Day 3 IVF Cycle

So I started stims on Friday evening. I can't say I'm feeling much of the effects of them, perhaps because I failed to decrease my lupron dose and didn't realize it until I'd already taken today's dose and was on my way to have my labwork drawn. It was definitely a "smack my head" kind of moment, and I got really panicky. I thought, "You dumb ass, how in the world could you screw up something so important?!?!?!" I told the medical assistant who drew my labwork so she could note it in my chart, and her comment to me was, "Well, at least we know you won't ovulate early right?" And I thought to myself, are you kidding me? I just ovulated on BCP's AND lupron, and last time we cycled, I had bad cramps the day before my retrieval and I was worried that I was ovulating before they could do the retrieval. We still don't know for sure if I did, BUT, that was the cycle where they went into do the retrieval and got back a few hundred cc's of blood from my pelvis. I am REALLY hoping that nothing will happen before they go in to get those eggs from me.

No worries at this time though, I WILL take only 5 units of lupron in the morning, and tonight, I am to increase my follistim to 100, and keep menopur at 75 until my next appointment Tuesday morning at 7:30am for ultrasound and bloodwork. My estradiol today was 106 (up about 40 points from 2 days ago).

Phone Call #1

No doubt sure to be the first of many. Sonya called and she said that my estrogen was 277, and my progesterone was 7.4. I ovulated. If you're like me you're thinking "WHAT?????? I'm supposed to be suppressed?!?!?!" Sonya said that it could be one of two things. Either I was not suppressed enough, or that I flared on the lupron. Generally lupron is for suppression, but she said that lupron's job is to dump the LH and FSH and that for some people it will cause them to be stimulated instead of suppressed. Oops! So, the cyst is likely left over from ovulation, and when I start my period in the next two weeks to call and we will start stims then.

The whole ovulation thing actually makes sense to me. *TMI warning* About a week ago I thought to myself for a couple of days, "What in the world? I have this fertile looking mucus, but that can't be right because I'm on lupron and BCP's and that's for suppression. Not sure what that's all about." And I didn't give it another thought because I WAS ON BCP's AND LUPRON!!!! Haha. My body is so confused it doesn't know what it is supposed to be doing.

So anyway, my instructions are to call as soon as I start my period and we'll go from there. And here is my small sigh of relief!!!

Not a Good Appointment

I told ya. Granted, nothing is written in stone yet, that is until my nurse calls me this afternoon.

Still no period. I got to the appointment this morning and asked if I should be worried, they said I should start it today probably. Next was my ultrasound. I have 4 follicles on my left, 9 on my right, all little, they said that this is what they like to see, they want to see these little ones. Whew! I was worried. HOWEVER, I also have one cyst on my right side, it's cloudy, which according to my nurse means that it's resolving. I also have one on my left side that is bright, clear, and is larger than it was on my last ultrasound, and this means trouble. They did say that my lining is very thick, that I should start my period soon. Yet another reason I probably won't start stims today.

The concern of course is whether it is putting out estrogen. My nurse said it could go away when I start bleeding. She said that I could be kept on lupron longer (although even she admits this would be pretty miserable). She also said that sometimes Dr. M will aspirate the cyst while I'm still on lupron and then start me on stims. I sort of like the sound of that last option. Here's the problem...I imagine that aspirating it would be done by ultrasound guided needle aspiration, much like my retrieval, however, being as it's a relatively minor procedure, I imagine this would not really be done with anesthesia-YIKES!!!!!

When I left that appointment I went to my acupuncture appointment I had scheduled in hopes I'd be starting stims. She treated me for the infertility stuff and for my back pain. Now I can't sleep. I am just waiting for my nurse to call me and that won't be until 2-ish. I've prayed I feel like nonstop since before my appointment that the feeling I had was wrong, and I've prayed since my appointment that maybe everything will look ok, and they'll decide to let me start stims. Help!!!

Special Package!!!

I got this by UPS today!



