Trigger tonight...

Today’s u/s went well. I had 16 follicles w/ the following measurements.

Right Ovary: 19, 18, 18, 17.5, 17, 17, 16.5, 16, 16, 15
Left Ovary: 18, 18, 17.5, 17, 16.5, 16

Lining was 13.5

E2 was 2500


Trigger shot (HCG) is tonight at 8:30 and ER will be on Friday morning at 8:30. I have to be there at 7:30 so J and I will drive up the night before and stay in the city. We don't know yet if we'll have a 3 day or 5 day transfer. Dr. Z tends to do more 3 days transfers so we'll see what he says. Right now we're debating on how many nights we should stay up there. The driving back and forth has gotten really old! We've now driven almost 60 hours for appts at Dr. Z's office and we haven't even gone to retrieval yet. I figure that is about $500+ dollars in gas alone. We're still planning on minimizing our overnight stays. Questions for all of you...do you think it's okay for J to drive me home (4 hour drive) after the egg transfer. I figure I can put the seat back and hopefully sleep the whole way...DR. Z wants two days of full bed rest so I don't know if I should avoid such a long drive. What do you think? I prefer my own bed and being home w/ my dogs...etc...plus saving the very high cost of hotels in the city. I laugh as I write that b/c in the scheme of things a hotel stay or two doesn't make a dent in what we're coughing up money wise for this cycle. But...hey that is still a new outfit or two.... or maybe...just maybe it could go towards stuff for the nursery (hoping, pleading, praying, begging) ....

Interesting side note- HCG 10,000 units shot is to be given in the stomach subcutaneous w/ a 27 gauge needle. Interesting b/c I didn’t know the HCG could be subcutaneous. In the past I’ve always had to give it to myself deep in the hip muscle (intermuscular).

Also...just want to mention how much I'm thinking about my cyclesistas right now. I'm pulling for each and every one of you.

One step farther

...u/s on Sunday went well. I still managed to produce 15+ follies after 3 full weeks on Lupron. I had 10 on the right ovary (where the huge cyst was) and 5 that could be seen on the left ovary. The left ovary was playing hide and seek behind my large intestine so he didn't hunt too long for it and figured we'll get a better count next time. He was able to see at least 5. The largest 6 were all measuring at 12. My lining was at 10.2 and my E2 was 895. Prolactin was 17. I go back on Weds for another u/s. At they time they'll also do another Natural Killer Assay and see if I need IVIg again before transfer. Dr. Z predicts that I will have my ER on Friday or Saturday. (Can I just point out that my old RE Dr. A-hole Hands Off was completely off base when he said my ovaries were crap b/c of high FSH.) I guess I still don't know if my eggs are any good but I take it as a decent sign that I stim better than average.

I started the Lovenox injections last night. Lovenox is another name for Heparin. I was told I'll do these shots every night all the way through pregnancy and for 2 weeks after delivery. The shots have to be given in the abdomen so that will be fun at 8-9 months pregnant. I'm on this b/c of my two MTHFR mutations. Lovenox is a blood thinner and prevents the formation of blood clots. For anyone that is on this or will be, here is some assvice I've learned. This shot can cause a lot of bruising and will be made worse with pressure or heat. So avoid putting any pressure on the injection site after the shot. You want to b/c it feels like a lump under your skin. Also no heat of any type for a few hours before and after the shot. This includes, heating pads, showers, baths, etc.

Right now I'm trying to picture this working... (mind/body connection). I'm trying to stay positive and upbeat (now that the migraine is gone) since either way this isn't the end of the road. It'll work and all of my prayers will have been answered and if not I'll hopefully have some frozen embryos to use w/ a FET or we'll move forward and do another fresh cycle. I will not think about the worst case scenario. Will not. Will not.

Infusion Therapy

I'm going to back up to Monday. On Monday I worked for a few hours before coming down with a horrible migraine. I believe it was Lupron induced. My Estodial was down to 14 on Sunday so it was most likely down to zero on Monday since I didn't start my stims until Monday night. I made it home and holed up in bed dreaming about the Imitrix in my medicine cabinet that my RE said I cannot take. I am only allowed Tylenol which might as well be powered water. I had to basically crawl to a dermatologist appt in the afternoon b/c I'd had the appt for 3 months. My primary doctor wanted me to have some suspicious looking moles looked at. The nurse at the Dermatologist was the high pitched talkative type. She asked me questions and found out I'm on fertility drugs for my IVF cycle. She proceeded to tell me that she didn't get pregnant for 2 years b/c she was too obsessed with baby making and finally did when she relaxed. By now I had mentioned to her that I had a headache at least 3 times and really wanted to push her out the window.

