::ALL THINGS EVERYWHERE CROSSED::
I'm now 6 full days out from my latest aspiration and I feel.... pretty OK, actually. I had another check up this morning, and while there is still fluid hanging out in my midsection, especially in my upper abdomen, the areas around my ovaries are looking waaay better. And I feel better. Like.. more human. Capable of handling (small chunks) of life. I will take it! Happily! Please and thank you! Let's keep this up, body!
Meanwhile the betas continue to go up, still peskily refusing to double, but the doctors still seem OK with it. They went from 715 on Wednesday to 1242 on Friday, and I'll get another reading later today. Then, assuming I don't relapse, no more appointments until FRIDAY! When I'll be just about 6 weeks, and they can start hopefully looking for some baby bits in there too.
One weird consequence of things finally starting to level out a bit (LET'S HOPE) is I no longer know the cause for, like, anything that I'm feeling. We went to the mall for a few hours on Saturday to pick up some gear for Iceland, and I had to abruptly cut the trip short because hey! I need to go lie down! Like... rightnow! So we went back home, where I settled into the couch with my feet up to rest... and promptly fell sound asleep for two full hours, at 3pm in the afternoon. After sleeping for nine hours the previous night. So, hormones? OHSS? Pregnancy? ANYONE'S GUESS!
So for now I just hope for good betas today, hope the fluid continues to drain, and hope that I can stop drinking two gatorades a day sometime very soon.
Showing posts with label fertility. Show all posts
Showing posts with label fertility. Show all posts
December 14, 2015
December 10, 2015
Moar OHSS
After writing that post on Monday, I got a call from the office: my doctor had seen my bloodwork and fluid-filled ultrasounds, and moved the aspiration up to Tuesday instead of Wednesday. This was highly fine by me because I was miisssserabllle at that point. My nurse called at about 1:45 with that news, advised that I should definitely keep on with the protein and gatorade, and by the way, I was home, right? I admitted that no, I was at the office, but planning to leave soon because it was getting to be too much. "OH MY. Yes. Leave now. Do you need a note? I can write them a note. Please go home right now."
I left shortly after that and was in tears for most of the ride home, because... just, everything. I was having terrible thoughts, wondering if it would be better for the fetus not to make it, because at least then I could recover from the OHSS. Which obviously is NOT what I want. But it was getting increasingly hard to face an undetermined amount of time dealing with this when there was nothing I could do to treat it, stop it, or have any idea of when it would fix itself. It's unbelievable to me that I've only been dealing with this for a week - one week! - because it feels like an eternity. And the thought that it could continue for several MORE weeks, when I was in such a bad state... it was no good.
I had another night of failing to sleep because everything was terrible, then worked from home for the morning ("worked") and headed back up to the treatment center Tuesday afternoon. On Monday, I had been all "oh yeah, let's try to wait until Wednesday, it certainly can't be good for me to go under anesthesia so frequently!" On Tuesday I could barely make the car ride without crying every time we turned, swerved, hit a bump, accelerated, you name it. I was VERY READY for some effing anesthesia if it meant GETTING THIS OUT OF ME.
This time they got out 2.4 liters. That is considerably more than one of those big bottles of soda. The doctor who performed the procedure came by to see me afterwards and was like, "Two and a half liters is a LOT for someone your size! You must have felt terrible!" Yes. Yes, I did.
But of course the benefit of getting drained is IMMEDIATE relief, so I felt a lot better than that sad picture up there as soon as I woke up. I more or less hadn't eaten in 2 days at that point (Tuesday in preparation for the anesthesia; Monday because I had run out of room for food) so we went straight to a pho place where I downed a very respectably sized - and protein-filled - bowl of soup.
I went back in Wednesday morning for follow up bloodwork and an ultrasound to see how my insides looked. At this point I was about 15 hours post-draining... and I already had some pockets of fluid back. WHAT THE HELL BODY JESUS H CHRIST ON A CRACKER. The pockets were still comparably small, at least, and were still just in my lower abdomen around the ol' ovaries, nothing (yet) up higher where it starts making it hard to breathe.
The good news is we're now another day out and I have not yet ballooned out fully, so I'm hopeful that this time maybe I'll be slower to refill. I finally have had 2 good nights' sleep in a row - much more manageable without a grossly distended stomach! - and I am feeling exponentially better as a result. But good gods I would love to also kick this freaking thing.
And now for some numbers! My first beta was early, at 8dp5dt (this is how every post on IVF/fertility message boards look, by the way. They are entirely in code, and I frequently have to google these abbreviations in order to follow along. 8dp5dt = 8 days post 5 day transfer, meaning my blastocyst was 5 days old when they transferred it, and my beta was done on the 8th day after transfer... or what would be 13 days after ovulation in a normal person).
8dp5dt (13 dpo) = 223
11dp5dt (16 dpo) = 475
13dp5dt (18 dpo) = 715
So the numbers are going up, which is reassuring, but they are not quite doubling each time, which is traditionally what you want. They assure me that this is OK in my case, because my blood volumes are so messed up right now. Hopefully they are not just saying that to placate me.. I'd rather know up front if they are concerned so that I can manage my own expectations. But for now I'll assume numbers going up = good and leave it at that. And obsessively checking my numbers against online databases for reassurance, naturally.
I left shortly after that and was in tears for most of the ride home, because... just, everything. I was having terrible thoughts, wondering if it would be better for the fetus not to make it, because at least then I could recover from the OHSS. Which obviously is NOT what I want. But it was getting increasingly hard to face an undetermined amount of time dealing with this when there was nothing I could do to treat it, stop it, or have any idea of when it would fix itself. It's unbelievable to me that I've only been dealing with this for a week - one week! - because it feels like an eternity. And the thought that it could continue for several MORE weeks, when I was in such a bad state... it was no good.
I had another night of failing to sleep because everything was terrible, then worked from home for the morning ("worked") and headed back up to the treatment center Tuesday afternoon. On Monday, I had been all "oh yeah, let's try to wait until Wednesday, it certainly can't be good for me to go under anesthesia so frequently!" On Tuesday I could barely make the car ride without crying every time we turned, swerved, hit a bump, accelerated, you name it. I was VERY READY for some effing anesthesia if it meant GETTING THIS OUT OF ME.
This time they got out 2.4 liters. That is considerably more than one of those big bottles of soda. The doctor who performed the procedure came by to see me afterwards and was like, "Two and a half liters is a LOT for someone your size! You must have felt terrible!" Yes. Yes, I did.
But of course the benefit of getting drained is IMMEDIATE relief, so I felt a lot better than that sad picture up there as soon as I woke up. I more or less hadn't eaten in 2 days at that point (Tuesday in preparation for the anesthesia; Monday because I had run out of room for food) so we went straight to a pho place where I downed a very respectably sized - and protein-filled - bowl of soup.
I went back in Wednesday morning for follow up bloodwork and an ultrasound to see how my insides looked. At this point I was about 15 hours post-draining... and I already had some pockets of fluid back. WHAT THE HELL BODY JESUS H CHRIST ON A CRACKER. The pockets were still comparably small, at least, and were still just in my lower abdomen around the ol' ovaries, nothing (yet) up higher where it starts making it hard to breathe.
The good news is we're now another day out and I have not yet ballooned out fully, so I'm hopeful that this time maybe I'll be slower to refill. I finally have had 2 good nights' sleep in a row - much more manageable without a grossly distended stomach! - and I am feeling exponentially better as a result. But good gods I would love to also kick this freaking thing.
And now for some numbers! My first beta was early, at 8dp5dt (this is how every post on IVF/fertility message boards look, by the way. They are entirely in code, and I frequently have to google these abbreviations in order to follow along. 8dp5dt = 8 days post 5 day transfer, meaning my blastocyst was 5 days old when they transferred it, and my beta was done on the 8th day after transfer... or what would be 13 days after ovulation in a normal person).
8dp5dt (13 dpo) = 223
11dp5dt (16 dpo) = 475
13dp5dt (18 dpo) = 715
So the numbers are going up, which is reassuring, but they are not quite doubling each time, which is traditionally what you want. They assure me that this is OK in my case, because my blood volumes are so messed up right now. Hopefully they are not just saying that to placate me.. I'd rather know up front if they are concerned so that I can manage my own expectations. But for now I'll assume numbers going up = good and leave it at that. And obsessively checking my numbers against online databases for reassurance, naturally.
December 07, 2015
OHSS: increasingly intolerant side eye
I am so very over OHSS, which is unfortunate for me, because my body shows no signs of letting up. On the one hand, that's a "good sign" because it indicates I'm still chugging away with the pregnancy hormones. On the other hand, I feel like shit warmed over.
