Day 11: Trigger Day

That's right, girls and... er... girls! You read the title correctly. No, I am not hosting a photo exhibition honoring Roy Rogers' horse. I am triggering tonight, because my E2 was 4356 as of ass o'clock this morning.

4356, what can I say? I can say that

1. It's above some clinics' cutoffs for retrieval/transfer, but below others'. A lot of clinics use 3500 as the cut-off, but others use 5000.
2. It's much much much better than I had feared. See, I was getting what I believe is called a geometric progression -- doubled between days 5 and 7, almost tripled between 7 and 9... the fact that it only went up to 4400 between days 9 and 11 is marvelous.
3. It still puts me at risk of OHSS, but whatever, right? People say it's unpleasant, but it's not fatal. And you know what else would be unpleasant? Doing this whole damn thing again if I don't have to. I'll take my chances, spike the retrieval IV with albumin, and hope for the best.
   
4. It's a very cool number because if you transpose the first two digits it's 3456, a numerical keymash.

Once again my prodigious powers of worrying have, by the force of my mind, managed to avert disaster.

Retrieval is scheduled for 8 am Wednesday. Have to be there at 6:30. Without having had coffee. HAHAHAH. Still not sure how we're going to get there -- cab, I guess. My darling doesn't drive and I'll be in no shape to be driving home afterwards

EE EE EEE! Excited! Happy! Mood swingy! I LOVE ALL OF YOU -- YES, YOU OVER THERE, ESPECIALLY YOU.

Day 10 of Stims

When some people need to be soothed and inspired, they go to church. I head to Value Village. Today I was richly rewarded for my faith: for $1.21 I picked up a copy of Robot Building for Beginners.

I really think this could change everything for me.

the stats that don't show up on the lab slips

Number of hours spent obsessively Googling all that could go wrong with this cycle: 5
Number of women I found with E2 lower than mine who got canceled, had OHSS, or both: nine gazillion
Number of women I found with E2 higher than mine who were just fine, proceeded to transfer, and now have adorable bairns in their sigs: dunno, I'm sure I wasn't looking, why read about that when you could read about the bad outcomes?
Prolonged hysterical crying fits I had on my beloved's soft bosom: one
People who are now allowed to use the internet only for pre-approved purposes: me

Day 9 of Stims

This morning's ultrasound was fine -- reducing the Follistim dosage to 75iu seems to have slowed things down a good deal. Counted 14 follicles; one was 13mm, two were 17mm, and the rest were 14-15mm. Uterine lining 13mm.

Things I am worrying about now: did the follicle growth slow down too much? Will my uterine lining be too thick by the time we transfer? Will I break the internet by over-Googling?

The E2 results should be back soon, and then we'll know the plan. Likely trigger is Monday, with retrieval on Wednesday. This pleases me because I have a lot of annoying meetings on Wednesdays.

ETA: Bloodwork back. E2 is a startling 3460. 75iu of Follistim/75iu Menopur today, no Follistim at all and just Menopur tomorrow. I think this is called "coasting". A swift google reveals that coasting does not compromise pregnancy rates, and may even lead to better-quality embryos. (or perhaps the women who are responsive enough to require coasting simply produce better-quality embryos. either way I'll take it.)

Monday morning more bloodwork, another ultrasound. Dr said probably trigger Monday night for a Wed retrieval, but if my E2's very high at that point I imagine I'll coast another day or two.

ETA2: after looking around, I'm not sure it qualifies as coasting since we're continuing the Menopur. So now I'm all worried about OHSS again. Man, if this cycle gets canceled I'm going to feel as flat as a very very flat thing.

Day 8 of Stims

I can't think beyond two weeks from now. I keep trying to make Passover plans and I can't. My brain just keeps fuzzing out.

Logically I know I'll be perfectly fine no matter what happens. But I am simply unable to imagine myself two weeks in the future, either pregnant or not pregnant.

