Trigger Day!

I haven't updated in awhile, not sure why. I've been emailing with friends to share my progress, and keeping track of it all in my little blue book (which Dr. M asked me about yesterday, as I was frantically writing down follicle sizes during my ultrasound- he probably thinks I am a totally neurotic weirdo). Here is my little blue book that goes everywhere with me nowadays:

And here is one page from inside, with my estradiol readings from all three of my IVF cycles:

Now, to sum up the past 4 days: on Friday we went in for an 8:45 appointment, where we saw that my follicles were continuing to grow but I was not showing a whole lot of improvement. I had 4-5 follicles measuring around 10mm. My lining was 6, which is thin but not terrible. I was disappointed, but later we learned my estrogen had doubled- which is a good sign. But it was still low, just 191, and you can see from the chart above that it was much higher my first cycle. 

We went back Sunday, and saw some improvement. My lining had gone up to 7, which is much better. Ideal for implantation is anything over 7, though somewhat higher is even better. As for follicles, they had really improved: I had six ones over 10mm, and two at 8.5mm, and about 4 under. They said I was getting very close. My lead follicle was 15.5*13, with some 13s and 11s. My estrogen came in at 489, which was a big step up from Friday. We were asked to come back again the next day to see about triggering.

So, we came back Monday, and things were looking even better. Lining was at 8.3, and I had a couple of follicles at 18 and 18.5 (lead one at 18.5*13.5), and a total of seven over 10mm, with six of those over 12mm. My estradiol came back at 765- a big jump, considering it was only 24 hours, not 48 hours like the others. 

To sum it all up, we decided to keep me on one more night of meds, but we dropped my Follistim to half what it has been. This morning was my last Ganerelix shot, and tonight I trigger at 7 pm. I go in for retrieval at 7:30 am on Thursday. Transfer will be Sunday.

I'm feeling really positive, much better than at the start of this cycle. This different protocol has led to similar results as my first cycle, but way, way better than my second cycle. Of course we won't know anything definite till retrieval, but I feel hope again. I also feel weepy- but that, of course, is mostly my high estrogen levels. I also want chocolate! And cookies! All the time! But I am trying to control myself  :)

In other news, my 97 year old granny is nearing the end. My mom just sent me this email, which is so sad. I had to put my head down and cry at work for a couple of minutes, but it's also such a sweet email too. My mom is wonderful and I hope I end up making this come true: 

"End of life is a very difficult thing.  I am hoping that the end of my mother's life will coincide with the start of my granchild's life.  Wouldn't that be a fitting gift of the cosmos? Did you know that you were conceived on my 32 birthday?  That is a cosmic gift too.

I am off to sit with granny for a bit now. 

I love you sooo much. you are wonderful.

xxxx ooo mom

Round 2, Day 4, Down in the Dumps

I've had three nights of the stims so far. My belly is sore. Much more than last time, or maybe I just don't remember it. Worse, I'm not doing very well. I'm much more emotional and depressed and hopeless than last cycle. I guess last time I was super hopeful and nervous, and the adrenaline kept me going. This time, after one failure, I am slogging through it, not feeling motivated and buoyed by hope. Just depressed and bitter and angry and sad.

It doesn't help that B has been in California since Friday morning. I've been alone since then, and staying busy with friends, but it's not the same kind of support. I am thrilled that K is pregnant, and we're emailing still, and even went for a walk on Sunday, but her pregnancy has made me more despondent about my own failure last time, and worried that if I don't have success this time, I won't have the support that I've had from her going through this the same time as me.

I did my day 4 bloodwork this morning and I'm waiting somewhat anxiously for them to call back. Hopefully the higher dose of Follistim to start will have made a difference and I'll have some more eggs this time. But it's really the ICSI that we need to work. That was really our problem last time (or so we think).

I'm just so weepy all the time. I read a magazine, I watch a movie, and I'm bawling all over myself. I'm having trouble sleeping because I can't turn my brain off from running in the same negative circles. I'm getting more upset about other things that wouldn't bother me quite as much. I think it's a mixture of emotions I'd be having anyway on a second IVF, plus the hormone swings from all the drugs. I have to remember that I am on a higher dose this time, and two weeks of Lupron at this point as well.

So, waiting on bloodwork, support group tonight, then B gets home very late. I'm glad he'll be back to be with me for the second half of the stims, and I hope that this cycle is the one for us. I don't know how I will get out of bed from now on if it is not. I really don't.

See? I'm hopeless and melodramatic. I realize it, but I feel unmotivated to try to be any different. Blegh.

Big Medication Mess-Up

We had a pretty rough time yesterday.

First, at work I learned that my estrogen levels were too low. We bumped up my dosage of the Follistim, and I had to re-fill my prescription. Another $508, thankyouverymuch. Thanks, estrogen that didn't rise the way it was supposed to.

Then, I went to the dentist to have a small cavity filled, and learned it's actually going to need a root canal. Wonderful. And I can't get it done for two more weeks. Luckily I am not in pain.

