Home after egg retrieval and PESA

Thank you, all the loyal blog followers, and ICLWers, for leaving such supportive, encouraging and wonderful comments on my blog. It carried me through the anxiety. I'll be commenting soon, but first, here's what you've been waiting for:

Today was a good day. Instead of the predicted 8 eggs, the RE retrieved a whopping, surprising 13 eggs. I'm beyond ecstatic, because they also found sperm during Dh's aspiration. No motile swimmers, but sperm nonetheless.

Since the little tadpoles are being ICSI'd 1:1 into the eggs this afternoon, we could care less that they're not motile. Ladies and gentleman, after 11 years of waiting, we now know we have both sperm and eggs! We will receive the fertilization report tomorrow, but I have a feeling we'll have something to transfer.

Dh's is in excellent spirits despite braving an overnight snowstorm that threatened to derail our best laid plans. We were up at the crack of dawn to be at the clinic at 6:30 a.m. (hey, who can sleep in when your future is about to revealed in spectacular fashion?)

My incredible hero of a husband had to brave 16 needle sticks in his nether region, and the urologist finally used the dreaded "gun" to extract tissue from his testicle. Ouch! Ouch! Ouch! I'm cringing for his sake as I'm writing this. He's been up and about since 7 a.m., directly after the PESA. The Novacaine's effects are waning, but he says he doesn't need Tylenol. (He's usually a baby when he has a head cold, so I believe him that he's okay!) Men dealing with MF, take heart. Hubby took it all in his stride. My tough guy.

As for me, I'm feeling unexpectedly terrific! I can remember everything prior to and directly after the retrieval, but nothing of the retrieval itself. Okay, I'm a girl, so I have to tell you what I wore: cute soft babyblue socks with dark blue arrow grippies on them, a most fetching hospital gown, and a must-have blue hair net.

A very sweet nurse put the IV in my left arm (no drugs yet), and hooked me up to the heart rate monitor while she was chatting with me. (My heart rate was beeping way over 90 and rather intermittently - I was scared sh!tless!) My resting heart rate is usually nice and low: 50 to 60.

Hubby commented on the stirrups that look like humongous snow boots. It cracked me up. Yeah! I've reached the summit and the only way forward is to go down at breakneck speed.

I was seated in an upright position while the RE, anesthesiologist and nurse walked us through the pre-procedure questionnaire, consent forms, and post-op instructions. The RE popped in briefly to check on me. He was there just long enough to say, "Hey, how time flies. Can you believe you're in the OR already, just 2 weeks later? We're here to get you pregnant soon... and then get you outta here. Are you ready? Start visualizing that cute baby bump of yours. Can you see it yet?" I nodded an emotional "Yes..." and swallowed tears.

The anesthesiologist clipped the oxygen monitor to my left thumb, lowered me with a warning about how fast it will feel and he even let out a "Wheeee!" like a little boy riding a roller coaster. The roller coaster visual totally made me smile, and you IVFers will know what I mean.

The nurse put my feet in the stirrups, the anesthesiologist then gently inserted the air tube in my nose (weird!), and then I was blissfully gone. Asleep. Hubby, who was in the OR throughout the procedure, said I started saying something, but trailed off in hilariously and embarrassingly incoherent fashion as my eyelids started closing.

I woke up to the sound of, "We retrieved 13 eggs!" It confused me completely, because the number was so much higher than I had anticipated. I confirmed 3 times, "Really? 13? Are you sure?" I was lucid then... just in utter disblief. I thought I'd be out of it, sleepy, groggy, but I was wide awake. The nurse brought me my clothes and while I got dressed, she poured some green tea for the drive home, brought me my coat, and escorted me to the car.

I was awake all day, feeling a little lightheaded, but fine. Hubby and I took an hourlong nap. There are a few light cramps every now and then, but nothing like the sharp, stabbing cyst or Endo pain. It's not even as severe as my regular period pain, and I haven't taken any pain meds.

Anyone who's had surgery or an operative laparoscopy: retrieval is a walk in the park in comparison. Of course, if you suffer complications from retrieval, then that's another matter altogether. But I got lucky today.

Trigger happy

A colleague in the know commented tonight on how calm, happy and serene I am despite IVF. Anyone going through IVF knows that's the nicest compliment one could hope to receive, especially on the night you are triggering. We all aim to be relaxed, but it's not really an attainable or realistic goal when Lupron, stim injections, the stress of IVF, and a full time job is in the equation.

