Ovum Totem

I am told this is "a thing," these little fertility-themed good luck trinkets I've subconsciously stashed around the house; in my office, in the bedroom, in the Christmas tree, even.  It's as natural as, say, Oscar hoarding every single rawhide bone you give him, keeping them close without ever eating them.  It's like he's willing them to multiply and that's exactly what I'm doing: willing us to multiply. 

The only things I've purchased recently are some sparkly bird nests with two eggs in each.  I thought they'd go well in my peacock nest on the mantle but I suppose the fact that I've constructed a nest on the mantel (this is someone who doesn't even really like birds) means I've probably been obsessing about this fertility thing.  Well, duh.  I just didn't expect it to be the driving inspiration for my holiday decorating but here we are.


I had some tasty egg salad for lunch.  Now it's getting serious. 

The little zygotes that could

Our embryos have made it to Day 3, as far as we know.  It's Monday and we only have two more days to go until we learn their fate.  That sounds so weighty but it's true.  I keep telling myself "no news is good news" but the sleeplessness has returned.  I really do wish the lab could give daily updates.  I realize that's not practical but it would be a huge relief and offer some peace of mind to every couple going through this process.  Then again, on any given day there are up to 20 retrievals so that would be a whole heck of a lot of phone calls to make. 

Right now, the little zygotes should be in the "cleavage" stage where they have divided from one cell into several cells, 8 or so.  They look like tiny blackberries at this stage. Tomorrow they will be known as morulae (resembling Everlasting Gobstoppers) and finally, blastocysts by the time we meet them.  Blastocysts kind of look like sunny side up eggs in an outer casing.  If we make it to transfer, we get photos!  How many kids do you know that have pictures of themselves as blastocyts in their nursery?

I'm digging into my penultimate week of fall quarter here, trying to get things lined up for "finals" which are basically a unit plan and I think a PowerPoint presentation?  December 3 is my last day.  It went so quickly this term.  10 weeks: whoosh!

I have no idea when winter quarter starts but I assume January 6, as that's my first day at Metuchen High School.  We typically get one week off in between but this will be a welcome change for the holidays.  There's a silver lining.  Hopefully it will be time to enjoy our tidings of great joy.



 

 

Not complaining, but...

Actually, I am.  I am going to take a minute to throw myself a pity party because GUESS WHO HAD TO GO OUT AND BUY NEW BRAS?  Me. 

Why? 

Oh, I went from a 34B to a 36C in like two days.  That's why. 

Effing progesterone.  Effing prednisone.  I hate them both.  I would rather shoot myself in the ass with a needle than suffer these godawful suppositories for the next 9 weeks of my life.  Even if this does take, I'm on them through Week 8 of pregnancy.  (Seriously?  Haven't I undergone enough indignities to last a lifetime?)

Imagine a Pez Dispenser from hell.  Imagine inserting a giant white pill the size of a kumquat up your lady bits three times a day.  Imagine having to change your extra-long panty liners at least that often as the Progest-a-pez has to leak out somewhere. 

It's not pleasant.  I look and feel, well, pregnant.  How unfair is that?  I've got a lot of respect for any woman who has made it to this stage in her IVF cycle multiple times with nothing to show for it.  Woof.  Let's talk hot flashes, menstrual-like cramps, facial flushing (hello, Rosacea - ain't no "glow"), fluid retention, a general sense of squishiness, cravings, tender, throbbing breasts...

And the steroids?  Also fun.  

OK, enough.  Pity party's over. 

Just wanted to say it is definitely not a picnic right now.  Thank goodness I have a light week of school work.  I found myself tearing up at random moments like during "Top Chef" for example.  Padma wanted a second serving of Shirley's traditional Chinese New Year dumplings?  Shirley got emotional and so did I.  It was SO MOVING.  What?

Also embarrassing: found myself gazing longingly at the tent-like sparkly maternity wear at Kohl's today.  Considered buying it because I feel like it would fit me now - of course it wouldn't but it's all right there, within reach, but not just yet.

Don't ask me what I had for lunch.  It involved roast beef, provolone and a ton of jus.  Ew.  Excuse me while I walk 15 miles now...  

Eight is Enough

I'm a day behind in posting but I honestly think it's taken us this long to catch up on sleep and wrap our heads around our wonderful fertilization results!  This blustery, frigid Sunday morning we have a lot to be thankful for, that's for sure.  Fittingly, we were in the Wegman's parking lot about to chow down on some hormone-sanctioned sour cream doughnuts (heavenly!) when the phone rang.

It was Nurse Talia from RMA calling to tell us that 10 of our 18 eggs were fertilized and 8 of those made it to embryo stage.  Eight!  That's a great starting number, as we can expect to lose half of them in the next four days.  (I realize that sounds quite morbid but it's a statistically sound prediction.)   I'll take four blastocyts.  Heck, I'll take two so long as they're healthy.  It would be a dream come true to have leftover "frosties" but really our main goal is to have at least two to transfer.  Who knows?  If they both took, we'd be "two-for-one and done."  ha! 

