Nervous

Oh man, I'm feeling so nervous about tomorrow. It doesn't do me any good to speculate on the next ultrasound but that logic hasn't stopped me from running through all the "what ifs...?" in my head.

• What if we have even less follicles than yesterday? 
• What if the follicles aren't growing?
• What if all the follicles arrested?
• What if Dr. D wants to cancel the cycle?
• And in that vein, if he does want to cancel, how much will we be out?

I tried to talk over the possibility of having to cancel with E, just as a "what if" since he won't be at the appointment with me tomorrow but he didn't take it well. I was trying to figure out the numbers in my head and led with a figure waaaay higher than the actual amount, making him panic and freak out. Not at all helpful and not at all my intention. Crap.

I'm trying to be positive and hopeful that these 5 follies I have will look wonderful and mature and have healthy, perfectly fertilizing and growing eggs in them. That said, I can't not consider all the possibilities when the cycle looks so disappointing compared to last time. I think if Dr. D were going to cancel he would/should have done so already, instead of letting me stim for almost two weeks, so I don't see this happening. But, if we do have to cancel, the cycle rolls over and we are out the services/medications that we have already used. For this cycle, that would be:

• All monitoring appointments that I've had including ultrasounds and labs
• All medication I've used thus far 

This would leave quite a bit left to roll over:

• ICSI take two which we've already paid for
• Embryo Biopsy
• Egg Retrieval with anesthesia etc 
• Cryopreservation and storage
• Any unused medication, in this case it would be just the Novarel and a day of Menopur
• Any unused money ear marked for monitoring 

So really, it could be worse. If for some reason I walk in tomorrow and they say we need to cancel, we wouldn't be paying for the entire cycle all over again. It would just suck incredibly, but not as much as going ahead and getting no embryos.

Come on follicles. Come on eggs. I need you to be good and healthy in there. I don't think E could take cancelling a cycle and I couldn't handle giving up on getting more embryos to test. I've put too much of myself, my marriage, my heart, my hope, my love, my health, my body, into this to give up on one crappy cycle.

Happy Halloween

I wish I could start this post with better news but it looks like we've actually lost two of the follies we had on Wednesdays ultrasound. The 8 that was hanging out on the right side has basically shrunk to nothing and disappeared and one of the 12s on the left side appears to be arresting - it was only a 10 today. This leaves us with 5 follicles that could potentially have eggs but they're still not big/mature enough to trigger.

I'm telling myself to be positive: quality over quantity, those five follicles could have perfect, mature eggs that grow into five strong embryos. Still, I'd sure feel a lot better if we had 10 fabulous, mature eggs to pick from instead of just 5. I've been feeling really junky lately, a lot of uncomfortable pressure in my temples, one shoulder randomly going numb, sore lady bits and I need this cycle to be worth it. Come on eggs, I need you to grow, we need more embryos to test.  

With the extra Menopur I bought from Kaiser, I have enough to stim for 13.5 days - enough to get me through the weekend. Depending on what my blood work comes back at, my next appointment will probably be way too early on Sunday morning. If the follies are ready then and I have to trigger Sunday night, the pharmacy won't be open so I stopped in at Roxanne after my appointment. 

I don't know what the chances are of me actually triggering soon. I was looking over my old post-its from last cycle and they didn't trigger me till several follies were over 20mm. With these guys growing so slowly, the biggest is barely 18 :(,  I wouldn't be surprised if I had to get more Menopur and wait until Monday to take my Novarel.

 

In better news, I finally found a use for all these obedience classes I've been doing with Milou: Posing her for photos. After Halloween last year I picked up a couple pirate costumes for her on the clearance rack - she's usually a large or extra large in brands that make tiny dog costumes or a medium in brands that make costumes for larger dogs. I think these two came from Petco for a couple bucks a piece and are both larges, definitely a good score. 

 

I think the red and white costume is my favorite, it has a tiny pirate sword sewn to a black belt and is closed with two velcro straps which makes for a nice snug fit. She so sweetly let me pose her sitting or standing and even let me pose a too big pirate hat on her fuzzy head. That bit didn't fit all that well since it's technically my hat, but she put up with me like a champ. I love this girl so much.

