Egg Retrieval Set

I spoke with Dr. D and as expected, we are a go for triggering tonight. I'll be doing my Novarel (HCG) trigger shot at 12:15am tonight/tomorrow morning and my retrieval will be Tuesday at 12:15pm.

Dr. D went over my follicles with me and made me feel a little better about the ones we've got. He feels that since we got 4 solid embryos from our 4 best follies last cycle that it's perfectly reasonable to believe that these top 4 follicles will have healthy mature eggs in them that could be our next 4 embryos. It's an optimistic viewpoint and I'm choosing to share it and believe that these are the ones.

The prime three are the 20, 22 and 22. The 26 might be a little overcooked but the 17 could catch up between the trigger and retrieval, it's very possible. I'd like to see it at least 18 or 19 on retrieval day but I don't think they bother with measuring, he'll just take everything he sees.

I've definitely got stuff going on in there too, I'm hungry, beyond exhausted, still have that friggin' pressure head ache and feel all sorts of twingey cramping around my uterus. My ovaries don't feel too uncomfortable, no huge grapefruit feeling, so I think the estrogen the follies are putting out is to blame for the random sharp twinges in my lower belly. And I still have to pee over and over.

Now I just need to stay awake for my trigger! I've got an alarm set just in case but I think I'll be okay. I've been trying to nap all day without success so I just keep yawning and dragging my feet. We're so close, we just need to make it through this retrieval, get some healthy test results, and have a successful FET.

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.

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.

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!

TWW: We Meet Again, Endometrin

This morning marked the beginning of Endometrin round two. Oh most hated adversary, we meet again at last. I knew this day would come.

dun Dun DUN!!!

I know that this particular medication shouldn't be a big deal, it's not an injection or something particularly painful, but it's still, by far, the most obnoxious medication I need to take. Let's run through the side effects according to the manufacturer:

• mild nausea, vomiting, bloating, stomach cramps;
• diarrhea, constipation, bloating;
• dizziness, drowsiness, tired feeling;
• pain in your vaginal or rectal area;
• pain during intercourse;
• loss of interest in sex;
• breast pain, swelling, or tenderness;
• joint or muscle pain;
• increased night-time urination; or
• vaginal itching, burning, or discharge.

If you look carefully, many of these symptoms mimic early pregnancy symptoms. A super cruel joke to play on the woman who is desperately hoping to find out she's pregnant, examining every cramp and hiccup as a possible indicator that this cycle was a success. Others are just horrible sounding, and I count myself lucky that I only experience the mild ones. Last cycle I had to deal with bloating, cramps, tiredness, all the time peeing, crazy sore boobies, and the lack of sex and general grossness that comes with having a pill up your ladybits that dissolves throughout the day, necessitating the wearing of panty liners. Can we saw EW? EW.

At least my injections were a brief inconvenience, a moment of pain that was mostly gone in under a minute.  Twice daily Endometrin, on the other hand, is the gift that just keeps on giving. For a minimum of two weeks, and a maximum of 10 weeks if I do get pregnant. This is one medication I could seriously do without, if I wasn't willing to do anything possible to get and stay pregnant.

Little cells that should be dividing in there, this is all for you. E, I apologize for the lack of sexy time in your future. Only 8 more days till I can pee on a stick and hopefully find out that we're pregnant (if it's not too early), making all of this worth it. I can't give headspace to the next leg of our journey if we are successful, so I'm focusing everything on that positive test. 

Update: I took an HPT this afternoon and got a clear negative, which means the trigger is flushed out of my system. Any positive we get should be genuine from here on out!

Clear to Trigger!

We are a go for triggering tonight! I will be taking my Ovidrel at 10pm tonight and then I'm done with injections! I love that the syringe comes pre-filled, it's such a nice change to not have to mix a million little powders.

Ovidrel ironically next to my eggs

We need to be at Kaiser for our IUI at 8:30am on Monday so they can start prepping the sperm. Whether you give a fresh sample or a frozen one, they need to assess the sperm for washing and confirm that the counts are sufficient. The IUI itself will probably be around 10:30am and then I'll be heading to an acupuncture appointment to encourage those swimmers to swim, baby, swim!

We have our sample on ice, ready to go and I'm definitely feeling like the time is right physically. I finally have enough estrogen in my system to get some decent, trackable EWCM and I'm actually debating taking an ovulation test tonight before I trigger and tomorrow to make sure I'm not ovulating too soon on my own.

