IVF Days 1-3
On Friday (10/18), I got the official okay to start “stimming” (aka
ovulation stimulation, aka doing my injections to make my follicles/eggs grow).
As a bonus, Dr. N explained to me how to mix the Follistim with the Menopur so
I only have to do one shot! I just have to push the Follistim (from the pen)
into one of the vials of Menopur and mix it and then add a little bit of saline
to get enough liquid…love her!
The starting dosage is 150iu of Follistim and 2 vials
(150iu) of Menopur. I do this for 3 days and go back Monday for another scan
and blood work. I was a little nervous doing my first one on Friday (it’s been
a month since my last injection plus the first one for IVF felt like a lot of
pressure) but it was so easy – once I got through the Follistim part (I haven’t
used Follistim since April so I had to get reacclimated with putting in the
cartridge and putting on the needle) it was just like mixing Menopur which I
have done so many times. I am so happy to finally be starting!
As I am beginning this process, I am also mentally preparing
for physical changes that will come along with it. I am cutting my running WAY
back and will probably stop altogether at some point next week when my ovaries
really start to get enlarged. I plan to just walk for exercise. I also need to
focus on, particularly during the week, eating more (and eating healthy). I
know that this combination will lead to me gaining weight. I just keep telling
myself that I have to make a safe and happy home for my baby. I know most
people wouldn’t care about gaining weight since I will if I get pregnant but,
since we have been at this for such a long time, I have always tried not to
pack on the pounds. I am also anticipating
feeling bloating and uncomfortable as my ovaries fill up with follicles in the
coming days. But I am totally ready - flowing shirts and yoga pants will be my
wardrobe staples!
IVF Days 4-6
Monday morning I had my first scan since starting my meds –
not much to see but that’s pretty much what I expected. She said I have a good
number of follicles on both sides. After my blood work came back, Dr. N upped
my Follistim to 225 iu and kept the Menopur at 2 vials. It was back for another
scan Wednesday morning – I could start to see the follicles on the screen but
they still weren’t measurable in size. She reassured me that things were going
great so far and that they are just going “slow and steady” – too much medicine
at once and I could get overstimulated. Wednesday my estradiol level increased
from 59 (Monday’s) to 233. She decided to keep me on the 225 Follistim/2
Menopur. So we just keep putting along.
I haven’t really noticed feeling any different this week –
I’m not bloating yet, which is nice. I actually think I feel better being off
the birth control pills! For now, it’s back for another scan and blood work on
Friday. The NP gave me a heads up that I may be starting a new drug - Cetrotide - this
weekend to keep me from ovulating prematurely. I am hoping they can give me
instructions on how to mix it with my other meds so I still only have to do one
shot.
IVF Days 7-9
At Friday’s scan, things seemed to be moving along. I had 16
follicles on the right side and 18 on the left, although she said some of them
are really small and probably won’t develop. Most of them were about 8 or 9 mm (17-21 is
the goal for mature follicles). My estradiol rose to 560 so I had to add the
Cetrotide to the drug regimen. She also
had me increase the Menopur to 3 vials (225 iu) and keep the Follistim at
225iu.
I was able to mix all the meds together and keep it at one
injection, which is great. Adding the Cetrotide to the routine took some
getting used to but I was able to get a new rhythm down. Saturday night I
started to feel some abdominal bloating and maybe even some slight cramping/twinges
– it definitely feels like something is happening in there!
My nightly drug regimen!
IVF Days 10-12
Sunday morning it was off to Harrisburg Hospital for a scan
and blood work (we have to go to the hospital for monitoring on the weekends).
The tech told us she measured 10 follicles on each side measuring 9 or higher!
The biggest one, I believe, was about
12. That afternoon I got the call from the office that my estradiol was up to
1,207! The instructions were to keep the Menopur at 3 vials but to reduce
Follistim to 150iu. I was also to continue with the Cetrotide. They wanted to
see me again Monday morning. I was beginning to feel like we were getting close
J
Monday’s scan was great – the docs seem really happy with
the progress and it was great seeing all my big follicles on the screen! She
measured and measured and measured – 12 on the left and 19 on the right! Most
of them seem to be in the 11-13 range. There were a few bigger ones – 15 and 16
– but I think she said she was going to “let them go” (meaning wait to trigger)
in order to get the other group at the right size. Her best guess was that my
egg retrieval procedure would be Friday. They will likely want to see me every
day now. This is a bummer for my time and my veins (they are so sore already!)
but it’s all about 100% effort this cycle. This one’s for all the marbles!
On a sad note, I found out after my appointment that my
grandfather had passed away. It makes me sad that I never got to have a child
while he was around. But I am happy that he at least got to be at my wedding
and that I got to see him one last time last week before he died.
Monday afternoon I was informed that my estradiol was up
over 2,200 and I was to keep the same drug regimen that night. Nothing really
new at Tuesday’s scan. Jared came along and got to see all my crazy follicles
on the screen. There didn’t seem to be a whole lot of growth – she said she was
thinking more like a trigger Thursday and retrieval Saturday now. Of course, as
Penn State season ticket holders, we were bummed at the thought of missing a
home game…yet another sacrifice…Instructions were to keep Menopur at 3 as well
as the Cetrotide but to up the Follistim to 200. Estradiol at 3,018! Closer!
Closer!