My pal who went through this process assures me that the next four days are almost as bad as the dreaded "2ww" (two-week wait before the pregnancy test) but that no news is good news on the embryo front.  If all is progressing well, we can expect a phone call by noon on Wednesday telling us how many blasts we have and what time our transfer is scheduled for on Thursday morning. 

Of course there is the very real possibility that none of them make it to Day 5 which means they have arrested and are not viable or, alternatively, that they are growing but too slowly and just need a bit more time to mature.  The defined window for arrested development is failure to progress over 48 hours.  We'd get a phone call if this were to occur.  If we have growth but it's not within our designated window of time, this would move us to a FET (frozen embryo transfer) sometime in January and we wouldn't know this till Wednesday. 

So much could go wrong, it's kind of astounding that IVF is ever successful.  But we've put our faith in the experts and in nature to take its course. 

Bountiful Harvest

I meant to write about retrieval yesterday but I felt fairly, um, "intoxicated" until about 7:00 PM.  It was honestly a breeze and my drunk-like state was just the side effects of the anesthesia wearing off.  I was lucky: no bleeding, no nausea, just a background headache, but no cramping or pain.  Amazing!  I know there are women who are doubled over for days after retrieval but I made it through with no trauma whatsoever.

Now comes the hard part: waiting.  It's our favorite thing to do!  We're such pros at it now. 

We should get the call before noon telling us how many of my eggs fertilized.  With 18 to work with, I'm not terribly worried but there is always the chance that some aren't viable and don't survive to embryo status.  I had nightmares that none made it so that didn't help my sleep.  Silly, I know, but we've come so far that we just want the best shot possible at making it to Thanksgiving transfer.  With a starting number like ours that was completely unexpected, I'm just crossing my fingers and hoping for the best.  There's nothing left to do.

The procedure itself was brief.  Rhett said I was in the OR for all of 10-15 minutes and I got a pretty good look at the table and the equipment before they knocked me out.  The table had a hole for my bum and the typical gyno stirrup but these were hardcore strap-you-in-with-velcro.  I couldn't move at all.  I wish they could just numb you and leave you awake to watch.  I think it would be so cool to see your eggs getting sucked up into the incubator but I'm sure some women would absolutely flip over the size of the needle they use.  It's the length of a sword but very, very thin.

 Rhett says I was awake when they wheeled me back into my recovery bay but I don't remember anything before telling the nurse that I was going to Fuddrucker's for lunch.  bahaha.  Yeah, I don't think they hear that one very often.  I went on about eggnog and tree decorating for a few minutes - no memory of this - and then Dr. Forman popped in.  He held up a sign like he was judging a sporting event and said "this is your number."  I remember being super confused and then it dawned on me that he was talking about eggs.  18?  18 eggs from me? Are you sure? 

(Look, I got all ambitious adding photos to my posts now...)

Now we're off to Wegman's to kill the time between now and noon and probably buy a lot of festive seasonal products we don't need just because we see them.  It's our weekly pilgrimage and the running joke is to sneak things into the cart and wait for the other person to pick them up and say "Really?  You want to buy salted dark chocolate Marcona almonds for snacking?" 

Go time

We made it to Friday.  In 30 minutes, we'll be on our way to RMA Basking Ridge and in another three hours, I'll be wheeling my IV into the OR.  

We were both up at the absurdly early hour of 4:30 - training, I guess.  I took Oscar out at 5:00 and went back to bed for snuggle time.  We managed to loaf around until 7:30 or so.  Not too bad.  Then I had the genius idea to turn on the TV and "A Baby Story" was on.  Of course I watched it.  Great way to get those ovaries pumping hormones, I tell ya.

No fragrance, body lotions or deodorants allowed for either of us today.  Apparently eggs are quite sensitive to scent so there's a ban on all products for retrieval (and transfer, too.)  I'm curious to see how swank the waiting areas are.  In the regular monitoring lobby, there's a massive fish tank and three flat screen TVs spread around the room with seating for probably 50+.  Since we'll finally be inducted into Club Ovum, I bet there's a nice spread for the partners waiting around.  I told Rhett to pack snacks, JIC, as I take notoriously long to wake up in recovery.

Oscar is constantly at my feet this morning.  I told him we were going to harvest potential brothers and sisters and he just looks at me, tail wagging, dreaming of the dog park.  I'm most excited for this to be over so we have our count.  Of course, the next hurdle is tomorrow when we get fertilization results but with hopefully strong-looking eggs, our chances will be good for a blastocyst or two.

Tonight I've convinced Rhett to watch "Bridget Jones's Diary" with me.  Win.  (That only took nearly two years of marriage.)  Any night when I pick the movie is a good night.  Did I mention the pan of gluten free, dairy free peanut butter brownies I made last night...?  They're waiting to get in my belly.  Yes, please!

Updates to come.  Digits crossed. 