I went back in early this morning to see how I was progressing after they removed those 2 liters from me on Friday. Turns out I've filled right back up! While I'm obviously really uncomfortable again, I am not (yet) having difficulty breathing, as I was last week, which apparently is because my body is "getting used to" having several liters of rogue liquid making itself at home in my midsection. THIS DOES NOT SEEM LIKE SOMETHING YOU SHOULD ALLOW YOURSELF TO ACCLIMATE TO, BODY. They're hoping to wait until Wednesday to drain me out this time, so they can get out more. Also because I assume going under anesthesia and getting minor surgery multiple times a week is not exactly ideal.
I'm at work today but... man. I don't know if I can do this. If I need to wait until Wednesday, I think I need to do it lying down. (If I need/want to make the appointment for earlier, they were clear that I absolutely can and it's my call.)
One of the problems is that I can't sleep when I've got 2 liters of fluid in me. Lying flat does make it hard to breathe. Lying propped up has started painfully kinking my lower back. My pulse is hanging out at about 130 right now which isn't very... restful. There's not a lot of sleeping going on either way, basically. So adding exhaustion onto this is not making me particularly gracious about.. well, anything. I'm grumpy. And uncomfortable as shit. And so very tired.
I just keep reminding myself I'm glad I'm not at hospitalization levels. My lower extremities are not swelling. I've only ("only") got 4 pounds or so in me right now. Things could be far worse.
I would like it to stop, regardless. The doctors think it's likely that I have 1 - 2 more drainings in me before the OHSS resolves. I really hope that's all. From what I've read, even once the OHSS starts to dissipate, it can still take weeks for your abdomen to go back down to normal. Which means I have a shot of immediately shooting up to looking 4 months pregnant and just... staying there. Until I actually am 4 months pregnant. WHAT THE HELL.
Second beta results later today, to hopefully get the news that this little jerk is thriving in spite of its effects on me ;-)
I went back in early this morning to see how I was progressing after they removed those 2 liters from me on Friday. Turns out I've filled right back up! While I'm obviously really uncomfortable again, I am not (yet) having difficulty breathing, as I was last week, which apparently is because my body is "getting used to" having several liters of rogue liquid making itself at home in my midsection. THIS DOES NOT SEEM LIKE SOMETHING YOU SHOULD ALLOW YOURSELF TO ACCLIMATE TO, BODY. They're hoping to wait until Wednesday to drain me out this time, so they can get out more. Also because I assume going under anesthesia and getting minor surgery multiple times a week is not exactly ideal.
I'm at work today but... man. I don't know if I can do this. If I need to wait until Wednesday, I think I need to do it lying down. (If I need/want to make the appointment for earlier, they were clear that I absolutely can and it's my call.)
One of the problems is that I can't sleep when I've got 2 liters of fluid in me. Lying flat does make it hard to breathe. Lying propped up has started painfully kinking my lower back. My pulse is hanging out at about 130 right now which isn't very... restful. There's not a lot of sleeping going on either way, basically. So adding exhaustion onto this is not making me particularly gracious about.. well, anything. I'm grumpy. And uncomfortable as shit. And so very tired.
I just keep reminding myself I'm glad I'm not at hospitalization levels. My lower extremities are not swelling. I've only ("only") got 4 pounds or so in me right now. Things could be far worse.
I would like it to stop, regardless. The doctors think it's likely that I have 1 - 2 more drainings in me before the OHSS resolves. I really hope that's all. From what I've read, even once the OHSS starts to dissipate, it can still take weeks for your abdomen to go back down to normal. Which means I have a shot of immediately shooting up to looking 4 months pregnant and just... staying there. Until I actually am 4 months pregnant. WHAT THE HELL.
Second beta results later today, to hopefully get the news that this little jerk is thriving in spite of its effects on me ;-)
December 05, 2015
OHSS & first beta update
So after confirming that I had a good case of OHSS percolating, I went up to the treatment center late yesterday for the "fluid aspiration" procedure. It's done the same way as the egg retrieval, turns out: a big needle through the ol' vaginal wall once again, but instead of going into the ovary to get eggs, it's going into all the pockets around my ovaries to suck out the collected fluid. They had me nearly sitting up for the procedure this time (I mean, also still legs splayed and thank god still knocked out) so that the fluid up around my diaphragm and lungs would basically trickle down via gravity as space opened up.
The good news is the procedure offers INSTANT relief. As soon as I started waking up I could tell my abdomen was flatter and I could breathe far more easily. And since they took out nearly TWO LITERS of fluid - that's like 4 pounds!! - it's easy to see why the relief was so sudden and pronounced.
The bad news is the procedure is treating a symptom only: there is no guarantee this will not keep happening or even get worse. Especially since... drumroll... they did my first beta with my morning's blood work, and it came back at 223.
That means we're pregnant!
I mean, obviously this is still RULL RULL early, it doesn't mean we're out of the woods by any means, but still pretty exciting :)
However, it confirms that I'm definitely not out of the woods on the OHSS front either, since the pregnancy hormones will continue to agitate the situation over the coming weeks, should I remain pregnant.
So for now that means keep on with the Gatorade, make sure I'm getting a lot of lean protein, which apparently helps patch up the holey veins, and take it as easy as possible.
(Apparently the clinical term for when the veins get leaky like this is "fenestrated," which my doctor described as going from a normal window to a screen window. I immediately knew what he meant though, because I will always and forever remember the definition of the word due to the Defenestration of Prague. Did anyone else learn about that in highschool history, or just my weird class?)
Anyway. I also need to start blood thinners, since my bloodwork came back "pretty high" (he told me what exactly was high, but they were words I'd never heard before so I definitely do not remember them) - but basically as the blood leaks its fluid out, it becomes thicker and "sludgier" which puts it at higher risk for clots. And the way to administer the blood thinner? Injections!! For 8 to 10 weeks! So I'm back to stabbing myself in the stomach daily for the next 3 months! Yaaaaaaaaay!
All in all I certainly wish I was not going through this, BUT I feel oddly lucky, because a lot of my symptoms are in what many online sources classify as the "severe" bucket - the difficulty breathing, dehydrated enough to be at risk for clots (at the treatment center yesterday I went through both a "concentrated" IV bag as well as a normal "big bag" of IV fluids - then came home and drank 2 Gatorades and all the broth (and ate all the protein-rich kidney beans!) from a can of soup - and still did not pee for nearly 12 hours). But I have not retained a truly dramatic amount of fluid - some people put on like 20+ lbs during this - and so far I'm not at the hospitalization level, which most severe cases require. So what I'm saying is things could definitely be worse.
And, first beta was good! So it's hard being TOO mad, knowing the cause :)
The good news is the procedure offers INSTANT relief. As soon as I started waking up I could tell my abdomen was flatter and I could breathe far more easily. And since they took out nearly TWO LITERS of fluid - that's like 4 pounds!! - it's easy to see why the relief was so sudden and pronounced.
The bad news is the procedure is treating a symptom only: there is no guarantee this will not keep happening or even get worse. Especially since... drumroll... they did my first beta with my morning's blood work, and it came back at 223.
That means we're pregnant!
I mean, obviously this is still RULL RULL early, it doesn't mean we're out of the woods by any means, but still pretty exciting :)
However, it confirms that I'm definitely not out of the woods on the OHSS front either, since the pregnancy hormones will continue to agitate the situation over the coming weeks, should I remain pregnant.
So for now that means keep on with the Gatorade, make sure I'm getting a lot of lean protein, which apparently helps patch up the holey veins, and take it as easy as possible.
(Apparently the clinical term for when the veins get leaky like this is "fenestrated," which my doctor described as going from a normal window to a screen window. I immediately knew what he meant though, because I will always and forever remember the definition of the word due to the Defenestration of Prague. Did anyone else learn about that in highschool history, or just my weird class?)
Anyway. I also need to start blood thinners, since my bloodwork came back "pretty high" (he told me what exactly was high, but they were words I'd never heard before so I definitely do not remember them) - but basically as the blood leaks its fluid out, it becomes thicker and "sludgier" which puts it at higher risk for clots. And the way to administer the blood thinner? Injections!! For 8 to 10 weeks! So I'm back to stabbing myself in the stomach daily for the next 3 months! Yaaaaaaaaay!