Interestingly enough- the Dermatologist later disclosed to me that it took her 4 IVF's to have her first child. She did a bunch of IUI's with the same RE that I used before I found Dr. Z. She validated the fact that he was an A-hole and she also went running as fast as she could to someone else. Her biggest regret was that she wasted time w/ too many cycles on Clomid and IUI's. She wished she had gone straight to IVF and not wasted any time. She had a "oops-natural" baby a year after her 4th IVF finally worked so she has two children now. It paid off to share b/c originally she wasn't going to have time this week to remove a "funny looking" mole and when we shared IVF info she squeezed me in today (Thus). Dr. Z said I could have it removed this week but not one we got close to ER. So I'm glad I can get it taken care of.

I managed to crawl back home after the appt and go to back to bed until Tues morning when I had to travel 3 hours up north for my IVIg. It's amazing what you do when you have too. I took some books on tape (Thanks Yellowgirl) for the ride, food/Gatorade, Ipod and magazines for the actual infusion. I ended up being the only patient there for my entire infusion. This disappointed me at first b/c I thought it would be nice to chat with someone..but later was grateful as my head got worse and worse and I just wanted to die. At one point I had to ask for a break. My blood pressure was down to 71/53, (is that even alive?) I felt like I was going to vomit and my head had 6 hammers banging away at once. They kept telling me to drink more fluids and eat. I shoved food in my mouth while pushing down the urge to vomit hoping it would help. It didn't. They ended up giving me a half hour break from the IVIg and just put an entire bag of fluids into my IV... that helped a little and then they started up again until I was done. I had to use every ounce of strength I had to get home. I though briefly of staying over for the night but I had nothing with me and I really just wanted to get home. Once home I just cried from the pain in my head. J felt bad and tried to help but there was little he could do, except give me my shots of Lupron/Repronex and Gonal-f...

I think the Migraine I had going into this was the problem. I don't think the IVIg would be bad at all if I was feeling fine going in to it. The side effects can be nausea, headaches and aches and pain. I also noticed that the substance stings as it goes in at the IV site. They give you a heated pillow for your arm and that helps. There is a good chance I'll need another one next week so hopefully that experience will be much better.

Finally- today I feel better. Not 100% but great compared to before. You'd think I should be dancing around and running a marathon. Shouldn't I feel wonderful after having a $2500 IVIg. This stuff must be liquid gold.

It'll all be worth it when I'm holding our child in my arms.

Finally!

Yesterday was another long drive up to see Dr Z. The minute we started the u/s I knew the cyst was still there and as large as ever. It filled the entire screen. I was hugely disappointed and frustrated. I didn't want to be sent home once again and told to remain on Lupron until it finally decided to go away. I've already been on Lupron for 3 weeks and the headaches are getting much worse. After some discussion with Dr Z his recommendation was for us to aspirate the cyst and move forward immediately with the cycle.

I've now had cysts go away on their own, I've had them rupture, I've had one removed during a laparoscopy and now I've had one aspirated. The only thing I don't know about cysts is how to prevent them.

The aspiration was actually pretty interesting. I was pretty nervous b/c I expected it to hurt. Really wasn't bad at all. They give you local anesthesia and then guide this long needle with the u/s probe to the cyst. Once they puncture the cyst they drain out all of the fluid through a syringe. They removed two and a half large syringes full of fluid. I guess it was a lot...Nurse were talking about it around the office.

Basically the cyst was just a shell that wasn't going anywhere... or doing anything. Dr. Z said the cyst may fill up a little bit again but that it won't cause a problem b/c it's no longer secreting hormones and it wouldn't get very big. My estradiol is now 14 so obviously everything is very quiet... hopefully not too quiet! 14 is pretty damn low.

I start my Medrol, Doxycycline, and Gonal-f/Repronex today and will decrease my Lupron to 5 units. I'll be having my first IVIg tomorrow so I'll make sure I post again to tell you what that is like. Dr. Z won't bring me back for another u/s and blood work until next Sunday after 6 days of stims. My Natural Killer cells will be tested again at that time to see if I need another IVIg after the retrieval. J will do his part by providing a back up sample in what they call the jungle room.

Call out to Watson at My Dear Watson. I enjoyed our chat very much and hope we can meet up together soon.