12 eggs-a-laying

We've made it to Thursday - wait, it is Thursday, right?  I have a tenuous grasp on everything that's transpired in the past 12 hours, that's how out of it I am.  Triggering at 12:20 AM will do that to you, I guess.  If we thought we'd get any sleep last night at all, we were wrong!  I had to confirm with Rhett this morning as we were running out the door at 5:45 that I did indeed take my shots.  No. Memory.  I feel like Ingrid Bergman in "Gaslight."

Turns out things were running so slowly at RMA that we were 40 minutes late getting home, Rhett missed his train, NJ Transit was way behind schedule anyway so he just decided to work from home.  Now we can both nap.

Rhett took great notes from Mel B. this morning so it looks like our count is as follows:

Lining at 7 (we're in implantation range though -- I double-checked)

Left follies
22, 25, 11, 11

Large Marge is approaching the danger zone but as long as she stays under 30 by tomorrow, it should be ok.  If an egg is present in "post-mature" follicles (anything over 28 mm) it typically won't fertilize.  Not a biggie, considering the haul we have on the right.  Someone had to take one for the team.

Right follies
11, 24, 17, 17, 20, 20, 18, 13, 15, 18, 14

This is great!  Even that 13 could be big enough at 15 mm tomorrow to produce a viable egg.  The 11's are out but that's ok.  10 follicles on the right is excellent! 

We have a total of 12 mature follicles.  We can realistically expect half that number to be usable and half again of those that make it to embryo status to become Day 5 blastocysts.  The numbers will begin to dwindle and we have to wrap our heads around that before tomorrow so there aren't any surprises.  When I'm in recovery and they tell us how many viable eggs they got, I'll feel a little better.  I'll feel even more at ease when we get the call Saturday telling us our fertilization results.

So many hurdles left to jump, even though this is the first big one that sets things in motion.  It's daunting and so tempting to get ahead of ourselves but we're both making an effort to take it one day at a time so it's not so overwhelming.

Another migraine coming on now and then acupuncture so a restful afternoon and evening are in store. 

Time to pull the trigger

I get two shots in the belly at 12:20 AM.  My actual retrieval is timed precisely to this on Friday exactly 36 hours later.  There's a window for delays and such at the Basking Ridge office but only by 2-3 hours.  Sounds like I'm near the end of the day.  Last retrieval is around 2 pm or so, Anne said.  If you stop to think about it, Ovidrel is kind of amazing since they can time ovulation almost down to the hour with it.

My stats for today look good.  E2 is at 2999 and progesterone is climbing slowly, which is key.  It needs to stay low for the next week.  I'm at 1.2 now and we don't want to see a spike until after I start the progesterone suppositories.  Mmmm.  Should be great fun.

4 left follicles less than 11 mm in size
1 left follicles between 11 to 13 mm in size
0 left follicles between 14 to 15 mm in size
0 left follicles between 16 to 17 mm in size
1 left follicles between 18 to 19 mm in size
1 left follicles greater than 19 mm in size

Haul for the left is only 2-3 which is still more than we thought we'd have!

3 right follicles less than 11 in size
3 right follicles between 11 to 13 mm in size
2 right follicles between 14 to 15 mm in size
1 right follicles between 16 to 17 mm in size
2 right follicles between 18 to 19 mm in size
1 right follicles greater than 19 mm in size

Those 11-13 mm follies will have the chance to reach 15-17 mm in two days so it's a good thing my retrieval isn't scheduled until the afternoon.  Gives them another few hours to grow grow grow.  If they all make it to size, we could have more than 10 follicles producing retrievable eggs.  Anne did warn us that typically up to half of all fertilized embryos arrest during development but even still, we could have 4 or even 5 blastocysts by next Thursday if all goes well.

We have one more round of morning monitoring tomorrow to check in with Dr. B.  With his seal of approval, I go home and wait it out.  Nothing to eat or drink after midnight tomorrow.  We report to the mysterious Fortress Ovum on the first floor of the Basking Ridge office at 10:00 AM.  A friend warned me that your man is whisked away to a backroom to do his thing while you sit paging through magazines, nervously waiting for a nurse to start your IV and the anesthesiologist to come talk to you.  Dr. Forman will speak to both of us before I'm taken in for the procedure and then it's showtime.  The whole thing takes 15-20 minutes but they keep you in recovery until you can pee and eat some crackers.  We'll know by about 2 pm Friday how many eggs they got. 

The suspense is terrible.  I hope it'll last.  (Willy Wonka quote?  No?)

"You're ready"

"Looks like you're ready.  They all look pretty juicy." 

Ew?  Juicy makes me think of pomegranate seeds and I actually enjoy eating those but not when you compare it to my anatomy.  Thanks, doc. 

Mel Brooks was all smiles this morning.  Haven't seen him since July.  He went follie scouting one last time to get a final count and it looks like we have four lead follicles.  It's a quartet of 19-20 mm leading ladies so Hearty Harriet, Big Beulah, Large Marge and Long Lena are ready to perform on Friday.  He also counted 4-5 other mature follies between 13-17 mm so those will be in the mix as well.  That's a wonderful bounty.  Seems they enjoyed their sushi dinner last night.

