Day 8

Yaaaaaaaaaay! Today's check was fab! I haven't received my E2 results yet but had some big fatty follies growing! Two are a nice 19mm, two are at 17mm, one is at 15mm and two at 13mm. Today before leaving the office we got our instructions for trigger and retrieval. The practitioner said it looks promising for trigger tonite or tomorrow! We will know this afternoon after Dr K makes the decision and when nurse Katie calls. This would put retrieval at either Sunday or Monday. Yikes!


This part of the process is why we pay the $big bucks$.  To be successful it is imperative they follow a strict timeline.  If the follicles aren't big enough or mature enough and are aspirated early, they might not contain mature eggs and/or the eggs won't fertilize properly.  If they wait too long, I will ovulate all these eggs on my own and we lose the chance to retrieve them.  I've had heard they want follicles between 16-20mm for the best chance to find nice, juicy ripe eggs.  The other balancing act is the HCG trigger shot (aka "money shot").  The HCG acts as the LH surge in a natural cycle and puts the follicles through their final maturation process.  Without HCG (or LH) the follicles and eggs they contain are useless and won't fertilize.  The trigger MUST be given precisely 36 hours before retrieval.

Why do I say yikes! when I refer to retrieval?  It is a complicated and delicate process.  First, it involves me undergoing anesthesia.  Though I could administer it to myself thanks to my CNOR certification, it scares me to be the receiver and not the giver.  Second, I will be up in stirrups with coot for all to see.  Third, in order to get those lovely eggs, via ultrasound guidance they stick a giant needle through the vaginal wall to aspirate the follicles.  This might also involve pushing/pulling my already bloated tummy or a hole through the uterus if they can't get them via vag.  Oh by the way, please don't put a hole in my ureters or bowel, thanks!  Finally, I work in the operating room, I KNOW what goes on....  Sometimes it's fun.  Most times it's good, but when it's bad, it's b.a.d.  The reassuring angle is I know what to expect and really, this is a fairly minor (though nerve-wracking) procedure.  I also plan on wearing my own cute scrub hat instead of the ugly, itchy blue bouffant most patients are subjected to.   After retrieval, I'm hopped up on propofol (the Michael Jackson drug) and Vicodin and the rest of the work is up to the embryologist and his gang of pros.  They do some fancy work that involves isolation, incubation, and fertilization.  Most times they just mix up sperm and eggs in a dish and they fertilize.  Because of J's lazy ass sperms we will be doing ICSI or intracytoplasmic sperm injection.  After he gives it up in a cup, they'll pick out the bestest looking ones "going for gold" and inject one single sperm into each egg via a seriously tiny needle.  Like microscopic.  The next day we find out how many actually fertilized-  usually 80% do.  This is where they turn from eggs to embryos.  Then, we wait!  After fertilization, they start to divide.  Some will arrest after fertilization due to chromosome issues and whatnot.  The transfer (when embryo goes from petri dish to warm, comfy ut) takes places either 3 or 5 days after retrieval.  5 days is preferred as this is the point when the embryos have reached blastocyst stage.  A 3 day transfer is still o.k. And sometimes is done if waiting until day 5 has no advantage; say if you only had 1 or 2 embryos to transfer anyhow.  If more embryos than what we will transfer are still viable and growing at day 6, they can be cryopreserved or made into embie-cubes!  Even if we have eggs that fertilize and embryos that make it to blastocyst stage, our chances of making it to implantation and a screaming kid 36 weeks later are 65%.  In the IVF world, this is actually pretty darn good.
So, as you can see we have only managed to jump one of several hurdles.  I've made it past what i think is our biggest one, egg growing!  As J said, you can't make it past the other hurdles until you make it over the first one.  Man, he's awfully philosophical at 9am.  We are hoping and praying and crossing all possible appendages that retrieval, fertilization, blastocyst, and implantation will leave us with the biggest, fattest, BFP there ever was!!!