Twiddling my thumbs...

as I wait for my cyst to go down...When will that be since it has now grown from 40mm to 57mm in just 5 days. The even stranger part is that my estradiol (E2) is down to 50 from the original 255 so the Lupron is finally working. Dr Z feels that the cyst is at its limit in terms of growing and should burst anytime now since the estrogen supply has been cut off. So my E2 is where is should be but I have this huge mass hanging out and it sure doesn't feel like it's going anywhere. During the u/s Dr. Z did his best to try and rupture the damn thing. It seemed like he was putting all of his weight on that probe... forcing it to push on the cyst. I could see it moving and bouncing back on the screen. Dr. Z kept asking if I was in much pain and I wasn't which amazed him. I was just thankful for having an empty bladder b/c he would have had a face full of urine from the pressure that was also being applied to my bladder.

I go back once again on Sunday to see if it's gone as Dr. Z predicts. He basically feels that it should go away quickly now that my E2 is low. My lining was thin and my other ovary was quiet so I'm in the exact place I should be to start my cycle except for this damn cyst. Dr. Z plans to keep me on the Lupron until the cows come home (cyst is gone) and doesn't seem worried at all that I'll be too suppressed. Trust me when I say I'll do the worrying for him. We talked about him aspirating the cyst and he said he'd rather wait it out b/c the cyst can just fill right back up with fluid if it's not ready and he said the procedure is somewhat unpleasant. I guess only a tropical or local anesthesia is used and it will help but not completely take away the pain. I'd tell him to go for it if we didn't have to worry about it filling right back up and he seems so damn confident that my cyst will be gone soon.

I didn't have any side effects the first two weeks on the Lupron but now I'm feeling a little under the weather. Just in time to replace the chest cold that is finally starting to disappear. I'm on my 3rd week of Lupron (10units) and I have a headache and feel tired and somewhat like I'm in a tunnel. I figure the side effects are now starting up since the E2 is finally down. The Lupron probably wasn't having much of an effect when the cyst was producing all of those hormones.

Gross side note: I can feel the cyst easily as I press on my lower abdomen. I can even hear the fluid moving around in it. I now play with my cyst throughout the day hoping I'll either pop the thing myself or notice that it is no longer there.

Flunked Suppression

On Monday I went for a baseline E2 blood test and it came back at 255. Way over the 70 limit that my clinic wants to see. They told me to come in yesterday for another E2 and u/s so they could find out what is going on. I cancelled my IVIg appt and headed up for the long drive wondering what the hell was wrong.

I ended up having a 40mm cyst on my right ovary. Dr Z was pretty amazed. I didn't have any cysts at my last u/s on Dec 10th and that was the day I started my bcp's. So I grew this cyst while on bcp's and Lupron. Not exactly normal. Dr. Z actually called me special. I didn't take that as a good special. The E2 from yesterday came back at 198 so at least that's better than the 255. It's headed the right direction. My menstrual bleeding picked up yesterday so maybe that's helping.

The plan. I am to remain on Lupron until Sunday and will go back for another u/s and E2. Dr. Z thinks the cyst will go away on its own with the help of Lupron. It's pretty hard for me to believe that a 40cm cyst will disappear in 5 days. He mentioned that if it's still there and smaller than we'll just do an additional week of Lupron. Overall he said I should just plan on my cycle being pushed off by one or two weeks.

I feel pretty bummed and wonder why my body can never do what it's supposed to.

Colds and Needy Pets

My sore throat has now turned into a nasty cold. I sound like a croaky frog and I have lots of lovely phlegm pouring down the back of my throat and settling into my chest. It's just gross. I'm not happy that this is happening at the beginning of my IVF cycle. I asked Dr. Z if I should be concerned and he said no. So I guess I'll take the "approved" Tylenol Cold and hope I recover soon. I can't remember the last time I had a cold or the flu. It's been forever so it figures that my turn would occur at the worst possible time.

Today will be my fourth day on Lupron. I will take my last bcp tomorrow. I'm a little concerned b/c I started bleeding lightly on Weds night and it hasn't stopped since. This has never happened to me in the many years I've taken bcp's. I didn't forget a pill and I'm taking an active pill at the same time each day so I don't know why this would happen. Something interesting to note is that Weds would have been 28 days since my last cycle and I always have a 28 day (like clock work) cycle. So is my body trying to resist these artificial changes? Or could the Lupron which I've never taken before induce some bleeding? Has this happened to any of you? Dr. Z wasn't concerned about this either and said to continue as planned.