All in all I certainly wish I was not going through this, BUT I feel oddly lucky, because a lot of my symptoms are in what many online sources classify as the "severe" bucket - the difficulty breathing, dehydrated enough to be at risk for clots (at the treatment center yesterday I went through both a "concentrated" IV bag as well as a normal "big bag" of IV fluids - then came home and drank 2 Gatorades and all the broth (and ate all the protein-rich kidney beans!) from a can of soup - and still did not pee for nearly 12 hours). But I have not retained a truly dramatic amount of fluid - some people put on like 20+ lbs during this - and so far I'm not at the hospitalization level, which most severe cases require. So what I'm saying is things could definitely be worse.
And, first beta was good! So it's hard being TOO mad, knowing the cause :)
December 04, 2015
OHSS? O Y-E-S!
Not one to be content just sitting around when it knows there are more extreme reactions it could be having, my body has turned the corner into full on OHSS.
Yaaaaaaaaay.
For the past few days, my stomach had been getting pretty tight and crampy. Which, of course, is one of the 129375716234 possible side effects of progesterone (and probably estrogen too) so I was like lovely, just add it to the joys of the fertility process, and let's move on.
But by yesterday, I woke up at 6am, unable to sleep any more because of the pain in my abdomen. "These are some intense cramps!" I thought to myself, and then tried to remember if regular menstrual cramps are just... constant? Do they come and go? Or is this constant pressure feeling normal? Eh, who knows, IVF drugs be cray.
Then I got up and started to get ready for the day, but had to stagger immediately back to bed as the bathroom started spinning and I got the cold sweats. So that was cool. But it passed, so whatever, fertility drugs suck, it is known, etc.
By the time I got to work, I noticed that all of the bloating that had mercifully been abating over the past week seemed to be back. Like, ALL of it. In one day. Also I couldn't eat anything.
By the time I got home, my stomach was the size of my 5-month-pregnant friend's, causing me substantial pain & discomfort, and hard to the touch. I realized I had not peed at all that day. I chugged a gatorade and emailed my RE nurse, but since it was well after hours by that point I wasn't expecting a reply until the morning.
Last night was... not fun. Lying in any position aside from on my back and propped up by pillows caused immediate acute pain. I couldn't take full breaths. I did not sleep much.
This morning I called my nurse to ask if there was anything else I could or should be doing aside from binging on Gatorade and protein. She immediately scheduled me for a sonogram.
Results: fluid accumulated throughout my abdominal cavity, including in both the left and right upper chambers. Not severe amounts, and no fluid in my lungs or anything, but enough that I can't fit into pants and the pressure on my diaphragm is pretty substantial. So they're sending me to the surgery office (where I had my HSG, the retrieval, and the transfer) to get some of this liquid pulled out of me later today.
The good-ish news is that with late-onset OHSS like this, the cause is almost always a spike in hCG... which would be due to a successful implantation. The bad news is that if I am in fact pregnant, the hCG will continue to feed this condition. So! Yay?
For now it's all about managing symptoms. My doctor wants to take a very proactive approach, draining the fluid now before it gets worse, and after the procedure I will be on a strict Gatorade and protein ONLY diet. There is nothing I can really do to stop it from happening (or getting worse.. or coming back) so I just have to take it easy and try to stay on top of it. At the moment I'm relieved there is some relief in my future, even if temporary. I'm also super thirsty right now, since my body is helpfully leaking everything I drink into my abdomen instead of using it to, say, hydrate my body, AND I am banned from any food or drink until the procedure later today (since they will use anesthesia) but they're having me come a full hour and a half early to put me on an IV to try and hydrate me up a little.
So! Actions being taken! Good things! Eyerolls all around at my body and its need to always be a delicate flower!
Yaaaaaaaaay.
For the past few days, my stomach had been getting pretty tight and crampy. Which, of course, is one of the 129375716234 possible side effects of progesterone (and probably estrogen too) so I was like lovely, just add it to the joys of the fertility process, and let's move on.
But by yesterday, I woke up at 6am, unable to sleep any more because of the pain in my abdomen. "These are some intense cramps!" I thought to myself, and then tried to remember if regular menstrual cramps are just... constant? Do they come and go? Or is this constant pressure feeling normal? Eh, who knows, IVF drugs be cray.
Then I got up and started to get ready for the day, but had to stagger immediately back to bed as the bathroom started spinning and I got the cold sweats. So that was cool. But it passed, so whatever, fertility drugs suck, it is known, etc.
By the time I got to work, I noticed that all of the bloating that had mercifully been abating over the past week seemed to be back. Like, ALL of it. In one day. Also I couldn't eat anything.
By the time I got home, my stomach was the size of my 5-month-pregnant friend's, causing me substantial pain & discomfort, and hard to the touch. I realized I had not peed at all that day. I chugged a gatorade and emailed my RE nurse, but since it was well after hours by that point I wasn't expecting a reply until the morning.
Last night was... not fun. Lying in any position aside from on my back and propped up by pillows caused immediate acute pain. I couldn't take full breaths. I did not sleep much.
This morning I called my nurse to ask if there was anything else I could or should be doing aside from binging on Gatorade and protein. She immediately scheduled me for a sonogram.
Results: fluid accumulated throughout my abdominal cavity, including in both the left and right upper chambers. Not severe amounts, and no fluid in my lungs or anything, but enough that I can't fit into pants and the pressure on my diaphragm is pretty substantial. So they're sending me to the surgery office (where I had my HSG, the retrieval, and the transfer) to get some of this liquid pulled out of me later today.
The good-ish news is that with late-onset OHSS like this, the cause is almost always a spike in hCG... which would be due to a successful implantation. The bad news is that if I am in fact pregnant, the hCG will continue to feed this condition. So! Yay?
For now it's all about managing symptoms. My doctor wants to take a very proactive approach, draining the fluid now before it gets worse, and after the procedure I will be on a strict Gatorade and protein ONLY diet. There is nothing I can really do to stop it from happening (or getting worse.. or coming back) so I just have to take it easy and try to stay on top of it. At the moment I'm relieved there is some relief in my future, even if temporary. I'm also super thirsty right now, since my body is helpfully leaking everything I drink into my abdomen instead of using it to, say, hydrate my body, AND I am banned from any food or drink until the procedure later today (since they will use anesthesia) but they're having me come a full hour and a half early to put me on an IV to try and hydrate me up a little.
So! Actions being taken! Good things! Eyerolls all around at my body and its need to always be a delicate flower!
November 30, 2015
Transfer!!!11!!eleven!!!1!
ALERT ALERT I AM NOW HARBORING ONE BLASTOCYST
Well, I hope I still am anyway. On Thanksgiving Day, our doctor called to let us know that all 7 little eggs were still alive and well, although a few were growing slower than the others - including one that was a full day behind the others despite obviously having been fertilized at exactly the same time as his siblings. ::cue suspicious side-eye at my already-falling-behind potential offspring::
But the good news was that all 7 were still growing, and the very good news was that one had developed into a Grade A blastocyst, looking excellent for transfer.
This is typically the next inflection point, when you and your doctor decide *how many* blasts to transfer. A lot of it depends on the woman's age and the quality of the blastocysts you have to work with. I have a friend whose doctor advised she put in two. She countered that she really really did not want twins. The doctor replied yes, I know: we need to put in two to get you one. (So she put in two, and now has one healthy baby!) Apparently, women over.. I forget the exact age now, 37 maybe? 38? are also frequently advised to start with at least two.
The reason for this is you do increase your overall chance at getting pregnant (with one baby) as you add in eggs, especially as you get older. In our situation, we had a 5% greater chance of coming away with a baby if we put in two.
....and a 40% increased chance of having twins.
So we swiftly and happily agreed to put in just the one good-looking blastocyst, and freeze any others that looked viable.
The transfer is quick and painless, and SUPER COOL. The room they had me in opened on one side to the waiting room, and on one side directly into the lab. Once they had me all set up (nether bits a-flappin') they opened the door to the lab and called out "ready for [my last name]!". A screen just above the sonogram screen illuminated with a view from the technician's microscope, which first showed my name and D.O.B to (re-)confirm the proper embryo, then actually pulled up a view of the exact blastocyst they were about to transfer (!!!). Meanwhile, a tech in the room pulled up a sonogram of my abdomen with a clear picture of my uterus, and I watched (right on the screen!) as the doctor inserted a tiny catheter right into my uterus. The lab tech popped in with a syringe containing my blast, and then we all watched as a tiny flash of light squirted out the end of the catheter right into my uterus. (The blastocyst is far too small to see with the naked eye, but it's in some liquid, and that's what you could see on the sonogram.)
Oh, and for the transfer? No one in the room can wear any scents, like perfume or scented lotion. Because smells *agitate the embryos* during the brief period they're out in the open. Isn't that weird / cool / amazing / crazy!?