I've been trying hard to calm myself, and be acutely aware of this profound moment in my life. Although this path to parenthood has no guarantees, and is not for the fainthearted, I do find myself feeling surprisingly happy tonight. It's a strange feeling, one that I'm at odds with. I do feel trepidation for what lies ahead, but I'm also in somewhat of a celebratory mood to have reached this point. For the longest time I didn't know whether I'd be able to do this - financially, emotionally, physically. Biologically, I wondered whether I'd be a poor responder or someone who would easily hyperstim as my first RE had warned. Doing the trigger shot tonight was confirmation that things have gone well so far.

Yesterday's u/s still showed 6 follies on the left and 2 on the right. It's not a huge haul, and some follies were on the small side, but the nice nurse reassured me they'd all be ready by Monday's egg retrieval.

My fridge is empty, my sharps container is full, and my heart is bursting with excitement, happiness, and fear.

Stim day 12 - oh so blasé

I just completed injection #23 and #24 - the last of the stims before the Ovi.drel trigger tomorrow. The whole injection thing is totally overrated by now. It's become completely old hat. I even have my own little injection routine down to a tee.

Around 8:30 p.m. I take 2 minutes to remove the Gonal-F pen from the fridge and move it to the bathroom so it reaches room temperature by the time I do the injections 30 minutes later. (Cold injection = pain.) I then proceed to set up the crack house: alcohol swabs, Lupron vial, Lupron syringe and Gonal-F pen, and dial up the pen to the correct dosage. Then I'm off to go do something fun, like catch up with my IVF-friends via their blogs.

At 5 minutes to 9 p.m. I wash my hands thoroughly, swab my belly and let it dry while I swab the Lupron vial and Gonal-F pen. (The needle will burn if you stick it through wet alcohol on your belly.) I don't use any ice or Emla cream.

I insert the needle into the Gonal-F pen and set it aside. Then I draw up 5 units of Lupron, inject it, and discard the needle into my fancy little red home sharps container. Gonal-F is next: I pull out the tab to the dialed dosage and confirm, inject, wait 5 seconds, pull it out, and discard the needle. The whole process takes no more than 3 minutes. It's become so routine that I don't even think about it anymore. I'm like a Ni.ke commercial. Just do it.

What takes the longest, actually, is to find a suitably unpunctured, pristine spot on the belly. I've been working "around" my recent lap surgery and old appendectomy scars. I have only one bruise to show for the IVF injections - that ain't bad. After 24 IVF injections, and just one more to go - I am proudly wearing my battle scars.

Stim day 10 - discomfort is the name of the game

I had a really nice nurse for my u/s appointment this morning. She showed me the u/s pictures from Wednesday, and took the time to talk to me while she drew blood. Pretty follicles, but not many, unfortunately. About 6 on the left and 2 on the right - fewer than what I had hoped for. She was very encouraging, though, repeating the "quality over quantity" mantra.

The follicles are growing very slowly, which is good. I'm somewhat frustrated by the thought of having to inject Gon.al-F until Friday. This would mean 12 days-a-stimming... and a partridge in a pear tree. I'm pretty uncomfortable already, and can't imagine what Sunday will bring. Moan, moan, moan. How do you gals who have 20+ follicles handle it? Aside from the occasional twinge, there's no pain, thankfully. The "twinges" are nothing compared to the stabbing pain of Endo and cysts. But, I'm nauseous, with a stubborn, dull headache, and of course, the bloating. Oh, the bloating.

Looks like I'll be triggering Saturday, and heading to retrieval bright and early on Monday morning. I.can't.wait.

Lupron "flare" protocol - stim day 3

My RE has me on the regular dose Lupron "Flare" protocol. I jumped right in with stimming on CD2 with a combo of gonadotropin (Gonal-F) and a gonadotropin-releasing hormone (GnRH) agonist (Lupron).

Since I'm at a higher risk of developing OHSS, the doses are 150 iu Gonal-F and 0.05 ml or 5 units of Lupron every night. So far, I had a killer headache today and lingering nausea throughout the day, but no other discomfort. It was incredibly hard to focus on work today, but I gave it everything I had. Of course, I came home and crashed, and woke up at 9 p.m. to do the injections. Having to wake up from an early evening nap to inject myself is an entirely new experience, and one I do not wish to repeat often. Having said that, I'm already on autopilot with the injections. So far, it's real simple, fast, and much easier than I thought it would be.

