We have Zygotes!

The doc called this morning with the numbers: out of 32 eggs collected, 24 were mature, and of those, 18 (75%) were fertilized normally! That's better than the 70% rate they like to see. So today is Day 1, and on Day 3 a nurse will call to let me know how they're doing and when to come in for the transfer.

Apparently yesterday when they were wrapping up, the doctor told C that it was likely they'd only transfer one embryo because of my risk of OHSS. I was a little disappointed when I heard that afterwards, mostly because of the decreased opportunity for only one embryo to implant. But it would be much easier and cheaper to take care of one little one! And OHSS complications are not very much fun (and last longer when one is pregnant).

My mom was happy to hear the news. She is calling them her Grandzygotes already. :)

I took today off work again, and have been sleeping here and there. Still feeling pretty swollen and uncomfortable. But I'm off the pain meds, so that's progress!

Retrieval

C and I got up at 4:30 this morning, showered, and hopped in the car. I'd slept better than I thought I would last night; I laid there being worried for several minutes before dropping off, but once I was out I was out all night.

We got there probably 20 minutes early, and had to wait about 20 minutes after we were supposed to be there for everything to be ready. I met the nurse and the anesthesiologist, and they went over what would be happening. Off went the pants, and they covered my lower half with a sheet while they hooked me up to the cardiac monitor and stuck the IV in. The IV was painful; it stung a lot and the anesthesiologist said it was probably because it was poking a valve in my vein. She adjusted it a little but it wasn't super helpful. She also put on one of those finger clamp thingies. Meanwhile, the nurse called down an order for more meds so we could pick them up in the downstairs pharmacy.

Then the doctor (the same one as my last two ultrasounds; I like him) came in with a resident (she squeezed my hand and it felt weird to be on the receiving end of a hand squeeze; no idea why) and had me sign consent forms. One was for the procedure and the other was so they could use my discarded eggs (ones that don't fertilize, or immature ones) for a study several of the doctors are working on that has to do with mitochondrial DNA therapy for fertility.

Once all of my thinking was finished, they went ahead and started the sedation. It worked FAST. I kind of felt weird for a minute, and then felt super tired. They got my legs up in the stirrups and turned the lights down, and then C said goodbye to me as it was time for him to give his sample. Turns out he missed the whole thing; they sucked out all the eggs and did some painful poking on something up in there (I can't remember what they were doing and I wasn't quite with it enough to say anything) and then got me out of the stirrups and I was lying there recovering when he got back. He was there, though, when the lab tech stuck his head through the door and said "We got THIRTY TWO eggs!" Holy cow. The doc said transfer would most likely be Sunday or Monday.

So I lied there for I don't know how long; maybe fifteen minutes, and then they started gradually sitting me up to see how well I was recovering. I was OK until I stood up and was helped back into my pants, and then I got super dizzy and sweaty and I told them I was going to have to lie back down. (I'm not surprised; even when I give blood I tend to need several extra minutes to lie there before I can get up.) So back down I went, and C stroked my arm and face for awhile. They had taken all of the heart monitor things off of me so they put the cuff back on and checked to make sure my blood pressure was OK. It was; and I slowly sat up again and this time was able to stand up and get over to a wheelchair. While I was upright, the nurse drew big rectangles on my butt so C knows where to put the progesterone.

The nurse wheeled me downstairs to the pharmacy, who had not checked their messages yet from earlier in the morning so they weren't ready for me. So C wheeled me out to the car where I called Mom to let her know I was doing well, albeit groggy. C came back to the car twice; once to give me a bottle of water and a scone, and once with the pain meds (acetaminophen and hydrocodone) and to drive me home. I slept for an hour in the car, and another hour once I got home, and now I'm taking it easy for the rest of the day.

Pre-Retrieval Jitters

Been a little jittery today, with retrieval thoughts in the back of my head, behind all of my work projects and underneath all the conversations in my meetings. It was mostly present in my feeling nauseated most of the day, just a little bit, like I had a migraine but without the headache. I ended up taking my lunch break in the car with a towel over my face and the windows down, and slept for awhile. That helped. I was worried a bit about OHSS but it's too early for that.

While I was bored yesterday, I counted: 46 needles have been in my belly and in my arm for one reason or another since we started IVF.

Tonight is the dreaded (but only by my husband) enema, in preparation for surgery. Seriously, he is more freaked out by it than giving me shots and can't even be in the same room while I do it. I have no idea why. It's like the least of my worries. We're all stocked up on Gatorade (to replenish electrolytes) and food, and I vacuumed, and will prepare the couch to receive me post-procedure. The only thing we didn't do was get my pain medications, which the RE was supposed to have called down to my pharmacy but my pharmacy had no record of it as of an hour ago. So we'll ask the RE when we get up there tomorrow; maybe they can redirect it to the pharmacy at the hospital instead. I kind of want those meds.

Stims Check #4: Last one!

C accompanied me to my final blood test and ultrasound today. The doc was happy to explain to him what we were seeing on the screen: softball-sized ovaries with lots of big ol' follicles inside. It took him about three seconds to decide that it was time to ovulate! So the nurse scheduled the retrieval for 7am on Tuesday and told us to trigger tonight at 7:30.