After work, we had trouble with the new Follistim dose. The pen let us dial up to 225 units, even though according to my math there should have only been enough medication for 150 units. This caused me to freak out. I ended up calling a pharmacist, who assured me that if the pen let us dial that much, it was available. It's so weird, but apparently the vials often have overflow. 75 units worth!?!?! The whole pen was only supposed to have 600 units, but it had 675!?!? Bizarre, and utterly mind-boggling. Each vial is $508, by the way. Fun times.

Anyway, once I was calmed down after the pharmacist's reassurance, I got in the car to go to the RESOLVE meeting. And, because nothing could be easy in my life yesterday, the Engine Malfunction light went on. Screw it. I drove to Cary anyway. I made it there, and home, with pouring down rain to boot. The car is going into the shop tomorrow. Sigh. But it's my sister's car so hopefully my dad will pay for the repairs.

And just when I thought it couldn't continue on this way, I watched someone else at the meeting do their Menopur, and something seemed... different. There was also a weird reaction when I was saying how big the needle was for me. At home, before bed, I consulted the instructions sheet. I learned that we've been doing the injections with the wrong needle! Instead of switching to a 1/2 inch needle, we've been using a 1 1/2 inch needle for the last four nights! No wonder it hurt so much!!! I was really, really upset- like all out, bawling. I'd been doing an intramuscular injection rather than a subcutaneous, and I was terrified that it might have messed up my cycle or my dosage. I was angry at the pharmacy for it's confusing packaging and lack of labelling, UNC for not having a real medication class ("just watch the videos"), myself for missing the instructions, and the nurse for the terribly written instructions. HANDWRITING a 1 1/2 so that it looked like   a 1/2 is really inexcusable.

Well, to finish this up, I talked to the nurse today and she just acted like I'm dumb, which infuriated me. This is REALLY complex for someone with no experience mixing and administering medications, and they really could have made this easier, for the THIRTEEN THOUSAND DOLLARS we're paying for this damn thing. You know?

Anyway, no harm is done, other than my very sore belly. For the next few nights, I've been told to let my tummy recover, and use the thigh for a while.

Tomorrow is my first ultrasound since starting the meds, and more bloodwork. I hope to have good news.

Day 4, and Bloodwork

I went in this morning, after three days of the shots, to get my bloodwork done. I had the blood drawn at 8 am, and the IVF nurse called just before 1 pm. My estrogen is low- around 99, and they like it to be 150 or higher at this point. So, I'm upping my Follistim, but leaving everything else the same. I need to order another Follistim this evening. Wonder how many hundreds and hundreds of dollars this will run me. Sigh. Oh well.

Anyway, my next visit is in two days- Thursday morning at 7:30 am. Another estrogen check, plus my first IVF ultrasound. I wonder what will be growing by then. This is all exciting!

In other news, tonight is the monthly RESOLVE support group meeting. I've been attending it since January, and it's been so helpful. B doesn't really like it- he feels reticent to talk to much about his feelings, and he has such a sunny outlook that he doesn't seem to need the support. But I find it very helpful to be able to recognize my feelings in what others say, and to get practical advice, and to learn about the different options and paths people are pursuing. I took over as facilitator recently, and put up a bunch of flyers at my clinic last week. Today someone new emailed me, as a result of the flyer, and I'm giving her a ride to the meeting tonight. I'm looking forward to the meeting this evening.

Day 3

Tonight will be the third night of injections.

Last night's shots weren't as bad as the first night. I still hate the "pen" for Follistim and the way it isn't a nice clean injection- B has to sort of jiggle it to inject all the medication, and it feels like the needle is moving around in me. And the Menopur is still such a huge needle that I can't even look at it, but the burning sensation last night wasn't as bad as the first night. Maybe I just knew what to expect.

After only two nights, my belly is already sore. I'm nervous about this. I still have 6-10 more nights! I am hoping that some of the soreness might just be from a hard workout at Body Pump last night. Maybe the abs work is contributing. In any case, last night was my last night at the gym for awhile. I am going to try walking at night when it cools off, but stay away from the strenuous classes that I enjoy so much at the gym. It's sad, but I don't want to take any risks. I'll ask the ladies at tomorrow night's support group about their experiences and how long they kept exercising.

Tomorrow is my first bloodwork, and I'm curious to see how my dosages will change. Hopefully they will give me an update, like to say if everything is proceeding as expected. I'll report back again tomorrow.

All of this feels very surreal. I can't believe it's really happening. Can you imagine just having sex and getting pregnant?? Crazy that it's all it takes for most lucky ducks.

First Night of Shots

So we did the first night of shots, about an hour ago. It was not fun. The Lupron is just little diabetic needles and I find those easy, but these two new shots were a whole 'nother story. 

