Trigger tonight at 9:15. Which is past, so it’s done. Did you know triggers are sub-q now and not IM?! Crazy! And so much better.
Egg retrieval Wednesday morning, then acu, then home to lie on the couch.
It was a reasonably entertaining day, meds-wise, but I’m worn out and so you’ll have to live in mystery.
Right. I forgot about this hurry up and wait bit towards the end. Not fun.
At this morning’s appointment, things looked a little bigger – by things I mean follicles, you know. Yesterday’s over-achiever, the 16 mm wonder, held on to herself and stayed at 16, which Dr. Soap Opera says is “good” because it will allow all those other kids to catch up. So yay?
Funny, I’d have thought they’d have grown more than they did considering I have been able to locate my ovaries inside my lower abdomen since this morning. There are citrus analogies to be made here – lemons as opposed to grapefruit, thank the tiny baby Jesus – but I won’t make them. I realize now I was really hoping there would have been a lot of massive growth and that I’d trigger tonight, but no.
I have not so conveniently forgotten how plush my endometrium is today – I want to say 14 mm, but that seems absurd, even for me. Who knows.
As per the message line, my estrogen is continuing to rise and is now at 1832. (I could have told you that based on my skin and how I smell – hint one is great and one is not. Estrogen is weird.) So more gonal-f tonight, same dose, and an other 20 IU of hcg and a vial of cetrotide. And they will see me in the morning. The current thought is trigger tomorrow or Tuesday and then retrieval Wednesday or Thursday. I’d rather Wednesday, if there’s anyone reading who has control over such things.
The troubling news of the day was that, according to the IVF nurse, who is dear, the earliest I would do a beta is the 25th. Which is 16 days after trigger if the trigger is Monday, aka tomorrow. And is a day after I fly to the west coast. Yes, I know there are places to get blood draws out there. But I had been counting on knowing what the fuck was going on before I got on the plane. Also, 16 days? I honestly don’t remember exactly, but I think for the previous IVF I got a beta 14 days after trigger? With the million FETs it was 14 days after I started all the meds. I think. See, now I am doubting my memory. Maybe I am just impatient? I don’t want to wait 16 days. Clearly, I am impatient and whiny.
So that scheduling revelation made me cry in the car. Or the truck rather, since I am borrowing my dad’s truck. All of this has happened before. Is the take home here that I should not go to the Cheater RE alone (cried both solo trips this week) or that I should not drive my dad’s truck? Who knows.
ETA: While I blogged very little of the previous IVF, I did mark appointments and such on my calendar. The Richmond RE wanted the first beta exactly two weeks after retrieval. Which would be the day I leave if the retrieval is Wednesday. It seems like the Cheater RE counts the day of the trigger as day zero and the Richmond RE counts the day of retrieval as day one. Lord. My kingdom for some consistency.
Anyway. Bah. 16 days post trigger. This clinic seems to enact policy based on fear (they do ICSI with sperm bank sperm because of one failure years ago and, damn, there was another example, but I’ve forgotten it) and I wonder if this is the same sort of thing. Do they do betas at 16 days past trigger because then a “chemical” pregnancy (you know what I think of that stupid term) is easier to miss? One would still be on the progesterone, though. A mystery. I will ask again, don’t you worry. And I’ll ask for an earlier one before I leave if it comes to that. I’d expected to get the repeat beta in California, but…. Well, there isn’t a but. Just trying to control shit I can’t control. Bah.
And? To add insult to insult, I need more meds. So far I am a grand over the top estimate that the Cheater RE gives. I think rates have changed and they haven’t updated their info. Which sucks. Because an extra grand is a lot. Lucky for me, these large checks just keep arriving via the USPS (so many reasons to love them), but I gave my Generous Friends a figure that is turning out to be wrong. Ugh. Plus, I can’t order more meds today and I will need some tomorrow. Bah.
Well, it had to get less fun at some point, didn’t it. Maybe things will look better in the morning.