So now, hopefully, that little blast is digging into my lining, getting nice and cozy, and setting up shop. On Saturday they called to let me know that of the remaining 6 embryos, 4 had looked good enough to freeze. So that's really fabulous news too - it's a huge relief to know that even if this doesn't work, we have a few more tries available to us without having to go whole hog with an entire course of injectables and another retrieval.
And for now... I wait. I'm still on the estrogen and progesterone, which thankfully stopped causing nausea after the first day, and are now onto generating super crazy, novel-worthy weird dreams every night. And even better, I FINALLY have started to de-bloat and - perhaps TMI, but I think we've long passed that point - things have started.. ahem.. moving in that region as well. The worst side effect for me by far was well over 2 weeks of going poopless. That is NOT COMFORTABLE, people. But I went nuclear on the situation during the days between retrieval and transfer with some serious laxative action, and I am OVERJOYED to report that although it took a few days, Things Are Now Much Better.
So! One blastocyst, hopefully enjoying its new surroundings, and no updates for LIKE EVER, aka the dreaded two week wait.
::drums fingers::
::whistles tunelessly::
::repeats for 13 days::
Well, I hope I still am anyway. On Thanksgiving Day, our doctor called to let us know that all 7 little eggs were still alive and well, although a few were growing slower than the others - including one that was a full day behind the others despite obviously having been fertilized at exactly the same time as his siblings. ::cue suspicious side-eye at my already-falling-behind potential offspring::
But the good news was that all 7 were still growing, and the very good news was that one had developed into a Grade A blastocyst, looking excellent for transfer.
This is typically the next inflection point, when you and your doctor decide *how many* blasts to transfer. A lot of it depends on the woman's age and the quality of the blastocysts you have to work with. I have a friend whose doctor advised she put in two. She countered that she really really did not want twins. The doctor replied yes, I know: we need to put in two to get you one. (So she put in two, and now has one healthy baby!) Apparently, women over.. I forget the exact age now, 37 maybe? 38? are also frequently advised to start with at least two.
The reason for this is you do increase your overall chance at getting pregnant (with one baby) as you add in eggs, especially as you get older. In our situation, we had a 5% greater chance of coming away with a baby if we put in two.
....and a 40% increased chance of having twins.
So we swiftly and happily agreed to put in just the one good-looking blastocyst, and freeze any others that looked viable.
The transfer is quick and painless, and SUPER COOL. The room they had me in opened on one side to the waiting room, and on one side directly into the lab. Once they had me all set up (nether bits a-flappin') they opened the door to the lab and called out "ready for [my last name]!". A screen just above the sonogram screen illuminated with a view from the technician's microscope, which first showed my name and D.O.B to (re-)confirm the proper embryo, then actually pulled up a view of the exact blastocyst they were about to transfer (!!!). Meanwhile, a tech in the room pulled up a sonogram of my abdomen with a clear picture of my uterus, and I watched (right on the screen!) as the doctor inserted a tiny catheter right into my uterus. The lab tech popped in with a syringe containing my blast, and then we all watched as a tiny flash of light squirted out the end of the catheter right into my uterus. (The blastocyst is far too small to see with the naked eye, but it's in some liquid, and that's what you could see on the sonogram.)
Oh, and for the transfer? No one in the room can wear any scents, like perfume or scented lotion. Because smells *agitate the embryos* during the brief period they're out in the open. Isn't that weird / cool / amazing / crazy!?
So now, hopefully, that little blast is digging into my lining, getting nice and cozy, and setting up shop. On Saturday they called to let me know that of the remaining 6 embryos, 4 had looked good enough to freeze. So that's really fabulous news too - it's a huge relief to know that even if this doesn't work, we have a few more tries available to us without having to go whole hog with an entire course of injectables and another retrieval.
And for now... I wait. I'm still on the estrogen and progesterone, which thankfully stopped causing nausea after the first day, and are now onto generating super crazy, novel-worthy weird dreams every night. And even better, I FINALLY have started to de-bloat and - perhaps TMI, but I think we've long passed that point - things have started.. ahem.. moving in that region as well. The worst side effect for me by far was well over 2 weeks of going poopless. That is NOT COMFORTABLE, people. But I went nuclear on the situation during the days between retrieval and transfer with some serious laxative action, and I am OVERJOYED to report that although it took a few days, Things Are Now Much Better.
So! One blastocyst, hopefully enjoying its new surroundings, and no updates for LIKE EVER, aka the dreaded two week wait.
::drums fingers::
::whistles tunelessly::
::repeats for 13 days::
November 23, 2015
Retrieval update!
So! Saturday was the big day: egg retrieval. So far, it's been by far the most taxing part of this process for me. The procedure itself was as quick and sedated as advertised, but recovery has been surprisingly challenging. I guess I figured since I've been so low on the side effects ladder so far, I'd bounce back from this easily as well (...assuming no OHSS!). And I should clarify, by "challenging" I still don't actually mean "awful" - I'm typing this from work, I'm not on prescription pain meds or anything - just, well... I guess I didn't know what to expect. So I don't want to oversell the awfulness of this, just the surprising nature of it.
As it stands, I'm pretty sure I've avoided any symptoms of moderate or severe OHSS so far, which I am REALLY GRATEFUL for. I have been obsessively weighing myself, and I am pleased/relieved to report that I am NOT gaining weight due to fluid retention, and I am peeing an entirely appropriate amount in relation to my liquid consumption. But man oh man, my abdomen is SORE. I was crazy bloated on both Saturday and Sunday (I mean, I was already super bloated leading up to the retrieval, and additional bloating from having people muck around with your ovaries is to be expected.) At this point, the bloating has gone down somewhat, but my entire abdomen is awfully sore and tender. You know the feeling after having food poisoning, where your guts feel like they've been physically wrung out and it leaves you aching and sore? This feeling is very similar. Except I'm also sore even to the touch - I can't abide having a cat walk across my belly right now, for example. They prescribed me Percocet, but while this is very uncomfortable, it's definitely not in the narcotic pain reliever realm, and I'm fine taking the edge off with regular Tylenol.
I also started estrogen and progesterone supplements yesterday, to get my body all amped up and ready to be pregnant. The estrogen is a wee pill that I pop twice a day, whereas the progesterone is *awesome* to administer... in that I have to jam it up my hooch. Seriously. It's a vaginal suppository. It's very dignified. And I get to do that 3x/day! The other bummer is that I think it's making me pretty nauseated, which is lame. I am allowed to eat and drink whatever I want for the next few days (aka BOOZE) and right now I am hardly interested in even the occasional sip of water. So, hoping that chills out today and I can go full glutton by Thanksgiving.
But, back to the retrieval itself! The process itself is kind of fascinating. This is the only procedure that I was knocked out for, and that's due to the method used to extract the eggs: they get you all set up in the standard ob/gyn chair (aka thighs spread and nether bits waving in the wind) then knock you out... so that they can stick a big ol' needle THROUGH YOUR VAGINAL WALL into the ovary and suck out each egg that way. Then they repeat it on the other side. I am more than pleased to not have been awake for that.
It only takes about 15-30 minutes, depending on how many eggs you have, and then they bring you back out and wake you up, and let you know immediately how many eggs they were able to retrieve. I was surprised to learn they "only" got 9 from me. I put only in quotes, because don't get me wrong, 9 is a GREAT number and I am thrilled to have that many to work with. I was surprised though, because.. uh... what the hell were all those other follicles doing!? Why bother getting all hot & bothered (and swollen!) with all those lame follicles, OVARIES, if you weren't even going to produce eggs!?
But putting that aside, 9 is fantastic. They called yesterday with my first update, which was that of those nine, 8 were fully mature (yay!) and of those eight, 7 successfully fertilized (double yay!). They'll call again today with the Day 2 update, to see how many of the 7 continued dividing away overnight, then they'll let the remaining embryos alone for the following two days to let them grow and divide in peace. I'll find out pre-transfer how many made it to blastocyst stage.