Day 7 of Stims

Real post later -- right now I just want to jot down the stats for my own reference and, like, the historical record:

Counted 6 follicles on each ovary, range 11-14mm. Lots of smaller ones which likely won't amount to much.
E2: 1181
Follistim reduced to 75iu. Staying with Menopur 75iui and Lupron .05cc.

Day 5 of Stims

So far, so good! For posterity I record: right ovary, 7 follicles near 10mm. Left, 5 follicles near 10mm. Estradiol: 667.

My dosage of Follistim has been dropped to 150iu, holding steady on 75iu of Menopur and .05cc of Lupron.

Apparently the estrogen is somewhat on the high side, and of course I am furiously googling to find out the worst case scenario of having high E2. But I am cautiously pleased. I figure if I were hideously overresponding he wouldn't have dropped it to 150iu, he would have dropped it more. I know we don't want the follicles to grow too quickly -- less than 10 days of stims usually means poorer egg quality, I think. But at least I'm not, as they say, stimming like a granny.

*revs up ovaries, Leader-of-the-Pack style*

Yeah, I'm pleased. I didn't hear the two things I was most afraid of: "one huge honking lead follicle" or "poor response". Hopefully we can work out the rest of the details, bring everything into balance so we end up with a lovely large plump cohort of eggs in a dignified time period.

Of course the timing of all this positively couldn't be worse. I've got a two day class on Thursday and Friday, and our fascist training department requires written medical release for coming late to a class. The doctor's office did manage to dig up a sheet of letterhead that doesn't say "Baby-Making Doctor" on it. Hopefully the fact that it does say "Gynecology" will dissuade anyone from asking about the details. IT'S ABOUT MY COOCHIE OKAY. SHH.

Anyway, if we manage to extend the stim period for the desired 10 days, then my retrieval will be on Monday. On Monday I am scheduled to be in another all day class. This is a very special class taught by Fancy Consultant, who was flown 3000 miles and paid eleventy-million dollars to teach it. And I will just not be able to be there. Ooops. Oh, my 12 little follicular chickadees, see how I already am sacrificing my professional prospects for you?

Day 3 of Stims

Thing's're going well. I'm feeling pretty good. The morning Lupron shots are now warm and familiar enough that, even half asleep, I scoot over to the side of the bed and assume the position my quite willingly. The volume's down by half (.05 now) and my darlin brought me home a bunch of 28 1/2 ga needles, which are so very tiny that they can barely be felt.

The evening's entertainment has been the stim medications. There's certainly a satisfying amount of pomp and circumstance in this procedure. Before the shot I carefully arrange all the supplies -- Follistim pen, vials of Menopur and sterile water, 3cc syringe, 22ga 1" needle of mixing, 27ga .5" needle for injectin', Q-cap for mixing, alcohol swabs, sharps container. 225iu Follistim, 75iu Menopur, .5cc water, mix, shoot up. It hurts more than the Lupron -- not so much the needle stick, but there's a distinct stinging sensation as it's injected, and since there's a lot more of it, that last a little while. It doesn't hurt very much on any absolute scale, though.

After the shot I lie down for 20 minutes or so and listen to this meditation cd I bought because I am a sucker okay. It's a pretty standard guided meditation, except it leads you through picturing the medications gently coursing through your blood (I think of it as little dollar signs mixing in with the red blood cells). The medicated blood surrounds your ovaries, coaxing out a bounty of healthy eggs.

I like it. I'm skeptical enough that when she says something about "bringing forth new life" I always have to say out loud "maybe". But it's a nice time to lie there and visualize metaphors. I think right now the one I'm grooving on is forcing seeds. Because that's what we're doing, see. The Follistim is the Gro-Light, and my ovaries are some nice rich potting soil, and hopefully tons of little seeds will spring forth. Unfortunately I know even less about gardening than I do about reproductive endocrinology, so that's as far as the metaphor can go really.

My first follicle scan is on Tuesday. Think big, people. Lots of nice follicles pls. They don't have to be fast-growing, slow is fine, but I want a lot of them.

In other news:

Things I like about Blogspot
How easy it is to post pictures without worrying about hosting
Being able to get actual names from nonmember commenters
The interface, in general
The fact that it's not Livejournal.

