited about that part.

Although I was hoping for only a couple days with tons of injections, it looks like I won't be that lucky:

CD 1: Nothing
CD 2 - 14: BCPs
CD 15 - 17: Nothing
CD 18 - 25:  2 injections of Menopur (4 and 4), 1 injection of Omnitrope and 1mg Dexamethasone

At some point I'll add in an injection of Cetrotide for 4 days, bringing my injection total to 4 injections per day. My little belly is going to be so, so sore! I have to go in tomorrow morning to get the small needles and syringes I'll need for the Omnitrope so I think I'll ask the nurse if I can inject the Omnitrope into a different place. If I'm already doing two injections into my belly each day, I'd really like to not have to add two more to the same place.

I was going to insert a photo of my new supplies in here, but I'm too lazy to take one right now. Just picture lots of needles and syringes, including big mixing needles, and I'll post one tomorrow when I'm less lazy.