So for now, I just mentally encourage my 7 embryos to keep on keepin' on, encourage my body to remain OHSS-free, hope for a morning appointment for my Thanksgiving Day transfer, and hope that all turkey baster activities go well on Thursday :)
As it stands, I'm pretty sure I've avoided any symptoms of moderate or severe OHSS so far, which I am REALLY GRATEFUL for. I have been obsessively weighing myself, and I am pleased/relieved to report that I am NOT gaining weight due to fluid retention, and I am peeing an entirely appropriate amount in relation to my liquid consumption. But man oh man, my abdomen is SORE. I was crazy bloated on both Saturday and Sunday (I mean, I was already super bloated leading up to the retrieval, and additional bloating from having people muck around with your ovaries is to be expected.) At this point, the bloating has gone down somewhat, but my entire abdomen is awfully sore and tender. You know the feeling after having food poisoning, where your guts feel like they've been physically wrung out and it leaves you aching and sore? This feeling is very similar. Except I'm also sore even to the touch - I can't abide having a cat walk across my belly right now, for example. They prescribed me Percocet, but while this is very uncomfortable, it's definitely not in the narcotic pain reliever realm, and I'm fine taking the edge off with regular Tylenol.
 |
| I spent virtually all day yesterday recuperating on the couch. The cats helped. |
I also started estrogen and progesterone supplements yesterday, to get my body all amped up and ready to be pregnant. The estrogen is a wee pill that I pop twice a day, whereas the progesterone is *awesome* to administer... in that I have to jam it up my hooch. Seriously. It's a vaginal suppository. It's very dignified. And I get to do that 3x/day! The other bummer is that I think it's making me pretty nauseated, which is lame. I am allowed to eat and drink whatever I want for the next few days (aka BOOZE) and right now I am hardly interested in even the occasional sip of water. So, hoping that chills out today and I can go full glutton by Thanksgiving.
But, back to the retrieval itself! The process itself is kind of fascinating. This is the only procedure that I was knocked out for, and that's due to the method used to extract the eggs: they get you all set up in the standard ob/gyn chair (aka thighs spread and nether bits waving in the wind) then knock you out... so that they can stick a big ol' needle THROUGH YOUR VAGINAL WALL into the ovary and suck out each egg that way. Then they repeat it on the other side. I am more than pleased to not have been awake for that.
It only takes about 15-30 minutes, depending on how many eggs you have, and then they bring you back out and wake you up, and let you know immediately how many eggs they were able to retrieve. I was surprised to learn they "only" got 9 from me. I put only in quotes, because don't get me wrong, 9 is a GREAT number and I am thrilled to have that many to work with. I was surprised though, because.. uh... what the hell were all those other follicles doing!? Why bother getting all hot & bothered (and swollen!) with all those lame follicles, OVARIES, if you weren't even going to produce eggs!?
But putting that aside, 9 is fantastic. They called yesterday with my first update, which was that of those nine, 8 were fully mature (yay!) and of those eight, 7 successfully fertilized (double yay!). They'll call again today with the Day 2 update, to see how many of the 7 continued dividing away overnight, then they'll let the remaining embryos alone for the following two days to let them grow and divide in peace. I'll find out pre-transfer how many made it to blastocyst stage.
So for now, I just mentally encourage my 7 embryos to keep on keepin' on, encourage my body to remain OHSS-free, hope for a morning appointment for my Thanksgiving Day transfer, and hope that all turkey baster activities go well on Thursday :)
November 20, 2015
Trigger happy
I've triggered!
...meaning, at 2am last night, I woke up and jabbed myself with yet another medication. This one is to "trigger" the final maturation process of the eggs. Before the eggs are released during natural ovulation, they go through meiosis to halve their chromosomes from 46 to 23, and that's what this trigger shot does for me via SCIENCE! instead.
The tricky thing is, ovulation will naturally occur between ~38-42 hours after this process, so the timing of the trigger shot is VERY SPECIFIC so they can schedule the egg retrieval for exactly 36 hours after you administer the shot, and catch as many perfectly mature eggs as possible right before they would normally be released during ovulation.
And seeing as my retrieval is scheduled for 2pm on Saturday... my trigger shot was at 2am last night.
They are SUPER SERIOUS about the timing of this shot, and were at great pains to impart on me how crucial it is to administer the shot at the EXACT RIGHT TIME, no seriously literally THAT TIME EXACTLY, we cannot stress how important it is (and given the window with which we're working, it's easy to see why). But that means I was in turn SUPER STRESSED about sleeping through my 2am shot time. I set two alarms to try to put my mind at ease. It did not work. I dozed fitfully, waking up in about panic about once an hour, sure I'd missed my trigger time. When I did it again at 1:30, I gave up and just waited in bed until 2 at that point.
...and then got up at 6:30 to have one more blood test done at the office before work this morning. I'm a wee bit groggy.
I also spent all day yesterday frenetically googling signs, symptoms, and prevention tactics for OHSS, because once I started googling, I rapidly terrified the pants off of myself with horror stories, which led to more googling to figure out how I could make this NOT HAPPEN OMFG. And guess what! There is absolutely nothing you can do to prevent it! If it's going to happen, it's going to happen, and you can only try to treat it once you have it! HOW REASSURING!
(Quick recap of OHSS, or ovarian hyper-stimulation syndrome: after egg retrieval, your now-empty follicles often fill with fluid, which causes your already swollen and tender ovaries to swell even more. This kicks off a chain reaction of events that can be "just" painful abdominal bloat and swelling, or can cartwheel into fluid leaking into your abdominal cavity and even start collecting around your lungs because your blood vessels become "leaky", which in turn leads to severe dehydration because any fluids you consume just leak out of your blood vessels into the now-giant collection in your distended abdomen OMFG.)
SO. Having the doctor sort of offhandedly mention that my follicle count + hormone levels might put me at risk for OHSS, but the next move is everyone just sort of shrugs and hopes it doesn't happen? I'm not usually inclined to be a hypochondriac, but this is freaking my shit out. Last night I ate pho for dinner (hydrating but with salt and protein! both of which are supposed to help suck fluids back into the rest of your body should your veins get leaky!) and bought a scale for the first time in my life, so that I can weigh myself daily to ensure I am not rapidly gaining weight due toIMMINENT DEATH fluid accumulation. And I mean, I fully realize it's all just to make myself feel better in the face of something I have no control over, but I'm still going to eat the hell out of some salty food, hydrate with gatorade, and stock up on protein bars.
On the cheerier side of things, because I *am* at risk for OHSS, they had me trigger with Lupron instead of HcG which should absolutely help the situation. And I don't know whether it's the Lupron trigger specifically, or just the fact that I stopped stimming with the other meds, but I feel WAY better today. Yesterday I had gotten to the point where I had to slowly waddle, with my arms clasped around my midsection, because walking was too "bouncy" for my ovaries to take. Today I feel great! Much less pain, and can walk like a normal human again! (I - of course - also had to google whether THIS was okay, or meant that my ovaries had already, like, shut down or ovulated or something, but it seems this sometimes happens and hopefully I should just enjoy the respite while I can.)
So. Assuming I stay OK, and assuming they are able to get some mature eggs at the retrieval, and assuming some of those are able to fertilize, and assuming some of THOSE make it to day 5... I'm looking at a Thanksgiving Day transfer.
We'll be putting both a turkey and a bun in the oven, with any luck ;-)
...meaning, at 2am last night, I woke up and jabbed myself with yet another medication. This one is to "trigger" the final maturation process of the eggs. Before the eggs are released during natural ovulation, they go through meiosis to halve their chromosomes from 46 to 23, and that's what this trigger shot does for me via SCIENCE! instead.
The tricky thing is, ovulation will naturally occur between ~38-42 hours after this process, so the timing of the trigger shot is VERY SPECIFIC so they can schedule the egg retrieval for exactly 36 hours after you administer the shot, and catch as many perfectly mature eggs as possible right before they would normally be released during ovulation.
And seeing as my retrieval is scheduled for 2pm on Saturday... my trigger shot was at 2am last night.
They are SUPER SERIOUS about the timing of this shot, and were at great pains to impart on me how crucial it is to administer the shot at the EXACT RIGHT TIME, no seriously literally THAT TIME EXACTLY, we cannot stress how important it is (and given the window with which we're working, it's easy to see why). But that means I was in turn SUPER STRESSED about sleeping through my 2am shot time. I set two alarms to try to put my mind at ease. It did not work. I dozed fitfully, waking up in about panic about once an hour, sure I'd missed my trigger time. When I did it again at 1:30, I gave up and just waited in bed until 2 at that point.
...and then got up at 6:30 to have one more blood test done at the office before work this morning. I'm a wee bit groggy.
I also spent all day yesterday frenetically googling signs, symptoms, and prevention tactics for OHSS, because once I started googling, I rapidly terrified the pants off of myself with horror stories, which led to more googling to figure out how I could make this NOT HAPPEN OMFG. And guess what! There is absolutely nothing you can do to prevent it! If it's going to happen, it's going to happen, and you can only try to treat it once you have it! HOW REASSURING!
(Quick recap of OHSS, or ovarian hyper-stimulation syndrome: after egg retrieval, your now-empty follicles often fill with fluid, which causes your already swollen and tender ovaries to swell even more. This kicks off a chain reaction of events that can be "just" painful abdominal bloat and swelling, or can cartwheel into fluid leaking into your abdominal cavity and even start collecting around your lungs because your blood vessels become "leaky", which in turn leads to severe dehydration because any fluids you consume just leak out of your blood vessels into the now-giant collection in your distended abdomen OMFG.)