Rhett and I were so happy, we were willing to overlook the juicy comment and this gem of an exchange:

M.B. "It looks like you may have a blocked tube?"
Me  "Well, no.  I don't have a tube.  It was removed with my ovary on September 30."   
M.B. "Are you sure?"
Me  :pause: "Yeah, pretty sure."
Rhett "It was Dr. Slomovitz on the robot."
M.B. "OK, cause I'm looking at these follicles..."
Me "We know.  It's a phantom ovary. We were shocked when Dr. Hock told us."
M.B. "Ok, looks good then!"

Did that just happen? 

I laugh now but our biggest beef with RMA is that they leave notes for each other so why the heck don't they communicate essential information like, oh, "Patient had unilateral slapingectomy/oophorectomy last month"!?!  Not. Difficult. OY.

I am currently awaiting trigger shot instructions for this evening.  I should get a call between 4 and 5 pm telling me when to take the two pre-filled syringes of Ovidrel.  I've heard it's a bitch.  I say bring it.  I've got one paper overdue, another lesson plan and rubric to finish, but I'm not worried. 

Looked up the retrieval schedule for Friday and it's - get this, House fans - Dr. Eric Forman.  ha!   He seems like a sensitive guy, someone you'd want to hear talking to you before they give you the propofol.  Honestly, is there a quota on that stuff?  I don't think I've ever had a hypnotic/amnestic as frequently over a six month period...this is the year of anesthesia and I'm so over it.

Gotta do more research into any pain/discomfort to expect after retrieval but since I'm not in any pain/discomfort now with my small bundle of eggs, I think I'll be ok.   Basically just feels like it's never-ending PMS but less severe than my usual monthly trip to the funhouse.  

Until later...

 

The race is on

Nurse Anne just called to say all looks on target for a trigger shot tomorrow.  We go back for morning monitoring and await instructions.  There are a few smaller follies they'd ideally like to see in the 13-15 range but it's anyone's guess how much they'll grow between now and Friday. 

Get this: Marge has been outlarged!   She's still hovering around 16 mm while two of my gals on the right have eaten some serious Wheaties and now outrank her at 18 and 17 mm.  That's awesome.  Hearty Harriet and Big Beulah are now contenders for lead follie.  What's even better, though, is the handful of runners-up chugging away on the right side.  At this rate, they will be ready for our bountiful harvest by Friday. 

2 left follicles less than 11 mm in size
0 left follicles between 11 to 13 mm in size
0 left follicles between 14 to 15 mm in size
2 left follicles between 16 to 17 mm in size
0 left follicles between 18 to 19 mm in size
0 left follicles greater than 19 mm in size

3 right follicles less than 11 in size
5 right follicles between 11 to 13 mm in size
1 right follicles between 14 to 15 mm in size
1 right follicles between 16 to 17 mm in size
1 right follicles between 18 to 19 mm in size
0 right follicles greater than 19 mm in size

Dr. Shastri said the minute we get a solid >18 is when we trigger so that should be tomorrow night at some point.  They stagger the times of retrieval so it could be anywhere from 5:30-midnight that I take the Ovidrel meaning 36 hours later I'll be in the OR.

I'm trying not to get too much ahead of myself.  E2 is 2015 which is great.  Lining is still a 7 but I have a week from today before transfer, should we make it to that point.  It should be noted that not every follicle will contain an egg.  In theory, they should each produce one ovum and in some cases two ova but nature's a sneaky bitch sometimes and fools even the pros.  Even if we do get an initial egg from each, we can expect a percentage of them not to make it through fertilization.  This is some Darwinian action in motion. 

I'm also trying not to count my follies every day as human error alters the total from scan to scan (plus things move around in there and as the ovary swells sometimes you can't get an accurate count.)   It is tempting to say we could be looking at a haul of 10 follicles.  That's worlds away from the "four or five" I was quoted on Halloween and would give us a greater chance for having some frosties.  We went into this not expecting to have anything left over to freeze so any remote glimmer of a possibility that we could one day give a child a biological sibling...but I'll quit while we're ahead.  No point dreaming down that road until we prove that it can take the first time. 

Now who wants some filet?   

She-Hulk

OMG my rock hard abs (ha!) bent the Lupron needle this morning.  That was terrifying.  I think it's safe to say we've reached the stage where my belly no longer willingly accepts injections -- that or those are some seriously cheap-ass needles they've given me. 

I had a pear and a protein bar, took Oscar to the dog park, came back and fell asleep for 40 minutes.  Then I got up to write a paper.  That was short-lived.  I can't stare at this screen for more than 15 minutes at a time so I caved and wrote my profs asking for their patience but that my meds were making online coursework next to impossible. 

I'll get it done eventually.  I managed two discussion posts just now but I think it's time for a tub.  (I've convinced Rhett that's what Brits say to their babies when they bathe them: "time for a tubby!"  I'm pretty sure I made that up.  Oscar enjoys it, though - the bubble-eating, not so much the getting wet.)