OPK Cheapies. I still have toooons of these from TTC naturally

I might be extra bold this cycle and test out my trigger to see how quickly it leaves my system. I'm feeling really good and positive about this attempt and I might be up for testing a bit early this time! I just want to make sure I won't be getting false positives from the HCG in the trigger.

Send good vibes and positive thoughts to my follicles for me, I need these little buggers to yield healthy, unaffected embryo(s)!

A Loooong Morning

At 6:45am this morning I found myself driving around in circles looking for parking. There was a massive construction zone in front of the hospital and my usual parking place was "No Parking" till after 8am. I ended up finally parking up the street at a meter that didn't start till 8, but was happy to accept every silver coin I had to get to 2 hours in case I wouldn't be able to come back down.

The ground floor was empty, not even the security guard was there, and I went up to the third floor lab to find that dark and deserted too. Not only was the floor empty, but the lab was closed on the weekend, despite what the Phone Nurse had told me yesterday. I was not at all amused and went up to the next floor where my RE's office is to ask one of the nurses if I should try another lab. This is what I saw when I stepped off the elevator:



As you can see, that door is clearly locked. There wasn't a soul on the floor to ask and even the door to the stairs was locked. I pushed the call button to get another elevator back down and the cabin was full of cheerful construction workers who were happy to joke about my appointment screw up but who said they weren't planning on unlocking the door until 11am. Well, Fuck.

I got back down to the ground floor and decided to try the medical offices next door, which I knew would have an open lab on the 3rd floor and hopefully someone I could talk to. Thankfully the lab was open, if busy, and I was able to get my E2 drawn by 7:30am. The techs were really nice but had no idea when the neighboring building would be opening back up so I went back to the ground floor and just as I was leaving, I saw a security guard who was heading out the front door. She was exactly the kind of person I had been looking for and she told me she was on her way now to unlock my floor! Yay!

We walked back over and as she was letting me in, one of the nurses showed up. By the time I had sat down in the waiting room, 3 couples who were clearly doing their IUIs today rushed in. Three more nurses followed them and another 3 couples, packing the waiting room and making it look as if the place had been open for hours.  Everyone was quietly talking to their partners but it was obvious they had been super worried when they couldn't get in. Normally Saturday is reserved for IUI procedures and I was the only one there being checked.

My ultrasound showed that my 7 follies are still in excellent shape and have grown so quickly over the past day that they surpassed our wildest expectations. Normal growth is about 1-2mm per day, but my biggest follicle had boomed from 15mm to 19mm with several 18mm and 17mm friends to keep it company.  The dominant follicles are starting to edge out and steal resources from the smaller ones, Nurse C made a joke about survival of the fittest, and I think the smallest two are now 12mm and 13mm. I was a little bummed they didn't get a nice boost in growth but it's normal progression once the dominant follicles get this large. 

My E2 came back at 1476 which is fabulous, that's 210 for each of the 7 if you assume they're equal which they're probably not. I think those bigger 19, 18, 17 follies are probably putting out more than 200 now. I'm waiting now for confirmation that I'm triggering today and am planning on the IUI happening on Monday!

So excited! We should be triggering with several mature eggs, I really think this is our month!

Cycle Acceleration!

While on my way to acupuncture this afternoon, I got a phone call from one of the nurses in the Kaiser infertility office. She had my marching orders for the next couple days and wanted to give me my instructions. I was driving so I had her on speaker and was listening for confirmation of Nurse C's instructions when this phone nurse said something completely different.

To Recap, Nurse C's Instructions:
During my appointment, Nurse C said I would require at least a couple more days of stimulation and had me order 10 more vials of Menopur. She guessed that we would be doing my IUI on Tuesday or Wednesday, and that I would be triggering on Sunday or Monday, with another appointment to check growth on Saturday. I would be continuing with my 6 vials of Menopur.

Phone Nurse's Instructions: 
Take the usual 6 vials of Menopur today and trigger on Saturday, with an IUI schedule for Monday. There would be no need to come in on Saturday.

This information did not at all jive with what Nurse C said. My E2 was good, yes, but with 7 follicles it was not the 200+ per 18mm follicle that we're looking for. It did not seem like a good idea to skip Saturday's ultrasound, this cycle and those follicles are too important to screw up. This also meant that we needed to have our donor vial on hand stat so I called the bank and placed our order over the phone. I'm so glad they store purchase history and credit card info, I never would have been able to place the order if the customer service rep didn't already have all my info in front of him.