The Menopur has to be mixed- you have to combine two vials into one, and replace needles, and it all has to be sterile. The Follistim comes in a "pen" which has to be loaded and then "dialed" to the correct amount. The Follistim wasn't too scary but the Menopur had a HUGE needle! The needle hurt, and the liquid burned as it went in. It bled for several minutes afterwards, though just a little bit.

But I survived, and B is doing all the mixing and giving me the shots (except the Lupron, I can keep doing that one). Only 7-11 more nights!

Although none of this is fun, I am so relieved and grateful that we made it to this point. Last time around, when I had to have the surgery, was such a disappointment. I am full of hope that in 3-4 weeks, I could be pregnant.

Off to get ready to go out to dinner with friends now. Looking forward to the evening out.

Crazy Raging B*tch

Sorry for the bad language, but that's really how I've been feeling for the past few days.

When I last wrote, on Monday, I reported one crying episode in the airport, but said that otherwise I was feeling fine. That didn't last long. By Monday night, I was angry, sad, and irritable. That was after 7 nights of Lupron shots. I had a huge fight with my husband and said all kinds of mean things, even threatening to not continue the IVF cycle. Tuesday night we fought again. I really FELT mad, but with a little distance, I realize that my emotions are pretty out of control. I cried inconsolably Tuesday night, even missing the movie we'd planned to treat ourselves with since yesterday was a day off from work. 


Yesterday, the 4th of July, I did better. We stayed out most of the day, doing things with friends- an outdoors festival, and a cookout in the neighborhood, and then saw the movie that we missed on Tuesday night. Keeping busy gives me less time to listen to my Lupron-induced hormonal mess, which is definitely a good thing. 


The positive news is that I only have two more nights of the full 10 units of Lupron. On Saturday evening, I cut the dosage in half, while adding the Menopur and Follistim. I don't know how those will make me feel, but I don't think they have the same emotional effects. I hope.


Other than my hormonal induced craziness, I'm feeling pretty okay. I'm getting excited for Saturday, to start the "real" IVF drugs. Not that I want the drugs, but after a year and a half of infertility, and a year of being in treatment, and a false start to an IVF cycle over three months ago, I'm just so ready to get the show on the road. I just want this all to speed up, to get over with, and to come out on the other side with a happy result.  

Good News!

I was so nervous that I laid in bed for over an hour after B fell asleep, worrying about today's appointment. We got in bed at 10:30 pm and I remember looking at the clock and it was 11:30 pm and I was still awake. This morning I woke up at 6:10 am and I was a bundle of nerves and stomach pains.

BUT: it all went well! My ultrasound showed quiet ovaries and a good endometrium lining. My estrogen is fine too, although I wasn't as worried about that part. The good ultrasound has calmed me down. I received my list of medication instructions and am scheduled to start the new shots this upcoming Saturday, July 7th. My husband starts his pills then too, and I go in on Tuesday, July 10th for bloodwork. Retrieval will fall sometime between Sunday, July 15th and Thursday, July 19th. Transfer will be 3 or 5 days after that. Pregnancy test sometime the first week of August.

Feeling a sense of relief after many days/weeks of being on edge, hoping and wondering.

Also, feeling okay on the Lupron so far. It's only been 6 shots but I am doing okay. I had one small freak-out in the airport last night, after I messed up my injection (which I then corrected), but overall it's been fine. However, I felt okay till after day 6 or 7 last time and then I crashed down and became a hormonal, crying mess, so there's no telling what awaits me.

But for now, relief.

Medications Class

Yesterday B and I met with the IVF Nurse to talk about injections, medication schedules, and overall IVF logistics. We left after over an hour, feeling very overwhelmed but ready.

My tentative schedule is as follows:

• Sunday, March 4th, 8 am: blood test for progesterone, to see if I have ovulated. If I have, we're ready to start. If not, we have to wait and re-test on March 11th.
• Monday, March 5th: begin nightly Lupron injections, sometime between 5-7 pm each evening.
• Continue Lupron for one to two weeks, till my period comes. Then, anytime that week, go in for bloodwork and baseline ultrasound, to be sure my ovaries are "quiet."
• Saturday, March 17th: continue Lupron, but also add Menopur and Follistim each evening, again 5-7 pm. That adds up to 3 shots a day. B begins doxycycline twice a day.
• Tuesday, March 20th, 7:30 am: go in for first estrogen blood test.
• Thursday, March 22nd, 7:30 am: begin daily blood tests and ultrasounds. Will be told if need to come in every morning or every other morning from now on.
• Continue shots and monitoring for 8-12 days total.
• Monday, March 26th: stop shots and give HCG trigger shot.
• Wednesday, March 28th: egg retrieval, rest that day.
• Saturday, March 31st: transfer day, begin progesterone (or maybe Monday, April 2nd if doing a 5 day transfer of just one embryo).
• Wednesday, March 11th: pregnancy test!

I know all of this is tentative and may fluctuate, and not everyone even makes it to retrieval, but I am excited and nervous to begin. May this next 6 weeks pass quickly and with few problems.