Holy moly!

My retrieval was yesterday. I haven't posted much because, well, I was kind of dejected.

By stim day 9, my E2 was up to 1400. By day 11, it was up to 2600. I was told that a dozen or so follicles were chugging along. I triggered the night of day 11, making for a ten-day stim period, precisely the same as my first and third IVFs.

By Thursday, Retrieval Day, I was feeling... tender. As in oh-god-I-never-noticed-that-speed-bump-was-quite-so-bumpy tender. I thought maybe this boded well, but I am nothing if not a rugged pessimist.

Retrieval went fine. Cab was eight minutes late, which reduced me to a rage-filled mess, but we got there fine, everything was fine, there was fineness.  As usual, I took the anesthesia flawlessly and woke up in a high good humor. I'm just super lucky in that whatever chemical pathways those drugs are supposed to tread are clearly wide open in my body; I go down like a sack of taters, and wake up like a sack of giggly taters.

I woke up, and eventually my doctor came by to say that he'd retrieved 27.

Whaaaa ---

My peak E2, the morning after trigger, was 3100. The most follicles I'd be told about was 13 or 14. My doctor had decided to switch from the Lupron trigger to the regular hCG trigger, airily saying "there aren't that many follicles, you'll be fine."

Where the hell were all of them hiding, is what I want to know?

It seems I may owe an apology to Dr. Stewart. For my third IVF, he counted 14 follicles and ended up retrieving 23 eggs. I attributed this mismatch to his rather ancient ultrasound equipment. But the ultrasound at Big Shiny Fertility Factor does everything but insert the wand itself. I'm going to have to form some theory that my ovaries are just coy little beasties, and sometimes they don't like to show their eggs until they absolutely have to.

When I heard "27 eggs" I immediately tamped down my expectations by reasoning that, with the E2 so low, most of them couldn't be mature.

Well.  Of the 27 eggs, 24 were mature, and 18 of them fertilized.

This is, in technical terms, awesome.

 So why was the E2 so low? Who knows. This cycle I took an antagonist, which various sources hint can lower estrogen levels and/or make estrogen tests less reliable. All I know is that a lousy cycle, my worst ever, suddenly turned into my best cycle in terms of mature eggs, and my second-best cycle in terms of fertilization (on IVF #1, I had one more).

I'm on OHSS watch, but I don't feel too bad -- tender and swollen, but taking it easy and sipping electrolyte drinks. Finally getting around to watching Legend of Korra (I was/am a huge A:TLA fan). Right now just being quiet, grateful, and wishing my best to the 18 little clumps of cells in a laboratory fifteen minutes down the road.

2dp5dt: the roller coaster continues

After the plunge from Saturday's embryo-quality news, I have been lifted up into the atmosphere again by the following news:

Eight of the remaining embryos turned into "very nice quality" (4AA or 4AB) by day 6 and were frozen! Eight! Eight! I expected to have nothing make it to freeze. And of course this is making me much more hopeful for the ones I have inside me. Maybe this batch of embryos are just slow but good-quality growers. That's okay with me.

1 day past ER: all good news!

Okay, this is just crazy.

It's Tuesday. As of last Friday I had five mature-looking follicles and we were still consdering cancelling the cycle and doing an IUI. As of Saturday, when I triggered, that number had doubled.

And as of Mondays' retrieval...

23 eggs. 21 mature. 19 fertilized.

19. 19. Where the hell did those come from? No one saw that coming. My doctor sure didn't, having carefully prepared me -- he was estimating 8-10, then revised his numbers upward to 10-15. I said I'd be ecstatic with 15 and happy with 10.

Of course there's no guarantee of anything, but the bigger the starting number the higher the chance of having multiple strong, healthy embryos.

The witches' brew of metformin - high stims - even higher stims - no metformin seems to have produced a bumper crop without making me sick as a dog in the process. As of today I'm sore and moving slowly, but I'm nowhere near the hit-by-a-truck shape I was in first cycle. I am lumbering to the bathroom all on my own, and it doesn't hurt to cough or, you know, breathe. I took three days off from work (vacation days, so I wouldn't have to have The Conversation) and I think that by Thursday I'll be in fightin' form.

Worrying will recommence tomorrow. Today I am just delighted.

Day 3 Report: Our Little Brood

Things're looking good! For the historical record, here's the current crop. The lab's grading scale runs from 1 (highest quality) to 4 (lowest quality).

