Two days ago I started a third daily injection, Cetrotide, which is used to prevent ovulation (since we don't want my body blithely releasing all of these eggs into the wild after working so hard to grow them). I take this injection in the morning, which on the one hand is nice, because I don't have to give myself three shots at once this way, but on the other hand... I am not at my sharpest, first thing in the morning. This is one of the slightly more complicated shots - while the syringe comes pre-loaded with fluid, you first attach a mixing needle (thicker gauge) to the syringe to transfer the fluid to a vial with the powdered medication, then carefully pull the mixed medication back up through that needle into the syringe, change out the needle for a smaller injection needle, and have at it.
This morning, I carefully attached the first needle, blearily wondered why I was having such a hard time getting the meds back up into the syringe, discarded the first needle... and then realized I had used the injection needle to mix the meds - and then thrown that needle away. Whoops. And there was no chance in hell I was using the giant mixing needle to stab myself. Interestingly, even though I've been giving myself two injections a day for over a week now, my body seems more offended by the Cetrotide than the other meds - I've bruised every time I've injected the Cetrotide (which has not happened with any of the other 20 (!) injections) and I get an itchy, hive-like rash at the injection site. It goes away in about an hour, but the bruises stay. Things are starting to look a little sad on my (increasingly bloat-puffed) midsection.
However, more concerning for me right now are my hormone levels. I'm now at daily appointments for a wand up the hooha to check on follicle number and size, plus a daily blood draw to check hormone levels. My estrogen jumped like 1000.. uh.. points? numbers? between Sunday and Tuesday and I'm now over 2,000. I have several follicles measuring around the 18mm mark, and I believe we're shooting for about 20mm, so I need another day or two of growth. But if my estrogen gets over 3,000, added to the fact that I seem to have a fairly large clutch of eggs percolating, they might be hesitant to do an embryo transfer at all due to the risk of OHSS while my hormones are so exuberant. The HCG my body would produce if the transfer resulted in a pregnancy could cause me to overstimulate, which they definitely do not want. Which means that there is now a possibility that I will not have a transfer next week at all. Which freaking sucks.
Nothing I can do about it, though. If my numbers are too high, they will freeze all of the viable embryos that they get from this cycle and we'd have to delay until a new cycle - I don't even know what the timing would look like in that scenario. For now, I wait for my daily call from my nurse with today's results and go from there.
Edit: I found the following article while manically googling acceptable estrogen levels during an IVF cycle, which was helpful - according to various women in various IVF forums, they were reporting levels of 10k or higher (!?) and still doing transfers. This post offers some clear & insightful data on exact numbers with studies & results.
Unfortunately there's always something to worry about in this process and, as scientific as it is, there's so much you can't freaking control. Hopefully you won't tip over into OHSS range, but if you do it's not the worst thing. There are some studies that say that FETs are more successful than fresh transfers, that fresh day 5 transfers are better than day 3, but it really it seems like it comes down to what's meant to be. My daughter came from a crop of a whopping 6 eggs retrieved, only 3 were left by day 3, transferred 2, and the third never made it to freeze. Try to not be disappointed about any perceived setbacks, just keep moving forward.
ReplyDeleteAww. Thank you. I needed that :)
DeleteYikes! It's all so complicated. I hope it all works out, one way or another.
ReplyDeleteEverything crossed that your estrogen levels get with the program! It is so frustrating that there is always something, but what "something" is seems to vary so widely depending who you ask.
ReplyDeleteI was just going to make the same comment as Betsy! My RE at my last consult talked about the fact that frozen transfers, because labs are getting so much better, may become more of the norm because your RE can better synch up your uterine lining and uterus for the transfer. Although I understand wanting to get a fresh transfer RIGHT NOW it is much better to wait and make sure that everything looks good. Fingers crossed you don't get OHSS!
ReplyDeleteThank you :) I know that on an intellectual level (and even that FETs often have higher success rates) but dang. It's so hard to let go of the idea of getting one put back in next week. But it's useless to stress one way or the other right now anyway... we'll see what the hormones do!
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