I'm so glad that it feels like it's happening so fast. Part of me is nervous, but the rest of me is happy to be moving forward.

Stims Check #3 - almost there!

Had my third check today. The nurse who took my blood put the tourniquet on way too tight so it hurt more than the needle, which hurt more than usual because with the too-tight tourniquet my arm was more sensitive. Then she had issues getting the bandage on (it popped off the first time she tried), and put that on too tight too, saying "well, that's not the prettiest job I've done..."

Then I had my ultrasound. My ovaries are now 1.5" across now, which makes sense considering they feel like golf balls. My lining is getting thicker, which is kind of fun to see, and the follicles are all close to 16-17mm. The doctor said they were super close but he wanted one more check tomorrow, just to be sure. He tentatively scheduled the retrieval for Tuesday - coming up quick! It'll be nice to stop the stims. There is bloating, and I'm pretty sure I now know why they prescribed an enema for the night before. (I Googled it just now, though, and people don't really complain about it until they start taking progesterone, so I don't know what's going on.) I don't really want to ever button my pants again, basically. For the sake of my coworkers, I'll be happy when this part is done. :)

Stims Check #2

Raced up to the clinic (it's about 75 miles away) for my second estradiol test and ultrasound this morning. Same on-call doctor, different resident, and I got the big room, which was nice. The resident looked like he was from Israel or someplace similar; and again I hung out for awhile after the follicles were measured so that the doc could show the resident around my organs.

So my follicles are now about 10-12mm, and my estradiol was 1097 (big jump!) so now I'm backing off on the Menopur; only doing 1 powder vial instead of 2. And I can tell things are going on in there; sometimes I feel like I have golf balls for ovaries and sometimes I just feel kind of full. Not super uncomfortable though. And I'm not moody at all (I don't think; maybe I should ask C!) which I'm happy about - the birth control made me moodier than the stims!

Afterwards, my friend E and her daughter L were kind enough to meet me downstairs and we chatted and played in the grass and the water fountain and the dirt for an hour. E has been my go-to girl online when I want to talk about this IF thing, and she's been so supportive; it's great being able to visit in person once in awhile. And her toddler is super cute too.

So back I go on Saturday! I'm looking forward to it; since I don't have to rush back down to go to work straight away. I'll stick around in the city for a few hours first.

Stims Check #1

After dropping C off at work, I ran up to get my estradiol tested. I was early, and was able to get into the blood test chair ten minutes before my appointment, which was good - I was hoping to get back to work to catch the tail end of a teleconference. But then the nurse asked me if I needed to use the restroom before the (transvaginal) ultrasound. Surprise!

I stripped down and wrapped the sheet around me and sat on the table... and sat... and sat for just over half an hour until the on-call doctor made it in with a resident and a nurse in tow. The nurse went to her place at the computer behind my head, and the doctor got started, but when he started measuring my uterus the nurse said "I've got computer problems, hold on a minute." So I got to lie there with the ultrasound wand for a couple of minutes while the nurse tinkered, and then we continued. It didn't take long; he measured several follicles (he wasn't even that interested in being accurate with a count because it's early yet, but there were at least 8 on one side and closer to 12 on the other I think, and they were all 6-8mm across) and measured a couple of fibroids (one of them he was a little concerned about interfering with the uterus so he was going to review my chart but I'm not too concerned because my doc wasn't concerned when he saw them last time). And then he spent another couple of minutes panning around my organs for the resident. I was glad I had put too much time on the meter!

This afternoon they called and said my estradiol was at 346, which was too high for a day 4 level, so they're having me back off on the Follistim by 50 units and they'll see me again on Thursday.

...and I missed the teleconference. :)

I'm dead inside!

Went to the doc this morning for my suppression check. The nurse took blood for an estradiol test and then the doctor did a quick transvaginal ultrasound to look at my ovaries and uterine lining. He also measured three or four fibroids but said that they didn't look like they'd be in the way of anything. He took snapshots of my ovaries, apparently, though I didn't see a thing on the screen, and then they sent me on my way. I met C out in the waiting room, who had been in the other room giving a backup sample to be frozen, just in case the one he'll be giving on retrieval day doesn't cut it.

The nurse called at about 4 to tell me my estradiol was at 28.2 and my ovaries looked good, so we can start the Follistim and Menopur tomorrow! I go back up on Tuesday for a quick hormone check.

Last night we used the last syringe that was in the Lupron kit, so tonight we had to use a different style. Not sure why, but it hurt a lot more than the kit needles. Guess I'd better get used to it; I hear the stims are pretty sting-y.

Birth Control: Done!

Yesterday was the last day of birth control. It feels good to be clearing hurdles!

The Knife and the Needle

The Knife

Last Tuesday night, I rolled over in bed and felt a weird pain down by my left ovary. I continued to feel it throughout the night; it would wake me up any time I used my lower abdominal muscles. I woke up a little worried that I couldn't tell the difference between wonky ovaries and pulling a muscle in that area.

The next night I felt it again but to a much lesser degree, and I slept through the night.

