2nd Ultrasound

I had my second ultrasound today.  I have 6 follicles over 10 (3 on the left and 3 on the right).  They are all between 13 and 15mm.  I have 1 or 2 follicles under 10.  My RE said to come back on Sunday for another ultrasound and blood work and that he anticipates I will be directed to trigger Sunday night and come back on Tuesday for the retrieval.

Not sure how I feel about this.  A part of me is worried 6 isn't enough, especially when I hear stories of people having 10 or 16 and especially when I hear that such a small percentage can fertilize sometimes and then less that develop to embryos and blastocysts.  I was hoping to have enough to both implant and then freeze so that I have options for having children in the future and can use younger eggs. (I'm always thinking further in advance.)

I don't know, maybe I'm just worrying too much and should be happy I have 6 when some women end up with even less.  We'll see what Sunday's story brings.

Another Update

Got a call from the fertility this afternoon after they reviewed my bloodwork and re-reviewed my ultrasound.  My RE decided I should double my Menopur and start the Ganirelix tonight.  That essentially pushes up what was on my initial protocol by about 2 days.  My husband is also supposed to start Doxycycline to prevent any infections in his sample.

First Ultrasound after Starting IVF Meds

Today was my first ultrasound and bloodwork appointment after starting my IVF meds.  I had 6 follicles.  Not sure if that's good or bad (will start Googling & torturing myself on the fertility boards and likely find everything from it's great to it is horrible!).  It also pushed up my protocol by one day. My husband will start taking doxycycline tomorrow instead of on Friday to prevent any possible infections in his sperm.  I will add Ganirelex to my injections tomorrow (to prevent ovulation) and also increase my Menopur to 2 vials (I'm guessing to help the follicles grow).

This morning was the first morning since I started stimming that I woke up without a migraine, so that is a plus! The RE said that the migraines are generally caused my low estrogen (which makes sense as I generally get them the first day of my period when estrogen tanks) and that it should get better from here.  I hope so!

Tonight I am also trying a Reiki session for general healing and hopefully to help with the fertility.  (Hey why not try everything?) I will do a post on how that goes.

Injections

Last night was my second night of injections.  Continues to go fine and the injection really is no big deal.  Don't need to use much pressure and doesn't really hurt (tiniest of pinches).  The only surprise is how easy it is and how much blood there is.  (Not a lot, but more than the dot I'd expect.  I want to be able to just blot with a tissue and move on, but I do need to use a band-aid, so of course straight to Amazon to get injection specific bandages.  I went with these ones because they were relatively cheap and I didn't need 500 that other brands offered.)

Since starting the injections, I have noticed slight twinges in my lower abdomen.  Whether it's actually my ovaries growing follicles or psychosomatic, who knows?  I have also been "blessed" with headaches each morning since starting injections.  I am a migraine sufferer and the only thing that helps is Excedrin or Rx meds, both no-no's once pregnant.  Yesterday morning I took one (instead of the regular 2) Excedrin pill to try to ward off the migraine I felt coming.  Then of course I did a bit of Googling and found you are not supposed to take Excedrin while stimming either.  Guess I should have searched first, but I'm not going to beat myself up about 1 pill early my first day of stimming when my RE never told me it was a no-no.  Excedrin is made up of 3 components: acetaminophen, aspirin and caffeine.  Acetaminophen is ok when stimming/pregnant, caffeine consumption should be limited but isn't totally off limits, and my protocol includes baby aspirin to encourage blood flow to my uterus.  So while I'll probably tough it out from here on out, I'm not going to beat myself up or think I may have "ruined" something. Live, learn, do better going forward.

Today I not only have a headache but am having serious problems concentrating at work, am super emotional (have broken down in tears and got overly frustrated with my brother about something).  I also am tired and just counting the minutes til I can go home.  While I must admit I am always tired, I woke up this morning feeling as though I slept well and was, for once, refreshed and not exhausted so you'd think I wouldn't be so exhausted.  Unfortunately, I've red fatigue is a side effect too.  (Or it could be the crying, crying always makes me tired.)

So that's today's journey, emotional, tired, and a bit of a mess. Hopefully this isn't a pattern that continues!

First Day of IVF Meds

Tonight was my first day of taking my IVF meds for stimulating my follicles to grow. My protocol is that I take one vial of Menopur (75iu) and 300 iu of Gonal-f.  In my teach class I learned how to mix the meds so I take one injection instead of two.

So basically it's take 1/2 cc of sodium chloride, inject it into the Menopur vial (Menopur comes as a powder that needs to be mixed with sodium chloride). Then add the Gonal-f to the vial, draw everything's up into the syringe, add the proper gage needle and inject. I'm over simplifying as I'm sure if you're doing IVF meds your RE and/or clinic will instruct you as to how to administer yours. 