9 cells, grade 1: 1
8 cells, grade 1: 4
6 cells, grade 1: 1
8 cells, grade 2: 4
7 cells, grade 2: 2
6 cells, grade 2: 1
4 cells, grade 3: 1

There's also one more unknown embryo, because I was writing fast and missed one -- we have a total of 15 at this stage, which seems to me to be a very good attrition rate given that we had 16 fertilize.

Confirmed transfer for 12:30pm Monday. Full steam ahead!

A Memo to the Internets

...apparently I've recovered enough to rant. This is inspired by a cluster of interactions, recent and not so recent, which bugged the hell out of me.

Dear Internet,

Following please find a list of reproductive scenarios. If these scenarios happen to you, you shouldn't be smug about it -- you should be grateful for it. To wit:

If you conceived on your first or second try;
If you conceived at home without any medical intervention;
If you conceived with minimal medical intervention;
If you had an uncomplicated pregnancy;
If you gave birth at full term;
If you desired and had an unmedicated birth;
If you desired and had a vaginal birth;
If you desired to and were able to breast feed.

Don't be proud of these things. Be grateful. The fact that you wanted {whatever} and got what you wanted is not a marker of your of moral superiority. It's a marker of having been lucky. There are plenty of people who wanted exactly what you wanted and still ended up with IVF/ICSI preterm drugged-to-the-gills Caesarean births. (please note: I also don't think you should judge yourself superior to those who didn't want those things in the first place... but that's really a separate rant. Don't worry, I'll get around to it.)

The proper reaction to luck is not to explain to everyone exactly what you did to get to {desired state}, and what {those who have not enjoyed the desired state} are doing wrong. It is to be grateful, and also to shut the fuck up.

For the record, although I joked in my tags about being a good little layer, I didn't do a damn thing that other people haven't done, people who end up with few or no embryos. I've been lucky, that's all (lucky and slightly polycystic), and darn tootin' I am grateful, and praying that my luck holds. If it does it'll be because I was... lucky. No other reason.

What (Good Things) Happened Overnight

Final egg count: 25
Mature: 21 (!)
Fertilized with ICSI: 16 (76%)

Chances are excellent for a 5-day transfer, which is just what we want.

I slept sitting straight up all night and only woke a few times to shuffle to the bathroom. Pain is much better. I still don't feel like moving, but I am suffused with gratitude every time I take a deep breath and it doesn't hurt. Maybe I can finish watching Scrubs today.

Yesterday I was hardly there -- just sunk in misery and watching the minutes pass by. Now I'm looking outward again. And just for today I'm not googling about anything that could go wrong.

done!

At home!

Preliminary count = 21 eggs "so far"; they were still looking through the fluid when he gave us the report. Doubtless many of those won't be mature (at the last ultrasound he counted 15 likely-looking follicles), but it's a lovely (lucky?) number to be starting out with.

The anesthesia was a trip, I've never had it before. Man, that stuff works. One minute I was lying there under the huge light, legs strapped into leg-elevator things, thinking about alien abduction. The next second I was someplace else entirely. I couldn't believe it. The very first thing I mumbled -- no fooling -- was "Anesthesiology is a noble profession." The anesthesiologist looked startled and said "thank you". I was just floored that it was all over, just like that. Floored and grateful.

Then I noticed OW OW OW OW. I am not shy and I communicated OW OW OW, and was rewarded with an IV of some narcotic (Diludid?). Unfortunately, it only took the edge off, and it took another few minutes to figure out that a big part of the pain was that I desperately needed to pee. Sadly, we have no pictures of My First (and hopefully Last) Bedpan.

All hospital staff extremely nice. Nurses rock.

The bad part is that now I feel like utter shit -- I can barely hobble half-curled to the bathroom. My list of woes: breathing deeply hurts. Laughing hurts enough that I had to turn off Scrubs. Moving hurts. My shoulder is randomly cramped and hurts as much as my abdomen. Gas pains keep bubbling up. I'm just sort of skating from one moment to the next, convinced that I am moving in the right direction because time is passing, and nothing will fix this but time. Every half-hour is an achievement. Who the fuck are these maniacs who go jogging round the block after their egg retrievals? When the nice nurse dropped her voice and advised me no sex, I could only stare at her in disbelief.

The good: my beloved is taking wonderful care of me, hovering with SmartWater and homemade chicken soup and pillows. I have this neat microwavable heating pad that feels really great on the shoulder. And I know all this is temporary.

Right now, though, right at this moment, I can't imagine ever choosing to do this again. Though I know that if we did this whole process again we'd rack back on the stims, I wouldn't get as many eggs, and thus would not feel so shitty. I'm told that there's a direct relation between the number of eggs and how wrecked you feel afterwards.