SO. Having the doctor sort of offhandedly mention that my follicle count + hormone levels might put me at risk for OHSS, but the next move is everyone just sort of shrugs and hopes it doesn't happen? I'm not usually inclined to be a hypochondriac, but this is freaking my shit out. Last night I ate pho for dinner (hydrating but with salt and protein! both of which are supposed to help suck fluids back into the rest of your body should your veins get leaky!) and bought a scale for the first time in my life, so that I can weigh myself daily to ensure I am not rapidly gaining weight due to
On the cheerier side of things, because I *am* at risk for OHSS, they had me trigger with Lupron instead of HcG which should absolutely help the situation. And I don't know whether it's the Lupron trigger specifically, or just the fact that I stopped stimming with the other meds, but I feel WAY better today. Yesterday I had gotten to the point where I had to slowly waddle, with my arms clasped around my midsection, because walking was too "bouncy" for my ovaries to take. Today I feel great! Much less pain, and can walk like a normal human again! (I - of course - also had to google whether THIS was okay, or meant that my ovaries had already, like, shut down or ovulated or something, but it seems this sometimes happens and hopefully I should just enjoy the respite while I can.)
So. Assuming I stay OK, and assuming they are able to get some mature eggs at the retrieval, and assuming some of those are able to fertilize, and assuming some of THOSE make it to day 5... I'm looking at a Thanksgiving Day transfer.
We'll be putting both a turkey and a bun in the oven, with any luck ;-)
November 18, 2015
Simmer down
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.
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.
November 16, 2015
Me + prune juice 4EVA
Eight days down! And things are starting to get awfully uncomfortable in the ovary region.
It's weird how this process gives you SO MUCH information, and at the same time still leaves you guessing so much. I'm going in every other day for bloodwork and sonograms at this point, but I still don't *really* know how the cycle is going. They call me after each appointment to check in and give me my dosages for the next few days (they set up a protocol with your meds and dosages up front, but based on these frequent monitoring sessions it's not uncommon for the med dosage to be tweaked mid-stream if things are not progressing at the ideal rate) and so far there has been no change to my prescribed protocol.
One of the few concrete data points I have access to is the number of follicles I'm working with. Except each time I go in, I get a different count. (In general, more follicles = good, because you want to start with as many viable eggs as possible. However, TOO many follicles = bad, apparently; you can end up with lower quality eggs if you have too many, and/or you're at higher risk for a fairly alarming condition called ovarian hyperstimulation syndrome, which can at the very least cause you some intense discomfort, but can also force a delay in the process where they need your body to calm the hell down before they'll put an embryo in, or worst case can even lead to hospitalization.)
ANYWAY. At my very first appointment to start this cycle, they counted 9 follicles in each ovary. Which is good! 18 is a decent showing. But at my Friday appointment, the nurse only counted 6 on each side, which seemed to me like an alarming drop, but the nurse didn't seem troubled by it. Then yesterday, they counted 10 on one side and 12 on the other. Follicles, u cray.
Meanwhile, whether it's 22 or 12 or 18, that is a hell of a lot more bulked up follicles than I usually carry around in my ovaries, and their presence is starting to make itself known. My abdomen feels... full. Uncomfortably full. It's almost like the feeling when you eat too much, except... below my stomach. Basically my ovaries have overeaten.
I've been lucky with the symptoms so far, probably because I'm on really low doses of the hormones. But I can now authoritatively say that The Bloat Has Arrived, and it is no joke. (Although after 4 straight days of a close personal relationship with prune juice, at least SOME of the bloat and general.. uh.. "fullness" in the region has been alleviated today. I have never gone more than like 2 days without pooping before. This was a full week. A WEEK. Praise Jeebus for prunes, is what I'm saying.) But man, even with The Bloat in full force, there is still not enough room for all of my plump new follicle friends.... and I still have several days left before they go in and relieve me of my clutch of eggs.
And all of this is BEFORE the myriad discomforts of pregnancy! #blessed
It's weird how this process gives you SO MUCH information, and at the same time still leaves you guessing so much. I'm going in every other day for bloodwork and sonograms at this point, but I still don't *really* know how the cycle is going. They call me after each appointment to check in and give me my dosages for the next few days (they set up a protocol with your meds and dosages up front, but based on these frequent monitoring sessions it's not uncommon for the med dosage to be tweaked mid-stream if things are not progressing at the ideal rate) and so far there has been no change to my prescribed protocol.
One of the few concrete data points I have access to is the number of follicles I'm working with. Except each time I go in, I get a different count. (In general, more follicles = good, because you want to start with as many viable eggs as possible. However, TOO many follicles = bad, apparently; you can end up with lower quality eggs if you have too many, and/or you're at higher risk for a fairly alarming condition called ovarian hyperstimulation syndrome, which can at the very least cause you some intense discomfort, but can also force a delay in the process where they need your body to calm the hell down before they'll put an embryo in, or worst case can even lead to hospitalization.)
ANYWAY. At my very first appointment to start this cycle, they counted 9 follicles in each ovary. Which is good! 18 is a decent showing. But at my Friday appointment, the nurse only counted 6 on each side, which seemed to me like an alarming drop, but the nurse didn't seem troubled by it. Then yesterday, they counted 10 on one side and 12 on the other. Follicles, u cray.
Meanwhile, whether it's 22 or 12 or 18, that is a hell of a lot more bulked up follicles than I usually carry around in my ovaries, and their presence is starting to make itself known. My abdomen feels... full. Uncomfortably full. It's almost like the feeling when you eat too much, except... below my stomach. Basically my ovaries have overeaten.
I've been lucky with the symptoms so far, probably because I'm on really low doses of the hormones. But I can now authoritatively say that The Bloat Has Arrived, and it is no joke. (Although after 4 straight days of a close personal relationship with prune juice, at least SOME of the bloat and general.. uh.. "fullness" in the region has been alleviated today. I have never gone more than like 2 days without pooping before. This was a full week. A WEEK. Praise Jeebus for prunes, is what I'm saying.) But man, even with The Bloat in full force, there is still not enough room for all of my plump new follicle friends.... and I still have several days left before they go in and relieve me of my clutch of eggs.
And all of this is BEFORE the myriad discomforts of pregnancy! #blessed
November 11, 2015
Shots! Shots! Shots-shots-shots-SHOTS! (Errrr'body!)
And not the fun kind! The kind you jab into your belly fat!
First, a quick overview of how IVF works, which I may or may not get right:
We ladies all have a bunch of follicles hanging out in our ovaries at any given time. Each month, a hormone called FSH (follicle-stimulating hormone) is sent down from the pituitary gland to stimulate [snort] a follicle and cause it to produce an egg. As the follicle grows, the FSH also encourages estrogen production in the follicle. Then once the estrogen level reaches a certain point, that signals to your pituitary gland to knock it off with the FSH and start producing LH (luteinizing hormone), which in turn causes ovulation. (That peak in LH is what you're testing for when you pee on ovulation sticks. If you happen to be someone who pees on ovulation sticks, I mean.) Once the egg is released, the empty follicle starts producing progesterone, which you need in order to maintain a pregnancy; if the egg doesn't fertilize, progesterone production calls it quits and everyone shuffles back to their places to start the process over again the next month.
With IVF, they use the same FSH and LH hormones, but control when & how much you're getting. Instead of your pituitary gland focusing on just one follicle, ALL follicles get a participation trophy and get stimulated equally with the FSH. The hope is to make every single follicle you've got hanging out in there produce an egg at the same time, then once you have two ovaries crammed full of ripe follicles, they trigger final egg maturation and ovulation (with an appropriately named "trigger shot") but swoop in and harvest the eggs from the follicles before they release into the wild (or, uh, I guess your fallopian tubes) on their own.
Then the mad scientist piece happens: in the lab, they individually fertilize each viable egg that they retrieved, then pop them in an oven to bake for a few days. (They do not actually bake them in ovens.) This is the danger zone for the newly fertilized little eggs though: there tends to be a lot of attrition over the next few days as nature takes its course. So it's not uncommon to have, say, 18 follicles, but only 16 eggs, and only 12 of those might be high quality. Then they can fertilize all 12, but maybe only 10 "take." Then of those 10, only 5 make it to the blastocyst stage, which is like a pre-embryo, and what gets put back in your cozy uterus (in my head, they're on a piece of parchment paper, and someone sort of rolls up the paper and tips it into my waiting uterus. I am told this is also not how it happens.) Then you pump yourself full of progesterone to convince your body to hold onfor one more day to the wee blastocyst(s) and hatch 'em into babies.