Thursday night I let the dog up on the bed, and as I shifted my weight next to him I got knifed in the right side of my groin. That's what it felt like, anyway. I yelped and ordered the dog off the bed, and stood up and leaned over the bed. C was so worried about me going into the IVF process with a problem that he told me he would stop talking to me if I didn't call the doctor the next morning.

On Friday morning the pain had diminished but I could still feel like something was a little off. As I was getting ready to go, I talked to C about why I didn't want to call the doctor. He'd either say it was nothing, or that I'd have to put off the IVF for another month. And that was about the last thing I wanted to do. I went without my breakfast and coffee, I was so upset.

And then, as I was putting on my shoes, I sneezed. Oh, man. Again, the knife. It was enough for me to decide to call and leave a message for the nurse when the RE clinic opened.

I got a phone call back pretty quickly, which was surprising considering how long it took last time. It was the nurse who had taught C and I how to administer my shots. After sharing a few details about what I was doing when it happened and how it felt the next morning, she concluded that it was most likely a muscular thing and that I should just wait and see if it went away on its own. And it largely has. After the first day of avoiding sneezes (at one point I drew in my breath to let one fly and at the top of the breath I remembered the knife - and that urge to sneeze disappeared quick!) it hurt less and less, and now it's just a dull, slight pain that I catch when I sneeze or throw my leg over my bike or something like that. What a fun little scare to start off my active IVF cycle!

The Needle

Saturday was our first Lupron injection! I thought about it all day and got more and more nervous as the afternoon wore on, mostly because I knew C was nervous too. (I don't really have a complex about needles; but being at the receiving end of one who's powered by a nervous first-timer was nerve-wracking.) I even bought myself a bottle of Beringer Cabernet Sauvignon just in case. I'd read the Stirrup Queens' Guide to Sub-Cue Injections a couple of times, and while C was drawing up the Lupron I started painting a spot next to my belly button with an ice cube. He went through two needles and several minutes, trying to get all the air bubbles out of the syringe, and once we were both satisfied I leaned back on a chair and he went to it. And it was fine, he did great! I felt a little poke (the same as when nurses do it) and the site was a little uncomfortable immediately afterwards (I think because of the medication) but it was fine! And then we were both so happy that we did it afterwards that we hugged and kissed and all my nervous energy let itself go and I felt really weird. I think I was just proud of us and all the day's nervousness was evaporating through my head or something.

So we did it once, and tonight we did it again, and it was fine! I was still nervous though, and C has learned to loosen his grip on my belly as he injects the Lupron and pull the needle out a little bit slower because when he kept squeezing me and he popped the needle out some of the Lupron beaded on my skin. Oops. I also made a pretty little rice pack for the stimulating injections that will happen in a few weeks. Never hurts to be prepared.

I'm still nervous about the intramuscular progesterone-in-oil, but that is fodder for another day, when it's actually staring me in the face.

Protocol!

Today C and I went up to learn how to do shots, and get the medication! I feel weird now, like a weight was lifted (in that now I know when and how everything is happening), and like another one has settled down (in that now I have to actually DO this stuff, not just talk about it happening someday).

The nurse was a cute, very Portlandy-looking lady with an eastern European accent. She sat us down in front of a table littered with little vials and syringes and round skin-colored lumps, and C practiced drawing liquid out of the vials and sticking it into the round lumps. It kind of reminded me of CPR class, with the victim stand-ins.

Then we went downstairs and sat for about an hour waiting for the meds to be gathered together in the pharmacy. They gave us a little pager a la restaurants-with-a-long-wait, and I crocheted and C used the wifi for a bit.

When the pager flashed at us, we went back to the pharmacy, dropped $3045, and came away with a cooler and a grocery-sized paper bag full of medications.



So here's the protocol:

Continue taking birth control until 8/13.
On 8/6 (this Saturday), start taking Lupron daily.
Go up to the RE for an ultrasound and estradiol test on 8/19, and wait for a phone call that says all is well. (If it's not, they'll rewrite my protocol.)
If all is well, decrease Lupron by half and begin Follistim in the morning and Menopur in the evening.
Go to the RE for a blood test on 8/23 and then again every 1-3 days while they check my hormone levels.
Retrieval between 8/28 and 9/2 (enema the night before, and of course trigger shot 36 hours before)
2 days after retrieval, take progesterone in oil daily until a positive pregnancy test and weekly for several weeks after that
Transfer 3-6 days after retrieval

Bada bing, bada boom. Hopefully. For now, we're squarely in the hopeful and happy phase.

Rawr.

The clinic just called. "We got your fax for your husband's blood draw results and we noticed that he didn't get an RPR done [for syphillus]! If he can get it done before Thursday we can go ahead with the procedure even though we're technically not supposed to without the results..."

So my local lab is supposed to be calling me back. They'd better be quick. (They also forgot to check his cholesterol levels when they tested him last time, so I guess I'm not surprised that they missed the syphillus screen too.) Thanks, clinic, for being so quick to look at my fax and call me back! (It was only a week!)

Update: Crisis averted. C was able to get a hold of the local clinic after they should have been closed and he's got his blood test tomorrow morning. We'll likely have the results by our Thursday RE appointment if they hurry up!