At this point, I am feeling nervous about several things.
1 – That the follicles will poop out. I think after being
used to scans every other day and seeing consistent growth, the piddly pace of
every day scans makes me anxious, especially since she pushed back her estimate
on the trigger/egg retrieval date. Also,
the fact that my follicles have pooped out before makes that a real thought in
the back of my mind.
2- Hyperstimulation (Ovarian Hyperstimulation Syndrome –
when, as a result of fertility meds, the ovaries become swollen and painful and
the abdomen gets bloated and fills with fluid). The doc seemed very nervous
about this and they are explicitly asking me how I am feeling each day.
3- Egg retrieval – as the possible day approaches, my
nervousness grows. I even broke down and googled about it (as I always do – I am
so weak!) and read some pretty scary things, especially about pain. Jared tried
to calm me by telling me that only those with bad experiences write about it on
the internet. He even ratted my googling out to the docs, haha – they were
both, “Don’t do that! No internet!” They knew it would get me worked up.
IVF Days 13-15
Wednesday was an early, early scan -7 am! - so we could head
out to Johnstown for my Grandpa’s funeral. Things really didn’t look much
different but she insisted we were progressing. It was looking like Saturday
would be the day, or maybe even Sunday. I got the call that afternoon that my
estradiol was 4,200 and that things were coming along. Meds were to remain the
same.
As an aside, I am almost completely bloated out of every pair of pants I own (I could probably get them buttoned but it would not be comfortable!) I have been doing my best to wear stretchy pants, skirts, and some of the larger items in my wardrobe. My belly looks like I just ate Thanksgiving dinner...twice...for about 3 days in a row, haha. Deep down I know that this is part of the process and I just have to deal with it. Maybe I will get pregnant and I can roll right into maternity pants!
Thursday I had my scan with a nurse from the Philly offices
– she was there covering for my docs. She was great and really helpful in
explaining things. I felt like I could really see a lot of growth in the
follicles, particularly on the right side. I had a lot that were above 17 – it was
looking good! She said she felt pretty certain I would be triggering that night
for retrieval on Saturday. She reviewed with me all my pre-op procedures and
meds. I think it was really starting to sink in that this was really a “real surgery”
which made me a bit increasingly nervous. She was to call me in the afternoon
(as always) for the official word and, if it was time, the dosage for my HCG
trigger shot (which is the last step – it’s done 36 hours EXACTLY before the
procedure and gets the eggs ready to be harvested).
The call was a rough one. My estrogen had skyrocketed above
8,000 which is not good. This puts me at an even greater risk of hyperstimulation. I was definitely going to trigger that night
but the doc wanted me to use “Ovidrel” (a name brand and lesser dose) instead
of the generic HCG. HCG is one of the things that triggers hyperstim so the
idea is to cut that to reduce the risk – however, less HCG can result in fewer
mature eggs. The doc also wanted to me to start medicine – Dostinex – to reduce
my chances of hyperstimulating. (Of course, trying to find a pharmacy that carried it in the
middle of nowhere like Juniata County proved to be a drama in and of itself –
thankfully Walmart had it!) And then the news that felt like a real blow – there
is a decent likelihood that if I do hyperstim, the doc will want to freeze ALL
the embryos and not do a fresh cycle at all. We would delay the embryo transfer
until next month. I was so upset and
scared. Not to mention my hormones – I am really not a person of sound mind at
this point! I just remember feeling defeated and overwhelmed…again. The words
that have haunted me over and over – should it really be this hard?
In retrospect, freezing everything is not the worst thing in
the world. The reality is if I would hyperstim, do the transfer, and then get
pregnant, the HCG produced by the pregnancy would make the OHSS way worse and
it would last longer. I have a friend who went through this and it put her in
the hospital with severe OHSS. I am still VERY scared about hyperstimulating.
From what I have read (yes, I was at it again), I could just be uncomfortable
for a while (painful, swollen ovaries) or, if the fluid builds up in my
abdomen, I might have to go into the hospital to have it drained out – uck! I
am following orders – eating protein and fresh fruit and veggies, staying
hydrated, making sure I am peeing enough, and , as of this morning, weighing
myself every morning. But if I do get OHSS it probably won’t rear its ugly head
until after the retrieval.
So last night (Thursday) I did my Ovidrel trigger. It is a
pre-filled syringe so there was no mixing. It was so quick and easy it almost
felt anticlimactic – there was so much anticipation about the “trigger” and in
2 seconds it was done! I had a final appointment for blood work this morning (Friday)
– they want to ensure that the HCG is in my system. My mom came along, which
was nice – to be able to show her where I’ve been going. She also got to meet
Dr. N. I didn’t have an appointment to see her but I really wanted to talk to
her because I knew she’d calm me down and she totally did. She still feels that
everything is going to go great although the other doctors are a bit concerned
about my estrogen level. But she said we will just wait to see how I feel to
determine whether we will do a fresh transfer.
Jared and I are headed to King of Prussia later today for my egg retrieval tomorrow. We
decided to stay over since my surgery is at 7:45 a.m. I am hoping to relax,
have a good meal, and get a good night’s sleep. In reality, I am completely
scared about the egg retrieval. I am trying not to think about it so that I don’t
get worked up. I just have to focus on the fact that by this time tomorrow we might have fertilized embryos!
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