I dropped a syringe, full of a little hcg and a lot of gonal-f and a good sized air bubble, into the sink, cap off, and bent the needle a bit. Then I tried to straighten it out. Which sort of worked. I wondered if I was having an experience akin to what a serious IV drug user would have if out of needles. Then I tried to push out the now-giant-seeming air bubble and lost some of the medication. Probably less than I feared? Who knows. I don’t know how to convert droplets to International Units.
And the cetrotide was its usual pain in the ass self: while it dissolved pretty easily in its bariostatic water, I couldn’t get the last bits of it drawn up into the syringe with the (giant) mixing needle and so I swapped for the (smaller) injection needle and it still wouldn’t all come up and then I said “fuck it” quietly and to myself and gave up and went to push out the (huge-looking) air bubble and lost what felt like a million IU of the medication. Like in the movies when they hold the giant syringe up and squirt out a waterfall’s worth of liquid from the needle before giving a shot? Yeah. It was like that. In my heart it was like that. For real, it was just a little.
So I am going with the “I sort of fucked all that up tonight and that’s just a little too bad because there is nothing to be done about it now” mode of coping. N.B. how “relaxed” I must be to have such an attitude. Surely this will all work out because I am so fucking relaxed and that’s all it takes.
I roped LB into going to the cheater RE with me today. I know she was anxious to see my ovaries on screen. (They are like tiny film stars, y’all.) Actually I think she has simply known me long enough to realize the my faux-casual “you could come if you want” masked a marked desire for company. Mind you, this was something I didn’t even realize myself until she asked if I *wanted* her to go for company. Ahem. And so she got to experience the wonder of a fertility clinic on a Saturday morning. She poetically described my ovaries as looking like dried lotus seed pods. She’s got a way with words, that one.
Any damn way.
You’re more interesting in stats. I know. Here you go, cribbed from an email to Bionic, who loves a plagiarizer with her entire heart.
5 + follicles on either side. Biggest on the left 16mm. Biggest on the right 14mm. Lots of “synchronized follicles” hovering around 13. Apparently once things get to 16mm then they are certain to “participate”. New info FTW! So more meds tonight and they will see me in the am. It should be Dr. W, who D**** and M***** call Dr. Soap Opera because he is so handsome. I like him. Also, Dr. Hot was in her scrubs today. *swoon* I think I should lobby for her to do all my procedures based on how I feel when looking at her in scrubs. Raised libido helps, right?
Honest, y’all. A woman in glasses with a voice of authority and some compassion does it for me every time.
Clearly, I forgot to record the thickness of my endometrium. It was something like 10mm. E2 came in somewhere over 1000, which is good. Once all those synchronized follicles get to 16mm or more, then I can trigger. Mid-week transfer, I hope.
For the first time in days (4? 5?) I don’t have a headache. I am blaming the gonal-f. And I’m really glad not to have one. The cetrotide makes me a little itchy at the injection site, but not too bad. Everything is manageable, but…. I’d forgotten that this last stretch is not so fun. I am still remarkably cheerful for the most part though.
Now, see I sort of wish I’d been better about blogging my first IVF because then I’d have something to which to compare this one. As it is, my memories of that summer are hot and tangled at best and so there’s little to go on. Maybe this one is moving along at the same rate as the last one? I really don’t remember. Three years is a long time ago, y’all, and there’s been a lot of emotional water under this proverbial bridge.
So post Tuesday’s mini break down(s), I opted to take a friend up on her offer of “whatever you need” and I roped her into going to this morning’s appointment with me. Bonus: she’s a nurse! It’s nice to have company! I’d forgotten. I used to make cho-girl (damn, she hasn’t blogged since before Facebook bought Instagram) go with me all the time and Red Row Farm was a driver several times for transfers in Richmond, but mostly, I’ve gone by myself to appointments. The doc today (wow, better) totally addressed my friend as if she were my Partner and the Other Parent-to-Be, which cracked me up. Also, it was great. I wish I wasn’t pleasantly surprised by such things, but I am. Anyway, today’s wanding was much better.