One more dawn, one more day

Tuesday morning and it finally feels like November again, thankfully.  We decked our halls this weekend and it hit 62 degrees yesterday.  Not ok, weather.  That's a recipe for S.A.D. which I am now convinced I have because I want to crawl into bed at 8:30 every night (and mostly do, which is even lamer.)  I'm still blaming the stims for my fatigue disorder and from what I've read, it doesn't really go away after even transfer...joy to the world.  It's the kind of bone tired that you can't even sleep off, try as you might.  I am now getting the constant migraine, the blurred vision when staring at a screen too long, the nausea, the weird dizziness that only comes when I'm horizontal, and did I mention the peeing five times before falling asleep?  I have the bladder of an octogenarian now.  Huzzah!

All of this is - say it with me now - normal.   I get it and I'll take it (grudgingly.)  It's been a real challenge not being able to do the things I'm accustom to doing during the day like, oh, exercising, having the attention span to focus on school work, etc.  It's temporary, I know, but not as temporary as you'd think.  When all is said and done, it will be over a month of this weird hormonal limbo followed by what is hopefully a healthy pregnancy and then it will all be worth it.  It's the uncertainty that eats away at you, even when things are going well.  I have to stop and tell myself, "the whole point is to have a baby and it may not feel like you're doing jack squat at the moment, other than feeling out of your skin, but there's no way to know if it's going to work before giving it an honest go."  Well, this is our honest go.  Were close.  So close.  I just want to get there.  We may trigger tomorrow or Thursday and I just want to hear someone tell me "everything looks great and you're ready." 

We had another RE visit, this time with Dr. Shastri.  Honestly?  The woman is stunning.  I may have a little doctor crush on her.  That sounds really bizarre, I know, but whereas Dr. Hock is a pragmatic Beverly Crusher type (yes, Rhett, we're talking Star Trek: The Next Generation), Dr. Shastri is the Counselor Deanna Troi of the Starship Enterprise.  Not nerd enough for that reference?  That's ok.  Google it and you'll get it. 

Know what I'm not looking forward to?  Tomorrow with "Mel Brooks" Bohrer.  He's nice enough in an elfin grandfatherly way but dude, how do you miss an abscess after routinely mentioning my hydrosalpinx during u/s?  Where there's smoke, there's usually fire!  Not cool.  He'll probably tell me my miraculous phantom planet is "just a cyst" but whatever.  I only have to deal with him for one day.  This is the downside of communal monitoring.  I may not see Dr. Hock again until after retrieval and I miss her perky encouragement.  There's something to be said for having low expectations and being totally blown away by a better-than-hoped-for outcome.

More later when I have my stats back...



  

Follies on fire

It's Monday afternoon.  I've had two five-minute "naps" but I can't seem to summon the now caffeine-free energy levels I had yesterday after my - whoops - peppermint mocha.  Oh well.  Somehow, someway this school work will get done.  I love leaving papers until the next-to-last minute anyway.  That's when I produce my best work.  And really, I'm growing a bunch of follicles here so my energy and mind are focused elsewhere.

I just received the RMA email with my stats.  Things are really taking off in the E2 department!  I'm now at 1313!  Holy cow, that's more than doubled since Saturday, and should continue to climb over the next two days.  We go back every day now for close monitoring because, well, we're that close to retrieval.  My lining is at 7 mm so that's progressing nicely but here are the rest of my stats (copied and pasted from my nurse's email):

3 left follicles less than 11 mm in size
1 left follicles between 11 to 13 mm in size
1 left follicles between 14 to 15 mm in size
1 left follicles between 16 to 17 mm in size

5 right follicles less than 11 in size
5 right follicles between 11 to 13 mm in size

Do we see that left follie I've highlighted?  That's Large Marge.  She's our lead follie meaning she's the standard by which all others are measured and the one who will determine when we trigger.  She's at 16 mm today and will probably be at 18 mm tomorrow, meaning we'd be triggering sometime on Wednesday, most likely.  Follicles are considered mature once they reach 15 mm so when the lead follie reaches 20, it's all systems go.  They don't want anything much under 15 or much over 20 by retrieval day so hopefully those slow pokes on the right catch up. 

Marge is a big girl. There's no way to explain why she's so eager and, um, robust, but she and her sisters on the lost continent are running this show now.  Go figure, right?  There's a chance we could get all five on the right to grow up to 16 or 17 mm by retrieval and that would be great.  At this point, Dr. Hock said they probably won't adjust my meds but she does want Dr. Shastri to check in on things tomorrow and then we'll see what the game plan is.  She's not concerned in any way but mentioned that the faster the big ones grow, the harder it will be for the others to catch up.  We realize that we risk having only 3 or 4 eggs to retrieve instead of the 8+ we could have but if they're healthy, that's what matters. 