SO! I'm still in that first stage, where I'm coercing all available follicles to get off their lazy asses and grow into nice, big, egg-harboring follicles. And to do that, I need to inject Gonal-F and Menopur into myself.
These are two of the EASIEST injections one can have: the Gonal-F is in that pen up at the top, and I just have to put a fresh needle on it each night and dial up the correct dosage by twisting the cap.
I mean, and then there is the part where I have to jam a needle into my own stomach, but the process leading up to it is simple, at least.
The Menopur is a little more complicated. I start with the big syringe, remove the needle it comes with, and put that plastic cap thingy in the center of the picture on it. The cap has a needle in it too, which I use to jam into one of the wee vials which contains sterile saline and draw the saline up into the needle. Then I jam the needle through the top of the other wee vial, which has the Menopur (which comes in the form of white powder). I shoot the saline into the Menopur vial, let the powder dissolve, then draw the mixture back up into the syringe, pop off the mixing cap, replace it with a (thankfully) thin small needle, make sure there are no large air bubbles, THEN jam the needle into my stomach. This is still on the easy side of the spectrum when it comes to mixing and preparing injections.
They have you go to an injection class before doing this because it's kind of overwhelming. And the injection class was great! I felt very informed and competent afterwards.
(I was also the only woman at the class who came sans husband. Apparently most people prefer to have their menfolk do this for them. One woman brought her husband AND her sister with her. I was all, psh! Whatever! I am totally fine with needles and giving blood and getting shots; I can do this! Plus I didn't want to make it Chris's responsibility, especially since he sometimes has to work late and there will be plenty of opportunities for him to have to miss work during this process; giving me daily meds didn't seem like a good enough reason yet.)
But man. Feeling competent, and physically jamming a needle into the tender flesh of your stomach? They are not the same. After learning what to do and how to do it, I was all, I'm cool! This is no big. I don't see what the hullabaloo is.
Fast forward to me standing in my bathroom, after having successfully mixed my first injection, with the primed needle ready and pointed at my stomach for like 45 straight seconds: ....ah. OK. I now see what the hullabaloo is.
I mentally shook myself, told myself to stop being a baby, and counted backwards in my head helpfully for myself. OK self, just stick it in on 1. Ready? 3.... 2.... 1!
[Self remains standing there, doggedly not stabbing self with needle]
Getting over the mental hurdle really is the worst part, though. The needles are wee. I can barely feel them going in. And fortuitously, I had been saving up a niiiice layer of fat around my abdomen for just such an occasion. Non Sequitor Chica warned me that the Menopur burns a little, which is true, but it really is just a little, and it goes away almost immediately. I'm now a 3-day veteran of the process, and even with all of the hand-washing, alcohol-swabbing, mixing, and stabbing involved, I'm down to about 3 minutes soup to nuts.
I'm also lucky in that so far I'm very low on the side effects meter. A lot of women are VERY uncomfortable during this process. My main complaint so far is a low grade but persistent headache, plus a dramatic, newly-developed flatulence prowess. I hear that I will soon be able to feel my ovaries, once they get jammed full of big-ass follicles, which I find equal parts intriguing and alarming. My sister - who was blessed with not only a robust set of her own extremely volatile emotions, but apparently also inherited all the ones I am lacking - is eagerly hoping that I become an emotional wreck as a result of the hormones.
Me: Wait, what?!
Her, literally cackling with glee: It will be HILARIOUS!!!
At least one of us is looking forward to that stage.
 |
| My new vanity set up: a pretty Kate Spade box filled with syringes, needles, and alcohol wipes; hormones ready to be mixed and injected; and a sharps container for allllll the needles. |
First, a quick overview of how IVF works, which I may or may not get right:
We ladies all have a bunch of follicles hanging out in our ovaries at any given time. Each month, a hormone called FSH (follicle-stimulating hormone) is sent down from the pituitary gland to stimulate [snort] a follicle and cause it to produce an egg. As the follicle grows, the FSH also encourages estrogen production in the follicle. Then once the estrogen level reaches a certain point, that signals to your pituitary gland to knock it off with the FSH and start producing LH (luteinizing hormone), which in turn causes ovulation. (That peak in LH is what you're testing for when you pee on ovulation sticks. If you happen to be someone who pees on ovulation sticks, I mean.) Once the egg is released, the empty follicle starts producing progesterone, which you need in order to maintain a pregnancy; if the egg doesn't fertilize, progesterone production calls it quits and everyone shuffles back to their places to start the process over again the next month.
With IVF, they use the same FSH and LH hormones, but control when & how much you're getting. Instead of your pituitary gland focusing on just one follicle, ALL follicles get a participation trophy and get stimulated equally with the FSH. The hope is to make every single follicle you've got hanging out in there produce an egg at the same time, then once you have two ovaries crammed full of ripe follicles, they trigger final egg maturation and ovulation (with an appropriately named "trigger shot") but swoop in and harvest the eggs from the follicles before they release into the wild (or, uh, I guess your fallopian tubes) on their own.
Then the mad scientist piece happens: in the lab, they individually fertilize each viable egg that they retrieved, then pop them in an oven to bake for a few days. (They do not actually bake them in ovens.) This is the danger zone for the newly fertilized little eggs though: there tends to be a lot of attrition over the next few days as nature takes its course. So it's not uncommon to have, say, 18 follicles, but only 16 eggs, and only 12 of those might be high quality. Then they can fertilize all 12, but maybe only 10 "take." Then of those 10, only 5 make it to the blastocyst stage, which is like a pre-embryo, and what gets put back in your cozy uterus (in my head, they're on a piece of parchment paper, and someone sort of rolls up the paper and tips it into my waiting uterus. I am told this is also not how it happens.) Then you pump yourself full of progesterone to convince your body to hold on
SO! I'm still in that first stage, where I'm coercing all available follicles to get off their lazy asses and grow into nice, big, egg-harboring follicles. And to do that, I need to inject Gonal-F and Menopur into myself.
These are two of the EASIEST injections one can have: the Gonal-F is in that pen up at the top, and I just have to put a fresh needle on it each night and dial up the correct dosage by twisting the cap.
I mean, and then there is the part where I have to jam a needle into my own stomach, but the process leading up to it is simple, at least.
The Menopur is a little more complicated. I start with the big syringe, remove the needle it comes with, and put that plastic cap thingy in the center of the picture on it. The cap has a needle in it too, which I use to jam into one of the wee vials which contains sterile saline and draw the saline up into the needle. Then I jam the needle through the top of the other wee vial, which has the Menopur (which comes in the form of white powder). I shoot the saline into the Menopur vial, let the powder dissolve, then draw the mixture back up into the syringe, pop off the mixing cap, replace it with a (thankfully) thin small needle, make sure there are no large air bubbles, THEN jam the needle into my stomach. This is still on the easy side of the spectrum when it comes to mixing and preparing injections.
They have you go to an injection class before doing this because it's kind of overwhelming. And the injection class was great! I felt very informed and competent afterwards.
(I was also the only woman at the class who came sans husband. Apparently most people prefer to have their menfolk do this for them. One woman brought her husband AND her sister with her. I was all, psh! Whatever! I am totally fine with needles and giving blood and getting shots; I can do this! Plus I didn't want to make it Chris's responsibility, especially since he sometimes has to work late and there will be plenty of opportunities for him to have to miss work during this process; giving me daily meds didn't seem like a good enough reason yet.)
But man. Feeling competent, and physically jamming a needle into the tender flesh of your stomach? They are not the same. After learning what to do and how to do it, I was all, I'm cool! This is no big. I don't see what the hullabaloo is.
Fast forward to me standing in my bathroom, after having successfully mixed my first injection, with the primed needle ready and pointed at my stomach for like 45 straight seconds: ....ah. OK. I now see what the hullabaloo is.
I mentally shook myself, told myself to stop being a baby, and counted backwards in my head helpfully for myself. OK self, just stick it in on 1. Ready? 3.... 2.... 1!
[Self remains standing there, doggedly not stabbing self with needle]
Getting over the mental hurdle really is the worst part, though. The needles are wee. I can barely feel them going in. And fortuitously, I had been saving up a niiiice layer of fat around my abdomen for just such an occasion. Non Sequitor Chica warned me that the Menopur burns a little, which is true, but it really is just a little, and it goes away almost immediately. I'm now a 3-day veteran of the process, and even with all of the hand-washing, alcohol-swabbing, mixing, and stabbing involved, I'm down to about 3 minutes soup to nuts.