Numbers! I haz them:
Endometrium (that’s uterine lining to you, kid) – 7.4 mm (the .4 is a guess – I can’t really remember), for those of you new to this particular game, they are looking for things to be at least 7mm at the time of the trigger shot, so I’m good to go in this arena. One thing I do well is grow endometrium.
Right ovary – 10+ follicles: 2 over 10mm, several hovering around 8mm
Left ovary – 10+ follicles: 2 at 12mm, at least one at 10mm plus some also-ran little guys who the RE said “might not participate” (he laughed at my jokes about participate – winning!)
E2 – 502
So. That all looks good! The message from the doctor this afternoon is that my estrodiol is rising a little fast for his tastes, so I am to cut my dose back to 412 IU tonight. That’ll be a fun number to find on the syringe. He also wants me to start cetrotide, which makes me hopeful that I’m only a few days to retrieval. Not to count any embryos before they are assisted-ly hatched.
And I am to come in tomorrow am for another wanding. Here’s hoping it’s either Nice Doc from today or Dr. Hot.
Also equals crying. Right. Fake hormones do this to me. I’d forgotten.
Since Saturday night (between 6 and 9, though honestly closer to 9), I’ve been shooting up 450 IU of gonal-f and 20 IU of low dose HCH. (Do I need to say low dose when I am putting down the actual dosage? Idk.) The mixy-mixy part is pretty fun: take the bariostatic water and inject it from it’s glass-looking hypodermic needle into the little vial of gonal-f powder and – presto! chango! – its 600 IU of ovary amping liquid! Then get 20 IU of HCG from it’s nice little vial, which you’ve been warming to something above fridge temp in your bra or armpit, as the case may be. Then! Combine those two syringes of medications into one other and slightly larger syringe and then with some fancy needle switching foot work and buy yourself a headache that lasts more than 24 hours! And a lot of trash. What I’d really forgotten is how much medical waste there is in This Journey.
Ok, for real, it’s not so bad. The headache could be something else. I am prone to them.
But the crying. Bah. I went for monitoring today and didn’t see Dr. Hot, which is fine. The other guy is fine. And they got me in and out of there really fast, which was good because I was racing the children to camp. But. But it was really fast. And I didn’t get it together to talk about the headache or to check in at all really. There was a resident, to whom I was introduced, and whose presence was cleared with me, sort of – it was so quick, I’m not sure how it would have gone down if I’d said it wasn’t ok for her to be there. And the wanding was honestly one of the more comfortable I’ve had. And the Other Doc (this is really the cheater RE, the one who left my old and dear RE at the other hospital to start this private practice) kept the screen tilted so I could see and narrated what he saw and laughed a my (one) joke. But he didn’t count noses, as my old and dear RE used to say when counting follicles. He didn’t look at my lining, which obviously isn’t the issue at this exact moment, but I’d still like to know what it’s doing. He just said that things looked good. I want details. And the nice IVF nurse was nice and combined my partial vials of gonal-f into one vial so I have an extra day of meds for (sort of free), but she didn’t do my blood draw and the nurse who did wasn’t so nice – not mean, but barely made eye contact. (Y’all, I get it. It’s also my job to make nice to people all day and sometimes it doesn’t happen, and she was perfectly civil and it didn’t hurt… but I just wanted… well, I wanted my old lab people. That’s the long and the short of it. I miss my old lab people.) And it was all so damn fast. Which was great for getting to work, but also, it sucked.
And so I cried a little in the elevator leaving. For all that I was one person inside the huge system of the big public teaching hospital before, I never felt like I was anything other than the only and most important patient of whoever (intake nurse, RE, lab tech, receptionist even) was taking care of me. And here I am at the fancy private clinic and the appointment is all moving so quickly I can’t catch my breath to think if I have any questions. I mean, I’ll be better prepared Thursday, but yuck. I guess I was spoiled. Which is sort of bullshit, because people should be treated like I was treated anytime they go for medical care.
For the record, Dr. Hot has so far always given me her full attention at appointments and I wonder if it would have been different with her? I wonder if part of it was that I dislike the round-robin of doctors model? (Am I using that sports-related term right? Even google can’t tell me.)