I know many of you are animal/pet lovers and I am right there with you. In fact sometimes I think I'm a little too concerned w/ and attached to my pets. I have one dog Molly (a Cavalier King Charles Spaniel) that is very delicate...she is pretty much intimidated of anything but me. This includes being left in the backyard for more than a few hours. I have to make sure the yard is very secure if I leave her out there all day b/c she'll do everything she can to escape. She shakes when she's scared and looks just terrified. She's very meek and lays flat when a stranger approaches her. We are pretty positive her previous owner abused/kicked her. The hard part is that I've really bonded with her. She adores me and follows me everywhere. She's always right at my feet or on my lap. This makes me really protective of her and I try not to leave her outside unless I have to. I'll now let both dogs stay inside if I can be away from the house for less than 6 hours. Pretty pathetic. I also refuse to leave Molly outside over night. My other dog Harley is fine outside. So I really worried about what I'll do with Molly when I'm away for ET and ER... I might be away for up to a week or even more. I can't leave her at a kennel b/c she'll become even more traumatized. This worried me so much that I made my parents agree to take her. They don't live anywhere near me but agreed to meet us and pick her up and drop her off so that I can worry a little less while we're away. This is so ironic b/c originally I wanted two large dogs (hardy and protective) to hike and run with. Instead I ended up with two smaller dogs that demand a lot of care. Harley was adopted from the shelter and we were told she was a Shepard mix and expected to be 50+ pounds. It's more likely she's a Chihuahua/Shepard mix b/c she tops the scale at 12 pounds. Molly is a long story but basically she followed me home one day when I was out jogging. She weighs about 10 pounds.

I can't complain b/c they are the sweetest dogs alive and I'd never trade them. Harley loves everything and everyone and is a bundle of energy. All she wants to do is play and play. Molly is getting better w/ her comfort level everyday and hopefully her devotion to me will spread and include J eventually. I also hope she'll become increasingly more at ease as time passes. We've had her about 7 months now. It's just interesting how things turn out. One thing would be that both dogs would be excellent with children... hmmm could that be why it turned out this way? The one big dog we had ended up being aggressive :-( and would have been a risk around children (although I know many large dogs are also wonderful around children)... In my dreams of dreams we buy a lab for our child when they turn 5 so they can grow up together. Hopefully dreams can come true.

Start of Lupron...

Happy New Year! May all our dreams come true in 2007.

We spent Christmas w/ J's family this year and then we had a low key New Years with a few couples. There were 8 of us total and we played a board game, (everyone drank but me) and we just had a nice time. I wouldn't have been up for a raging party or night out on the town. I came down with a pretty bad sore throat a few days ago and was worried about what it might be and how it would affect my cycle. All I had was the sore throat w/ no other symptoms for 4 days and now the sore throat is better and I'm starting to be congested so maybe it's a cold that took a long time to get started. I'm never sick and it sucks that I would come down w/ something at the start of my IVF cycle. I figure now is still better than at ER and ET time.

I start Lupron (10 units) tonight. (Are we both starting today...Hopeful Mother?) My last bcp will be on Saturday and I start stims on next Tues (Jan 9th). I will also have my first IVIg infusion that day. I'll be driving to Los Gatos for the infusion (Dr. Alan E. Beers Center). Should be interesting.

For the most part I'm just working on what I need to do each day. My stress level is better than normal. This may be due to the help of the Lexapro or b/c I'm working on my mind-body connection (probably both). The most stressful part at this point is trying to keep up with everything that needs to be done. I'm constantly on the phone ordering meds, dealing with the financial matters, consent forms, contracts, calendar dates, appt making, etc...etc... Things are finally falling into place and hopefully all of that will be behind us so we can just focus on which medications we should be doing and when.

I was thinking last night about how anxious I was to get going with the many IUI's we did back to back and even ready to jump on the wagon with IVF but now that we're here I feel like it's all happening really fast. Part of me wants to put it off and I think its only b/c if this doesn't work then we have no more options. We can only afford to do this a few times and then what. So... it's almost like if I put it off there is more time w/ hope and possibilities. Isn't exactly logical but I just don't want to face a negative(s). At the same time J and I are really ready to move on and put all of this behind us. I truly hope that a baby or two falls into that plan. There isn't much I can do to control the outcome. All I can do is follow the Re's directions to the letter and trust that God has a plan for us.