I was supposed to start the lupron injections this morning, but nothing you can do when the package arrives at 3:15pm. I took my first lupron injection at 3:30, and I will work it back by an hour everyday until I'm taking it around 8am.

I have an ultrasound scheduled with bloodwork next Friday morning, 2/4/11. At that point we'll hopefully be ready to start stims. This however, will mean that one day, the day I start stims, will require me to take 3 shots, yes 3!!! Geez. Oh well right? After that first day, I think lupron stops the next day and then I'm just on the two shots a day.

There are a few new drugs in my cycle this time. First is menopur, it has LH and FSH instead of just the FSH that follistim has (I am still taking follistim this cycle, however this combo scares me, see below). So this will mean I am on two stim drugs. The thing that freaks me out about that is that when we did IVF #1, I was overstimming. I had mild OHSS, and my E2 was very high. They threatened to cancel my cycle after retrieval (because pregnancy can make OHSS worse). Luckily they didn't, and I did fine, however, OHSS is not something I really want to mess around with. The severe cases the patient is in congestive heart failure essentially and is hospitalized. This is NOT my idea of fun. So I am a little hesitant to take this drug.

Estrace is also new for me. This is a form of supplemental estrogen which has been shown to improve pregnancy rates. The other drug that is new for me is the Endometrin which is what I will be taking instead of progesterone in oil (PIO). The PIO was an IM injection that Archie had to give me nightly after our transfer, and because we got pregnant on our first cycle, we continued this through the 12 week mark to support the pregnancy. The Endometrin is a vaginal suppository. Yuck. And from what I hear, it's all good while you're lying down (which my nurse says isn't even necessary, however, I want as much of the progesterone from it as possible if I plan to get pregnant right?), however, when you stand up and it has melted, it's supposedly very messy. And I have to take it 3 times a day instead of once a day. Great. To be honest, I'm not sure this Endometrin and I will get along. If I hate it, I do have the option to go back to the shot form of progesterone. That too has it's drawbacks (hello, it is a shot!), but at least it is once a day and not 3 times a day and so messy!

For some reason, this time I don't have a prescription for Medrol or baby aspirin. The medrol was something I to take/taking the last two cycles because we were doing assisted hatching and it helps decrease the inflammatory response possible between me and my little embryos. The baby aspirin decreases coagulation factors in the bloodstream that can be increased due to the really high levels of estrogen (thanks to the stim drugs like follistim and menopur), thus increasing bloodflow to the tissue. I have a call into my nurse to ask if this is due to a change in protocol with the switch to the new fertility clinic, or if this was overlooked, or if it is something that perhaps they will write for later in the cycle. My Type-A self feels the need to have this info, although to be honest, it may just not be as important as they used to think it was. Who knows?

Otherwise, there isn't much news on my end. I hate to be boring and not post much, but really, once I start stims I'll be boring YOU with posts about every other day (minimum) to update on my ultrasounds and bloodwork, so enjoy not reading my rambling while you can!!!

Mock Transfer and Sono HSG

I am scheduled to have my mock transfer and sono HSG on Tuesday morning at 10am. For my non-IVF friends who may not have a clue what that means, before you can do an embryo transfer, they like to do a practice one. It is basically a speculum exam where they put the catheter through your cervix and into your uterus while looking at it by ultrasound so they can see how far in they need to go to put those little embryos right back where they belong. At the same time that they do that (the mock transfer) they will also do a sono HSG where they will inject through the catheter some saline and look at where it goes by ultrasound. Being as I am down to one patent tube, they should just see saline fill up my uterus, go through and spill out of that other tube. It is really very minor, a little uncomfortable when they inject the saline, but not unbearable. I expect it to pretty much be a non-event, but it is an event in that it is our next step in this process.

Tuesday will also be the start of week two on our birth control pills...that means about one more week until I start on lupron!!!!!!!!!! Gosh it seems crazy to be excited to start on something that gives me wicked hot flashes and has the potential to make me even more moody than normal. That said, I think the hot flashes are what I remember the most, not really any more moodiness than usual.

I will post on Tuesday and let you all know that everything was completely boring and normal...right???