I use the Gonal-F RFF Pen: http://www.fertilitylifelines.com/serono/products/gonalf/pen/instructions.jsp
http://www.youtube.com/watch?v=fADyj_nLKqs

and Lupron:
www.youtube.com/watch?v=7sKKDH9qCkE

In terms of the cycle, I'm hoping for quality over quantity, and since this is my first IVF go around, it's hard to know how my body will react to the stims.

In addition to severe Endometriosis, I've now heard three different REs say that I have many antral follicles and although I don't have classic PCOS, I have "polycystic-like ovaries" - whatever THAT means. I guess time will tell. At least my new RE listened to my concerns, and agreed that I may have greater success with lower doses. All in all, I'm okay with less meds.

All in a Day - IVF/ICSI cycle #1 starts

The thing about relinquishing control is that life sometimes just magically works itself out, without my intervention. Sometimes, it's best to take my sense of reason out of the equation and just go with the flow. Today was such a day.

My plan was to go for a consult in March. Then the fertility clinic called and said, "We had a cancellation. Can you come on Monday?" I have always been impatient, and even more so where IVF is concerned. So, of course, I jumped at the earlier consult.

AF, usually as regular as clockwork, started two days late, and there I was, going in for a consult on day 2, and beyond all expectation, coming home with a protocol, prescriptions, and instructions to start a fl.are protocol TONIGHT. It's a beautiful thing, really, when you're in your thirties and have Endo, not to have to wait one nanosecond longer.

The doctors were contemplating the best approach and protocol, and the one said to the other, "She's ready, man. Look at her. She's ready." And so I was. In that moment when it became evident that I could start today, the weight lifted from my shoulders. The waiting is over, and I'm entering the next phase. I am suddenly feeling at peace with it all.

Hubby is beaming. I'm beaming. We're really doing this and it's not as daunting as it seemed a week ago. Now there's no turning back, and I'm okay with that.

On my way to buy the meds, I turn the radio on, and hear the ending of a song, "today... today... today." No kidding. Today. It's been an unpredictable day already, and it's only the beginning. It takes an hour to get the prescriptions filled, and they don't have it all, but I don't even stress about it. As long as I have the meds for tonight, I'm fine.

I switch the radio on as I drive to work, and hear, "Make a wish, take a chance, Make a change, and break away." No time to ponder the song, or bond with my box o' meds, as I'm late for a meeting. I grab an opaque bag and shove the meds in the work fr.idge. After the meeting, I retrieve the stash, and rendezvous with dh in a parking lot to do a covert meds handover as I head into another meeting. He couriers the meds home, while I focus all the attention I can muster on the meeting.

It's 8 p.m. when I'm finally home and can start to process the day, and figure out tonight's injections. Let the fun and games begin! The 2 shots (lupr.on and gon.al-f) were easy and painless. Now that I've spent months reading everything and educating myself, I can let go and just do this thing.

It's a crazy horse. But somebody's gotta ride it.

The Waiting Game

We’re just waiting. Waiting for FSH results, waiting for hubby’s appointment, waiting to make an appointment at the local clinic, waiting to cycle. I almost lost it when hubby told me he might have to reschedule his appointment because of his work schedule. With everything hinging on this one appointment, I wish he’d just get it over with so we can move on to IVF, and fast.

Are My Eggs Cooked?

I drove to the nearest Quest lab this morning to have my FSH, LH and Estradiol tested. Let’s hope my ovarian reserve looks as good as my RE said it did after looking at the “many follicles” during my u/s. I can’t handle more bad news right now.

If my FSH is over 9, then the news is not only bad in terms of ttc, obviously, but it’s a double whammy because we won’t qualify for the shared risk insurance option down the line. My mom was 39 when she gave birth to my brother, and I’ve read that one’s mother’s fertility clock can be an indicator of one’s own ovarian reserve. I’m cautiously hopeful.

A poster on one of the forums mentioned a clinical trial in NYC. I completed their pre-screening evaluation, so we will see if anything comes of it. They are comparing different IVF protocols. My RE reckons I’m at risk of OHSS, so mini-IVF wouldn’t be objectionable. I wonder if MF is reason for disqualification. We shall see. I wouldn’t mind a free IVF cycle.