This protocol emphasizes quality over quantity and Large Marge seems like she's enjoying her cereal-and-steak regimen so I have no problems keeping that up for the next few days while we wait for the trigger instructions.  

Phantom Planet

Allow me a tangential post before I write about today's appointment.  It will blow your mind, as it blew ours when we first heard.  You can't make this stuff up.

I have a phantom ovary on the left where my once-present ovary previously dwelled.  In this brave new solar system, we found three apparently healthy, growing follicles.  These are no minor follies: they are now 14 mm, outranking even the expected haul of five "measurables" on the right side.  What these follicles are doing out in space, we may never know.  Whether some healthy tissue was accidentally left or allowed to remain by design, we can only learn by asking Dr. Slomovitz, the DaVinci cowboy who did my surgery last month.  Dr. Hock said she felt like giving him a call to share the bizarre and unexpected news.  Of course, she said, she never expects the expected from me but this is unprecedented.

We first learned that there may be something brewing on the left side during our RE visit last Tuesday.  We were told these were most likely follicles but neither Rhett nor I wanted to believe it.  Couldn't they be cysts?  Blood clots and debris left over from surgery?  Talk about not trusting the expert opinion!  What on earth would healthy egg follicles be doing in the empty space left over from my hydrosalpinx and bum ovary?

When we went back on Saturday morning, the moons orbiting my phantom planet had grown.  They were responding to the stims as follies should.  How was this happening?  We began to allow ourselves to believe that these were legit.  They certainly looked identical to the burgeoning follicles on the right, though they lacked a measurable ovarian vessel.  Poor babies!  How are they attached?  Are they just hanging out, waiting for their mother-ship to return?  I feel bad for them.  They're all alone in there, acting like nothing is out of the norm when in fact they should medically, statistically not exist.  What if they're some kind of mutant super-ova? 

As ass-backwards as this seems, it is happening for real.  The proof is in my phantom planet. 

Feeling it

Hello, Sunday morning migraine.  Who invited you?  Oh, probably your pal Lupron...that same a-hole that's has given me these black and blue marks all over my belly and a real case of too-bloated-for-my-skinny-jeans.  Guess that means something is working as it should.  I feel disgusting and that's probably indicative of the sudden onset of injection effectiveness.  We're worlds away from Thursday and Friday morning now when it seemed like this would never happen. 

While"thrilled" isn't quite the right word, I am fine dealing with the unpleasant side effects because they are normal.  Anytime I get to use the word normal in this cycle makes me very glad indeed.  Yes, it is normal that my breasts feel like they've grown a cup size in less than a week and are super sore that even putting a bra on is an exercise in caution.  I say bring it on.  I have a reserve of tunics (or as Rhett calls them, "tents"), leggings and I-don't-give-a-crap on standby for the end of the week when I'm sure I won't even look at a pair or pants and that's just fine by me.  Most women start to feel this way by the end of their first trimester but we lucky IVF-ers get to feel it before we're even pregnant.  No matter: if we get to trigger on Thursday or Friday, it will all be worth it.  It's temporary. 

Tomorrow morning, we'll check in on the seven follies and my E2 levels.  We're now taking bets for how high it will be.  I'm going to say, oh, 850?  Honestly, I don't know what to expect from a medical standpoint but in four days it multiplied by 12 so it's anyone's guess how much it will have risen in two.  What we don't want is for it to get *too* high before my uterine lining starts to show some thickness.  Now, I'm only at 4 mm and I need to be over 8 for it to be optimum for transfer.  Ideally, the thicker the better up until about 14mm and then it's a bit too cushy.  There's still time and acupuncture to help me on my way so I'm not worried yet. 

We're convinced Oscar has noticed the change in my hormones because he tried to hop in the tub with me last night and this morning, he snuggled right on top of me for over an hour in bed.  He typically just lays his head on my thigh or something but this was a full-on body hug.  He's a sensitive pup and he's being so good for both of us during this time, even though his routine is off.  Right now he's standing on the kitchen chair, staring at Rhett cooking our steak and eggs.  As if, Oscar.  You're not getting any. 
  

Hallelujah!

It's Saturday morning, the sun is shining, and we are giddy with delight after my scan/bloodwork.  I now have 7 follicles growing, two of which are notiecably larger than they were on Tuesday.  One is already at 12 mm and the other is 14 mm.  They need to be at least 10 mm to be "measurable" and over 18 mm to make it to retrieval so we're almost there!  Dr. Hock was so happy she hugged me. 

It's safe to say no one in that exam room knew quite what to expect this round but there are healthy follicles growing at a rapid rate and even multiplying only four days into stims.  That's fantastic news for someone previously labeled a poor responder...it was almost too good to be true and I think Rhett and I went from shock to awe and back again.

While en route to Wegman's (our traditional Saturday morning outing) I got the call from the RMA lab in record time with my bw results.  My E2 is now 663.  Wait - come again?  Six-hundred?  That's incredible.  I had to listen to the message twice.  I started out the week at a dismal 54 and was feeling pretty shitty about that.  They want you well into the thousands by retrieval and it looks like I just might make it there after all.  Are we sure they didn't mix up my labs? 