When I got to acupuncture, I shared my concerns with my Acupuncturist S. Since she's a Certified Nurse Midwife at Kaiser, who has been there so long that she taught most of the OB/GYNs how to deliver babies (including my OB/GYN who is now the head of the department), she has an excellent relationship with most of the doctors, including Dr. K, and also happens to have her personal number. While I was on the table, having a treatment on my back this time, she gave Dr. K a call and talked over my procedure with her. I'm not sure if Dr. K had missed some notes or if she wasn't completely aware of the instructions given by Phone Nurse, but she agreed with me and S that I should be monitored on Saturday. At the very least, this would give us confirmation of the correct time to trigger so as not to leave viable eggs behind. I am incredibly grateful to have S on my team and feel much better about moving up the timeline as long as we check and make sure my eggs are mature first.

The new plan is to take 6 vials today, which I just did, and go in for another E2 draw and ultrasound at 7am tomorrow. I'm really not going to enjoy leaving the house before 6:30am but it's worth it to me to make sure these follicles are mature. If everything checks out, I have my trigger ready to go for Saturday and E has a rare day off on Monday. If they're still looking a little runty, I have more Menopur ready to go to give them a boost. Our vial will be picked up tomorrow and will be good and frosty for 5 days which gives us plenty of time. Whatever happens, we're prepared.

TWW: Eff You Endometrin

I don't have much to say today expect that I kind of hate Endometrin. If it doesn't stop fucking with me soon, I will... do nothing and continue taking it anyway because it's helping keep my potentially there pregnancy alive. I'm only 6 DPIUI, right in the zone for implantation, and it's way too soon to be having any side effects, but the progesterone gives you all kinds of pregnancy symptoms that makes you feel insane. I'm pretty sure my boobs might just fall off my chest, I'm still crampy, and it's also conspiring with my Menopur to make me feel extra fat. Eff you Endometrin, but please keep supporting my potential, maybe there, pregnancy.

Fatty McFatty

I'm also too afraid (read chicken shit) to pee on a stick and see if the trigger is out of my system yet. It's been about 8 days since I took it, but since it can hang around for something like 13 days, I'm scared of getting my hopes too high. In theory I should be able to see the line getting lighter and lighter until it's gone, and then any line after that should be a real positive. Maybe I'll check and see how light it is on Saturday, 9 DPIUI, and 11 DP Trigger. It should be pretty nonexistent by then.

Black Outs and Trigger Shots

I'm currently sitting in the waiting room of my RE's office. I should be going in for my 4th monitoring ultrasound in a few minutes but the power just went out to the whole block. Living in Southern California, losing power is not exactly a shocker in the summer.  It's ridiculously hot right now and a city block with at least 6 hospital buildings must draw an insane amount of power.

The back up generators clicked on almost immediately and now the nurses are trying to get the stubborn computers back up. It sounds like half the building is without computers which makes patient check in an interesting experience. Three different nurses have now called for the same person who I'm pretty sure is already back in a room. 

Lucky for me, I was able to get my blood drawn before the power went out. My right arm which I use for blood draws 99% of the time is a little battered and bruised so I asked the tech to use my left with its more stubborn veins. I'm starting to make friends with the tech since I'm there basically every day, and I was super impressed when he got it in one go.  The vein on that side is really deep and hard to find but he only left a tiny bruise. 

Veeeeeeiiiiinnnnnssss

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Damn, I had typed up a whole post but it didn't save when I put my phone down for my exam. The appointment this morning went well, but it was conducted entirely in the dark.  The nurse led me down the dark hallway and into the exam room, lit only by the screen on the ultrasound machine. It actually felt a lot like my acupuncture appointments, minus the candles and soft music and I was afraid I might fall asleep since it was still so early.

Everything was a little awkward since the table was electric and the back up generators didn't provide power to lift it up, but we made it work. The "group of follicles" on my right has been reclassified as a cyst (as I had initially thought) but it's very small and isn't a big concern. The mature follie on the left is a perfect 20mm and has several too small 9-10 follies behind it. There's also a 13mm follie on the right, but it's pretty small too. Dr. K said not to discount it entirely, so we're calling my total loot a follicle and a half. My estrogen supports that at around 280 so I was given the all clear to trigger tonight!  I'm nervous and excited all rolled in one, I need that egg to have my healthy X chromosome.

In the midst of all this infertility chaos, my best friend J is marrying his wonderful fiancee, C. I'm the Best Woman in their wedding and have felt awful about my infertility crap interfering with their wedding plans. Luckily, our IUI will be done before the wedding but it's still on the morning of the Bachelor/Bachelorette party, and I'm going to have to sneak away after the rehearsal but before the rehearsal dinner for some quick acupuncture. I'm so excited for them to tie the knot and the ceremony should be intimate, personal and beautiful.