Since costumes with straps probably aren't the most comfortable things to wear, Milou wore her second pirate costume to her agility and obedience classes. This one is a soft puppy t-shirt that slips over her head and two front legs and is super comfy. It also glows in the dark which is insanely adorable when we're walking at night - Trick "Arrr" Treat with a puppy skull and crossbones.

I hope everyone has a happy, safe Halloween filled with lots of delicious treats and merriment. If you have a few seconds to send some positive thoughts/vibes/prayers/good juju my way, I would much appreciate it. Happy Halloween!

Disappointing Ovaries

Today we had another ultrasound and I'm trying really hard not to be super bummed. My right side, which is usually packed full of beautiful follicles, has basically pooped out in the most disappointing fashion. My left side is definitely more dominant this time and is picking up a bit of the slack, but not quite enough.

I was so bummed and distracted that I didn't take a legible photo of our sticky note to post. So, I decided to rewrite a more festive version to bring in some positive vibes. Last cycle we had 10 follies at this point and as you can see, we only have 6 this time and they're on the small and peaky side. My estrogen came in supporting their scrawniness at only 486 so we've still got a long way to go. 

Since the follies are coming along so slowly, I'm going to need to stim for longer than I'd planned. I bought enough Menopur for 11.5 days, through Saturday morning, and the nurse suggested that I'd need enough to get through the weekend. That means three more 5 vial boxes of Menopur from the Kaiser pharmacy for a total of just shy of $900. I was short on Omnitrope as well, I only bought enough for 8 days instead of 12 with the increased dosage, so I picked up a third cartridge of that which Kaiser was wonderful enough to cover for the second time. Small victories, I'll take them where I can get them.

Last night was also day one of Cetrotide and I'd managed to forget in the past 5 weeks how badly this stuff itches. It only lasts about 2 hours but my skin turns red, swells up like crazy and I feel like I need to scratch my skin off. I also hate the pre-filled syringes it comes with, they never prime properly and always leave a nasty bruise. Instead, I prefer to inject the liquid into the powdered vial, switch it out for a regular 3ml syringe, use the included mixing needle, and use one of my own 27 1/2 gauge needles to inject.  My 3ml locking syringes are always reliable, easy to prime, and the 27 1/2 needles almost never bruise like the too small 30 gauge or too long 27 3/4 needles. The smaller needles cut capillaries = bruise and the longer needles are the same thickness but go just deep enough to bruise too. Bleh.

I just finished injecting tonight's meds and I'm wishing, hoping, and praying that more follies pop up and that they all mature. I don't think the cycle is poor enough to cancel but I'm so worried we won't get enough mature ones to get our good embryos. Come on ovaries, you can go it. Grow follies, grow!

Less Than Awesome Ultrasound

So this mornings ultrasound appointment was less than ideal. At this point in our first IVF cycle, we had at least 8 follies 10-13mm and a 9th slightly smaller than 10mm. Today we had only 5 follicles in the 10-14mm range, 3 follicles a bit less than 10mm and 2 less than 5mm. My right side, which is usually my best producer, is basically crapping out at the moment and I'm super disappointed in it.

I was hoping for a bit better :(

Every cycle is different so it's really tough to compare one to another but I can't help over analyzing everything I've done differently. For example, I suppressed for two days longer. I took Tylenol for cramps while on my birth control pills and tums for heart burn.  I was late yesterday for my shot by 30 min. I'm taking the higher, correct dose of Omnitrope. I'm using Italian Menopur instead of UK Menopur.

Realistically, I think the difference is probably from the extra birth control but there's nothing I can do at this point. I just have to hope that a few more follies pop up and the ones we can see grow into beautiful, healthy, mature eggs. I'm going to be adding in my Cetrotide tomorrow since the follies weren't big enough today and my next appointment will be Wednesday. Fingers and toes crossed!

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!

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!

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.