Anyway! I have 4 days worth of 450 IU of gonal-f in my system! That’s… maths… 1800 IU. Another wanding on Thursday morning!
Damn that’s a lot of exclamation points.
Done with birth control. And done with the antibiotics for various orifices. Whew. None of those were fun. I know they are nothing, so far as “fun” is concerned as compared to the injections I am about to undertake, but all the same, I’m glad they are over.
So yesterday I went for a “practice transfer” and a baseline wanding and some blood work and a little meds tutorial. This was supposed to be a “full bladder” appointment, but I forgot that part in my scramble to be sure I had all the Sperm Related Paperwork* in order. So I spent the 10 minutes or so in the fancy waiting room drinking cup after 4 ounce cup of water while texting my friend Melissa and uberbutch. (F y’all’s I, this does not work – they knew I didn’t come in with a full bladder.) Despite the lack of retained urine, everything went swimmingly, as it does, and now there is a “map” of my vaginal canal, cervix and uterus for whichever RE ends up doing my transfer (please, baby Jesus, let it be Dr. Hot, please).
It’s interesting to me how every RE has a different way of doing things. E.G. in terms of cervical navigation, my dear old RE wanted me to remember the direction northeast and tell that to him anytime he had to put something up and into my cervix. The Richmond RE made a thoughtful face when I told him this and then allowed has to how that made some sense, but he never referred to any of the cardinal directions when threading my cervix. Dr. Hot, meanwhile, looked at me like I was a little crazy (but she laughs at my jokes and is, well, hot, so that’s ok) when I said to her that my cervix was of the NE variety when she did my SIS, but then she turned into a cartographer while doing my practice transfer.
I know your real interest is in the numbers, though, so I’ll give them to you. In a list, because I care:
- 10 antral follicles, 5 on each side
- 3mm-ish lining
- e2 at 20
So I have, as I said, quit the BC pills and now I wait for my highly overpriced meds to be shipped to my house and then I start injecting them into my belly on Saturday evening. These meds are all Science-y! I get to mix powders and salines and then use various sizes of needles and alcohol wipes and terms like “sub-q” and “IM”, if only to myself, and it’s like I am a scientist all in my own house! Whee!
Any damn way, injections Saturday, initial monitoring wanding on Tuesday and then everyday/every other day after that until things are settled where they should be and then retrieval and then transfer. Ok.
Of note, I signed off on assisted hatching if we do a three day transfer. Thoughts?
Oh, well, hello there!
Are you even still here? Did you think I’d given up on having a baby? Yeah, me, too. But no! I didn’t! Why give up when I can torture myself more? Woo and hoo!
So a week or so ago, after a big, long break, I had a “counseling” session with my re, who was his usual great self. He wanted to recheck my thyroid* and was cool with my plan to put off the mega-pricey battery of auto-immune tests. If I hit the magic number of three miscarriages, my insurance will shell out mega-bucks. As I’m just one blood-bath short, I think I’ll wait. If this next try works, score! No need for testing! If it fails, well, at least I get the million mega-pricey battery of tests for free. See? Win, win.
Anyway. My thyroid checked out just fine, thank you very much. (Now, let us sing the praises of the lab people. Who not only remembered my name after all this time, but also remembered that I like a bit of gauze and a piece of tape rather than the big, stupid colored wrap that is the norm these days.) And so I was cleared for take off. Note the metaphor. It’s a Journey, y’all.
Here’s how it’s all going to shake out: oral estrogen starting on CD 2 (Have I missed counting cycle days? No, I have not.) and then prog (By vagina! Because that’s how we roll.) and some wandings and one blood draw and then off I toddle to Richmond to get one of my ten – yes, that’s 10 – embryos popped back up in there. There being my uterus.
So let’s beat this motherfucker into the ground this time. Hand me my stick.
*What? You didn’t know there’d been thyroid trouble? Well, that’s a story….from the Fall When Everything Fell Apart And Then My Cat Died. But we are living in the now, y’all. The. Now.