My nerves about the injection was how much pressure I would need to use for the needle to puncture the skin. As it turns out, very little. I am not squeamish so maybe that's why it was easy for me, but I simple pinched some of my skin on my stomach, inserted the needle, pushed in the meds, held for 3 seconds as instructed, released, and pulled the needle out. There was no pain (the expected feeling from inserting the needle but really it's the same as any injection, probably less so than your typical vaccine which is intramuscular rather than subcutaneous). I had read that Menopur stings/burns, it didn't. The only thing I was surprised by was that there was a bit more blood than I expected and when I say that, I mean that I expected there to be no blood and there was enough that I did need a bandaid. (Whenever getting vaccines I always thought the bandaid was overkill and thought how much blood could there be for a tiny needle. I guess there is actually some.)

So basically that was my first experience with doing my IVF injections. I think as with most things in life, the anticipation and concern about it is more than the reality. 

Meds Arrive

So my meds have arrived and it's a lot! (Don't think the photo really captures it since I condensed it all to get it into one shot.)

Even after going over the meds and seeing hem in the teach class there is still a lot when it's all laid out like that. Plus there's stuff that wasn't at the teach class and even stuff not in my protocol. I guess it's just in case the protocol changes?

The scariest of all of it? The total charged and expected from the insurance....over $11,000! Glad and so lucky insurance covers it and all I pay is $15 for the syringes.

Frustration

This whole IVF process can be frustrating and overwhelming. Maybe I have a quick trigger, short fuse, and am a quitter, but so many times I just want to throw up my hands and say "I'm done!"  Last week I had my IVF consult with my RE and spent a lot of time discussing genetic screening which would help to ensure the better likelihood of a successful pregnancy as well as the child not having Down's Syndrome.  (More details can be found here.)

Typically, it means that you do not do a fresh transfer, but instead freeze the embryos while you await results and it can mean you get hit for 2 cycles by your insurance instead of 1.  However, when I asked my RE about timeline he suddenly told me there was an option to test the blastocysts on day 5 and implant the next day on day 6 (and freeze the rest).  That seemed like a plan to me and something I was willing to go forward with.

Today, I got an e-mail from my nurse in response to my e-mail from  yesterday after I realized I forgot to start my baby aspirin on Sunday, saying it didn't matter as it was to support blood flow to the uterus for implantation and since I was doing genetic screening, I wouldn't be doing the transfer until later with a frozen transfer.  This contradicts what my doctor said.  The rational part of me knows that she was just responding with what is the standard protocol and that she likely hasn't discussed with my doctor what was discussed last week.  But the tired, frustrated, and overstressed part of me is really angry and upset and pissed and doesn't even want to go forward.  I know that may be silly, but I hate being told one thing only to then be told something contradictory.  I made my decision regarding genetic screening based upon one representation and feel like I'm having the rug pulled out from under me to find out something else.  The attorney part of me starts perking up when I'm told one thing to induce me to pay $3,000 and then told another afterwards, the word fraud starts circling around in my head.

I feel like I could ramble on and on about why it bothers me so much and some of you  may get it and some of you may think I'm crazy, but for now I'll just leave it at I'm frustrated and pissed.  Especially since I responded to my nurse with what my RE told me regarding the overnight test and it's been a few hours and no response.  Maybe she's waiting to talk to the doctor, but it still annoys me.

It also annoys me that my doctor told me that my husband and I could sign the consent forms they require during morning monitoring hours (6:45-8) when I went in for my ultrasound/bloodwork on Friday and my nurse told me to come in at 8 to sign them between 8:15 and 8:30 because morning monitoring hours get "busy."  Again, I understand it's two different people not communicating with each other, but don't other couples undergoing this have work? My husband has an hour plus commute from where the clinic is and is expected to be at work at 8:30.  I work closer, but also am expected at work between 8:30 and 9.  We will already have to take time off for the egg retrieval, etc...  It's a pain to be expected to miss work to sign consent forms.  They give you the option of doing it before a notary, but they only give one notary block on the form.  (In the thousands of legal documents I have drafted and/or read in my career, I have never seen one notary block for 2 signatures, it is always one notary block per signature.) My husband and I should be able to go separately and not have to try to track down a notary (an issue we generally don't have as we are both notaries as are many people at work, so if we need something notarized we always have easy access, but asking a co-worker to notarize a IVF consent form isn't going to happen) and go together.

Ok, so that is my rant.  The IVF journey I'm sure comes with it's highs and lows and many overreactions and just think, I'm not even on the crazy hormones yet! Although I think between the Clomid and Ovidrel from my IUI cycles and the birth control I'm taking now, my hormones aren't exactly at their "normal" level whatever that may be.