UPDATE: Retrieval will be Sunday at 0830!  E2 was 2603 today.  Wowza!  Once again J rocked out the money shot.  We ended up triggering with 10,000 units which means it'll take me ~10 days to flush it out of my system... Delays my POAS accuracy a lil more but i'm prepared.  I believe I have 10 pregnancy tests along with like 12 strips to pee on.  I'm going to be a POAS freak!  


Since trigger is done, NO MORE NEEDLES!!  Hallelujah!  

Oh the things we'll do!

I just got home, and even though I iced my bum before and after, it still hurts! Let me explain:

Last cycle I got a BFN! Are we surprised? I've just been sitting around the past 2 weeks waiting. Dr. K decided LEAP was the way to go and so I've been monitoring for ovulation with OPKs. On Friday I talked to Nurse Katie and she informed me they wanted to see me Monday (today) for an ultrasound just to check everything out. (Thank goodness I'm not working, or I'd def be getting fired for all these appointments!) She had mentioned sometimes they trigger ovulation with an injection of HCG, but I didn't think that was likely for me since I have an LH surge and ovulate on my own. Negative OPKs all weekend (I wasn't expecting a +until Wednesday anyhow).

Today the ultrasound is performed by the same doc I saw when I was cancelled. Ut lining is looking good and he sees 5 follicles measuring on track. I'm on my way out with instructions to keep using OPKs and I'll hear from Dr K and Nurse Katie this afternoon. I do a little happy dance for those 5 follies. :) 1pm rolls around and I get a surprise phone call "hey M, we want you to trigger tonite, will that be a problem?" I say no, but then realize I forgot J is CDO today. CDO is Command Duty Officer on the ship or HMFIC He is in charge of everything that goes wrong for the next 24 hours and can't leave the ship. Try as I might, I realize there is no way I can give myself The Money Shot. I frantically call a local friend who has done this, but she is out of town until tomorrow.. oh what to do! I email J... "uhhh, babe, will you have a couple minutes this evening to shoot me in the bum?" "yes, but we'll have to do it in the car." Really, in the car?? Gotta do whatcha gotta do, eh? I gather my supplies in a ziploc baggie and wedge an ice pack between my butt and the car seat on the way to see him. Driving through the gate to get on base, I feel like a criminal with my needles sweating for my next drug fix. Its 6pm, still very light out, and there are far more people walking around than I anticipated. We get some very odd looks as I mix and draw up the medication in the drivers seat. Instead of baring my behind for all of the shipyard and coworkers to see, I decide to reverse it 200 yards and park between a bunch of parked gov't vehicles and a dumpster. I hand over the syringe and hop out so J can eyeball where he is supposed to dart this thing in. I hop back in the car, crank the seat back and the steering wheel up for maximum access. For a guy who is squeamish with needles he sure knows how to stick a girl. As I'm pulling my drawers back up, the loudest loud speaker you've ever heard crackles announcing a fire drill. I steal a quick kiss and watch as J runs back to the ship hoping to not get caught outside! Talk about an adventure. I still can't believe I got a shot in the car, much less at J's work.... our baby book is going to have some amusing memories!

We don't have an "official" calendar yet for IVF #2 but it'll go a little something like this: Although today is Cycle Day 14, we are renaming it Day 0. On Day 8 I will start estrace(estrogen) pills. Day 9 I start a ganirelix injection. Do those until menses shows up. Start Follistim & Menopur CD3 until ? Trigger, +36 hours retrieval, +5 days transfer, +14 days HCG blood draw. The first and second weeks of August are going to be bery, bery busy.

As a side note, we found out we are officially moving back to San Diego! J's next job is going to start in July and will be for 3 years. According to the guy who does this job currently, he will be teaching leadership at a center for professional development and it will be cake. We are so excited! We were really worried how everything would play out and hoping we wouldn't have to move twice more before next summer... just once: from WA to Cali with the boat! A huge weight has been lifted. Everything is lining up perfectly for this April/May delivery! I think these next lil follies will feel a little more prone to grow knowing they won't be as stressed with moving and will be in SoCal for 36 months ;)