I'm also lucky in that so far I'm very low on the side effects meter. A lot of women are VERY uncomfortable during this process. My main complaint so far is a low grade but persistent headache, plus a dramatic, newly-developed flatulence prowess. I hear that I will soon be able to feel my ovaries, once they get jammed full of big-ass follicles, which I find equal parts intriguing and alarming. My sister - who was blessed with not only a robust set of her own extremely volatile emotions, but apparently also inherited all the ones I am lacking - is eagerly hoping that I become an emotional wreck as a result of the hormones.
Me: Wait, what?!
Her, literally cackling with glee: It will be HILARIOUS!!!
At least one of us is looking forward to that stage.
November 09, 2015
...and away we go
So this is happening:
That is the delivery of meds for one (1) round of IVF. Tomatoes and garlic optional, for seasoning.
I had a hard time deciding whether or not I was going to post about this, despite assuming for weeks that if we went for it, I absolutely would. On the one hand, I am resolutely refusing to feel any sort of shame around opting for IVF, despite my brain occasionally trying to persuade me differently. But feeling unashamed about the choice and publicly announcing it are two pretty different things.
For one thing, going public adds a(nother) layer of expectation to the process. Publicly sharing a goal - whether it be a weight loss target, or one's intent to join NaBloPoMo - adds a level of accountability that is usually intentional, to help spur you and guilt you into completion of that goal. Let me be the first to assure you, I require no additional guilt around this process. But publicly announcing that I'm starting IVF puts an awful lot of expectation on my future pregnant state, and IVF is far from a sure thing. There are a LOT of places to fail along the IVF route, between the stims not producing enough eggs or eggs of high enough quality, to fertilized eggs not maturing enough to be transferred, to me plain old not being able to keep the pregnancy even if the best possible embryos are put back in - but I think to some degree, there is the expectation that IVF is such a highly controlled, highly scientific process, that it's practically a done deal. So there are some obvious potential pitfalls to having an ever-increasing circle of people who I will possibly need to announce a failure to.
Plus there's the fact that this blog is neither private nor anonymous. I was going to post that picture of the meds on Instagram, but realized that there's a guy I know in a professional capacity who follows me there. While I don't have any inherent problem with him knowing, can you imagine the awkwardness if he casually brought it up with my coworkers present, making the (not altogether unreasonable) assumption that if I were posting about this online, I was being up front about it globally? It's not fair, but the fact of the matter is that letting people at my place of business know I'm trying to get pregnant or early along in a pregnancy can materially impact my career. (I am quite certain that is not the case for my male coworkers, but life is what it is.)
Ultimately, though, I decided a few things:
So! About that guilt. Each time I tell someone we're going forward with IVF, I feel the need to justify the decision, even though so far not a single person has had the reaction I keep anticipating, which is confusion / skepticism. Each time, I'm expecting to hear "...but you haven't been trying that long / long enough!" or "...but you've already been pregnant once, so you know it's possible!" But the overwhelming reaction so far (uh... from a sample size of like 4) has been delight and excitement. However! If you are feeling skeptical or surprised or like I'm jumping the gun, rest assured that I have a long explanation and justification allllll ready for you!
There is also a hefty level of guilt around the cost. This shit is NOT CHEAP, and 0% covered by our insurance. The two might be tied, come to think of it - if this were seen more as a covered medical procedure, as opposed to a pricey elective choice, I probably wouldn't feel the need to explain why we made that pricey choice. But it's not, and knowing that we are waaaaaay on the privileged side of life to have the ability to make this pricey elective choice carries its own set of guilt. On the upside, I'm getting in a lot of good practice for the ongoing guilt of motherhood, eh?
Anyway. Here we are, complicated feelings notwithstanding, starting Cycle 1. And man oh MAN have I learned a lot about this process, both through my own new & limited experience, and that of a close friend who went through this all a few months ago herself. And dudes, this stuff is FASCINATING. So I'm going to put it all out there: for posterity, for other women who might search for it, and because it's actually kind of super-neat. Worst case, if this cycle fails, I'll have a few more shoulders to cry on when I need the support.
In the meantime though, if you have any questions, ask away! Now that it's out there, I'm happy to talk about nearly any aspect of the process, from our specific protocol to general what/why/how questions that I incessantly asked my friend when she was going through it. Stay tuned for IVF lesson 1:training to become a junkie learning how to give myself injections!
That is the delivery of meds for one (1) round of IVF. Tomatoes and garlic optional, for seasoning.
I had a hard time deciding whether or not I was going to post about this, despite assuming for weeks that if we went for it, I absolutely would. On the one hand, I am resolutely refusing to feel any sort of shame around opting for IVF, despite my brain occasionally trying to persuade me differently. But feeling unashamed about the choice and publicly announcing it are two pretty different things.
For one thing, going public adds a(nother) layer of expectation to the process. Publicly sharing a goal - whether it be a weight loss target, or one's intent to join NaBloPoMo - adds a level of accountability that is usually intentional, to help spur you and guilt you into completion of that goal. Let me be the first to assure you, I require no additional guilt around this process. But publicly announcing that I'm starting IVF puts an awful lot of expectation on my future pregnant state, and IVF is far from a sure thing. There are a LOT of places to fail along the IVF route, between the stims not producing enough eggs or eggs of high enough quality, to fertilized eggs not maturing enough to be transferred, to me plain old not being able to keep the pregnancy even if the best possible embryos are put back in - but I think to some degree, there is the expectation that IVF is such a highly controlled, highly scientific process, that it's practically a done deal. So there are some obvious potential pitfalls to having an ever-increasing circle of people who I will possibly need to announce a failure to.
Plus there's the fact that this blog is neither private nor anonymous. I was going to post that picture of the meds on Instagram, but realized that there's a guy I know in a professional capacity who follows me there. While I don't have any inherent problem with him knowing, can you imagine the awkwardness if he casually brought it up with my coworkers present, making the (not altogether unreasonable) assumption that if I were posting about this online, I was being up front about it globally? It's not fair, but the fact of the matter is that letting people at my place of business know I'm trying to get pregnant or early along in a pregnancy can materially impact my career. (I am quite certain that is not the case for my male coworkers, but life is what it is.)
Ultimately, though, I decided a few things:
- I've been googling like a madwoman throughout this process, and reading blogs by other women going through it has been a hugely helpful and calming resource. If I can ever serve that purpose for someone else, I want to.
- My default state is one of oversharing. Plus, I'm not a highly emotional person, so I apparently never really learned how process complicated emotions. But I *have* figured out that talking about emotional stuff, in person or online, helps me a ton.
- Ironically, posting about it publicly is a way to force myself NOT to feel guilty about it, even though posting publicly also fell into the "this might make me feel guilty" bucket. But as much as putting a goal out there makes me feel somehow accountable, publicly stating "I am putting this out here because I refuse to feel guilty about going this route" works (hopefully) the same way.
So! About that guilt. Each time I tell someone we're going forward with IVF, I feel the need to justify the decision, even though so far not a single person has had the reaction I keep anticipating, which is confusion / skepticism. Each time, I'm expecting to hear "...but you haven't been trying that long / long enough!" or "...but you've already been pregnant once, so you know it's possible!" But the overwhelming reaction so far (uh... from a sample size of like 4) has been delight and excitement. However! If you are feeling skeptical or surprised or like I'm jumping the gun, rest assured that I have a long explanation and justification allllll ready for you!
There is also a hefty level of guilt around the cost. This shit is NOT CHEAP, and 0% covered by our insurance. The two might be tied, come to think of it - if this were seen more as a covered medical procedure, as opposed to a pricey elective choice, I probably wouldn't feel the need to explain why we made that pricey choice. But it's not, and knowing that we are waaaaaay on the privileged side of life to have the ability to make this pricey elective choice carries its own set of guilt. On the upside, I'm getting in a lot of good practice for the ongoing guilt of motherhood, eh?
Anyway. Here we are, complicated feelings notwithstanding, starting Cycle 1. And man oh MAN have I learned a lot about this process, both through my own new & limited experience, and that of a close friend who went through this all a few months ago herself. And dudes, this stuff is FASCINATING. So I'm going to put it all out there: for posterity, for other women who might search for it, and because it's actually kind of super-neat. Worst case, if this cycle fails, I'll have a few more shoulders to cry on when I need the support.
In the meantime though, if you have any questions, ask away! Now that it's out there, I'm happy to talk about nearly any aspect of the process, from our specific protocol to general what/why/how questions that I incessantly asked my friend when she was going through it. Stay tuned for IVF lesson 1:
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