Things I dislike about Blogspot
The lack of THREADED COMMENTS. I had not anticipated how much I'd hate not being able to easily reply to comments. Instead I have to go like this:

Dawn, I love that picture! My favorite wedding dress designer (is it sad that I have a favorite wedding dress designer?) is Atelier Aimee, whose main gag is pinning a lot of silk roses to things. I throughly approve.

Big love going out to Emily and Shannon and Kristy and Lizzies. Your presence as we go through this krazy kaper is something I'm very grateful for. HART.

Sarah/Mrs Bluemont, thank you so much, and welcome! I've enjoyed your blog for a while now so I'm very glad to finally make your acquaintance.

Cowgirl, thanks! And I am so glad to be off the BCPs -- they made my breasts so sore that my dog would brush one with his paw during the night and I'd wake up hissing in pain. I started sleeping with a pillow protectively covering them. No fun.

Now see, that would have been a lot easier on LJ. Has anyone come up with a threaded comment solution for Blogspot? Or is the answer "move to Wordpress"? I kind of like the Googley oneness of Blogspot, but the lack of threaded comments is really really annoying.

Last Day of BCPs

7th day of Lupron, last day of birth control pills. The Lupron's been treating me very well. Every morning my heart's own love brings me a cup of coffee and a syringe. Eyes still firmly shut I shimmy over to the side of the bed and bare my belly. I feel the cold swipe of an antiseptic wipe and start fuzzily counting. I feel hardly a prick and by 3 she's done. A swish of aloe gel to keep it from itching and that's it.

For two mornings I felt really nauseous an hour or so after the shot, and got as far as sprinting to a puke-suitable place with my mouth watering. Then I remembered that I'd changed the vitamins that I take with my coffee every morning . Today I didn't take my new iron-heavy vitamin, and hey, no nausea. I don't know if the hormone + iron combination or if I just got the wrong kind of multivitamin, but I'm very happy to have (I hope) solved the problem.

I have been looking at wedding dresses online. I think a part of me wants the reassurance that if I don't get pregnant, we can still move to Canada or some other nice country and get married. I can still get something I want. This is moronic, because of course I have almost everything I want. I've been phenomenally lucky in a thousand different ways.

It's just that the crumpled list of dreams I have always carried in my heart still has a few big-ticket items left on it.

I've been so blessed. More, please.

Lupron day 1: the money shot

Finally I get to post that ritual picture in every IVFers's blog, The Money Shot. Here are my drugs. I rearrange them gleefully. Not pictured: four boxes of Menopur, tucked behind the Lupron and syringes; two bottles, one of antibiotics and one of steroids, in the front gold bowl. Three vials of progesterone in ethyl oleate, on their way from a pharmacy in Colorado, because I am a pushy patient and refused the progesterone in sesame oil thankyouverymuch. I muttered something about food allergies, but really I just generally try and avoid painful experiences, and the PiO shots are supposed to hurt like a mofo. The ethyl oleate preparation is supposed to be much much easier, and can be given with a much smaller needle.

The peacock fan I carried as maid of honor in my best friend's wedding. The sheela na gig also comes from her. Since she got knocked up one month after the wedding, I have great faith in both of these talismans.

Ganesha is the solver of problems and remover of obstacles. Qwan Yin guards the souls of children and is a goddess of mercy, compassion, fertility, and childbirth. And Juno is the Roman goddess of fertility and childbirth.

I know it's not an exhaustive pantheon, but it's a decent start, don't you think?

First Lupron shot this morning went swimmingly. My girl has deft hands, and is used to giving injections since in her lab she has to inject various substances into mice. Apparently I'm easier to handle than a mouse, probably because I neither tried to bite her nor climb over her head. She did one clever trick which I'd recommend: she asked me to count to five very loudly. I was focused on filling my lungs for that and barely noticed the needle going in.

In other news, the receipts attached to my big bag o' meds added up to over $7000. My copay was around $140. I priced the same meds out at around $3300 over the interwebs. People, our medical system is broken.