Naturally, I'm trying to contain my excitement - we both are -  just because we know what it is to come crashing back down to earth after high, high hopes.  But I finally feel something this morning, something better than fear or anxiety: I feel in control.  I feel like I'm actually contributing to this process instead of holding us back.  I feel like the demons of the summer may be far enough behind us that I can look forward to getting back on this bucking bronco of a cycle and ride it out. 

Just seeing those would-be eggs, my lovely little follicles on the u/s screen, reminds me why we're doing this.  They are there and they are growing, even if I can't feel them.  It's hard to keep reminding yourself that everyone feels this way at some point going through IVF, that there's nothing abnormal about feeling disconnected or down on yourself because you're not producing the volume or quality you thought you were biologically entitled to.  Looking at that screen, you can see something tangible that's worth all the ups and downs and uncertainty.  That's enough to hold onto for another two days until we go back on Monday morning for some more good news.

Pre-scan blues

It's Friday.  For most people, this is the best day of the week.  I've got a lot to look forward to, as well: Rhett comes home tonight after three nights in London and tomorrow is our first check-in bw/us during this stim cycle.  I should be super excited but instead, I feel numb.  I blame the Lupron.  I feel so negative and on edge since I started injections this time.  I have a weirdly non-existent appetite for anything but - get this - Golden Grahams.  I went to sleep on Wednesday just craving them so I drove myself to the store on Thursday, bought a box, and that is basically what I ate yesterday.  What the heck?  I don't even like Golden Grahams and as a general rule, stims are supposed to make you ravenous for everything in sight but nope.  I just wanted some cereal.

Is this even working?  That is what I keep thinking over and over.  Why don't I feel like anything is growing?  Why am I not moody/sad/bloated?  Sure, it's only Day 4 but I am honestly so down on this whole process that it scares me.  I don't like this feeling one bit.  I want to be positive, I want to hold onto that hope I tell everyone I have but where did it go?  Did I have it in the first place or was I saying my lines, the dutiful performance of a desperate IVF patient?  It's maddening to watch myself spiral like this.  With every injection, I feel more emotion slipping away and now I can't stop Googling adoption and dreaming of a plump Asian baby.  WHAT IS HAPPENING TO ME?

And the truly frightening thing is, I consider today a "good day."  Yesterday was terrible.  I almost walked out half way through acupuncture because I didn't see the point.  Isn't that nuts?  Then I got the ear needles and they always calm me down.  She says it's my stress point and I have a lot of anger.  Really?  You think so? 

Then again, maybe the stims are doing what they're supposed to do if they're messing with my body  chemistry this much.  I don't like it but I'll cope if that's the case.  Tomorrow we'll have a better idea of what, if anything, is happening so maybe I'll be able to take a chill pill after the appointment.  Probably not, but at least there are a bunch of dumb movies on Netflix to queue up with my boys this weekend. 

Let the stims begin!

It's Thursday. I've now had one full day of stims on the microflare protocol.  Basically, microflare is the end of the line in terms of dosage.  It's the most aggressive plan of action for those labeled "poor responders" which typically means women over 40 and, um, me.  My eggs are ancient at 27, or at least they're acting all decrepit in there.  Thanks, ladies.  Not helping things!

That terms slays me, though.  Poor Responder?  The only things I've ever responded poorly to in my life are dairy and algebra.  There is a lot of shocking lingo in the ART field (such as "not compatible with life" when they grade your eggs) but I digress...

This is what my schedule looks like currently:

20 IU Lupron between 7:30 and 8:00 AM

20 IU Lupron
15 IU low dose hCG
450 IU follistim
(All given between 7:30 and 8:00 PM)

This is technically the third day of the stim cycle, as I began Lupron Tuesday night. If we're counting down, I have at least seven more days left before I trigger. My next bw/us is Saturday morning in Basking Ridge.  Dr. Hock, our doctor, is on the monitoring schedule so that's a good thing. I've seen her more already this cycle than I ever did over the summer!

I don't know what to expect in terms of growth after only three full days of injections but I am hoping the five follicles we saw will all be measurable. My E2 was only 54 on Tuesday which is normal for me but I guess pretty low (and indicative of DOR--diminished ovarian reserve.) That needs to be well near 1000 by this time next week for retrieval to happen. I read that you can expect 200 per follicle so I'm just going to keep my head down and stim on, trying not to worry about it.  Did I mention that endometriosis is a bitch? An otherwise completely healthy ovary just can't support the numbers of follicles it normally could after sustaining such intense damage from the disease so I'm pretty fortunate to have even five good-looking follies to work with.  

So far, I have had raging diarrhea from the Lupron, a bit of a headache and stinging throughout my abdomen immediately after injections but that goes away after a few minutes. It's really nothing at all so I'm fortunate. The spotting from coming off of BCP has finally stopped. Ugh. I felt like I was bleeding for 14 straight days, which I was, and it was unpleasant. Now I feel some slight cramping. It's almost like my uterus and ovary is waiving saying, "yup, we're still here!" No pain, no mood swings yet. I was ready for bed at 9:00 last night so fatigue is definitely rearing its head. Otherwise, I know it's Day 3 so I'm just bracing for the week ahead.

11/12/13

I promised myself and any future children that I would chronicle my experience leading up to their birth. My first two cycles, I didn't journal at all, I was in that much pain. It's just as well, as they were cancelled. So here we are after my first Lupron shot on Tuesday, November 12, 2013. I will write through it this time, if only to give me hope and make this real.

After bw and u/s (that's blood work and ultrasound), the nurse hands you a calendar when you meet to go over the shots. Just looking at those small boxes with dates makes it seem almost surmountable. "Look," you tell yourself. "I will be finished with these injections in 10 days or so and everything will be alright." If only it were that simple. I know what lies ahead and it is less than simple. It's a miracle babies are born naturally at all when you consider everything that can and does go wrong. We IVFers have it rough, that's for sure. We know too much. There's a danger in thinking about it constantly but try as I might, my entire day is structured around shot in the morning, shots at night. I want to get it right this time. I MUST get it right this time. It's our last chance.

To anyone who's been here, who is here with me, godspeed on your journey. I hope each and every one of us gets exactly what we wish. It would be nice to think that could happen because we want it so badly, because we're good people trying to perform a basic human function that was denied us by some cruel genetic lottery. My heart goes out to those who trudge on, BFN after BFN (big fat negative.) This cycle is it for me. I know it, my family knows it, and I am learning to accept it. It gets easier, day by day, as we get a little closer to our goal. It could work out. It could not. For now, I'll tell my story as it happens since that's all I really can do as I wait the wait we all meet with equal parts excitement and fear. Will it ever be me? In a month we'll know for certain but until then, hope is where I hang my hat.

Backgrounding

The genesis for this small family blog comes from my mother wanting me to "write through it."  She has a good point.  IVF brings out a lot of emotions you didn't know you were capable of feeling so in order to not implode/explode/drive your spouse and dog completely nuts for the next few weeks, a healthy outlet is essential.  I'm not much of a talker so therapy wasn't really an option, plus this is free.  Boom!  A blog is born.

I had been writing a journal of sorts in a Word doc for the past couple of weeks so in order to bring everyone up to speed, here is where things stand from a historical perspective (I'm much calmer now - ha!):

October 22, 2013

 

This isn't news to any woman who has gone through multiple IVF cycles: waiting SUCKS. I had my check-in with my RE yesterday following my September 30 robotic salpingectomy/oophorectomy and hysteroscopy. Got the green light from my surgeon last week to go forth and get pregnant so I had convinced myself that my RE would take one look at my now squeaky-clean insides and be like, "let's do this!"
Wrong. I just get so @*#&ing frustrated that I've wasted a month healing and am now going to be sitting around for another 3-4 weeks until I get my period and get back on BCP for 10-14 days. It seems interminable! I have Stage IV Endo - apparently some freakish kind that multiplies seemingly overnight - and I have yet to complete a cycle after starting IVF in July. I'm getting super anxious that by the time we do get started again, all the good the surgery has done will be wiped out because my natural hormones are that powerful. Also, on the sonogram she made a big gd deal out of two tiny dots she found in my uterus and was all, "let's see if these disappear with your next period and if they don't, we're doing a saline sono again." HELL to the no! That is even more time waiting and more trauma on my poor body. I did not react well the last time and got a fever and cramps for days after. Hello, infection anyone?
This sounds all very whiny and boo-hoo-poor-me, I know, but when is it my turn? When do I actually get to make it to retrieval and at least try? I can't stand not knowing if my eggs will grow, if we'll have viable embryos, if other issues will present themselves...I just want some answers and not another month to sit around and angst over things I can't change.
So...back to acupuncture on Thursday. I'm giving myself the best possible chance with Co-Q10, weekly acu sessions, cutting out coffee and alcohol, staying on my strict GF, DF diet and trying (unsuccessfully) to stay away from Halloween candy...ha! Yeah, right.

November 1, 2013

Things are beginning to look up so there's no need to flip out about any more invasive tests and bullshitting around (for the moment.) I am happy to report that my Halloween scan and blood work looks great. I have a thin, bump-free lining and 4 healthy 10 mm follies ready to grow, grow, grow. My RE thinks we stand a real chance of having at least one blastocyst transferred -- hopefully successfully so! I feel like I could dance for joy that things have not fallen apart yet but perhaps I shouldn't count my chickens...or eggs? ha!

This will be our 3rd IVF cycle and the first - fingers crossed - that we actually complete so there's a lot of holiday wishing going into this one. Maybe this time we'll get lucky and I can stop tying my stomach in knots whenever I think of another Christmas or NYE without being pregnant. Maybe we'll grow out very own turkey baby this Thanksgiving, which is probably when we'd be having our transfer. LOL.