Today's monitoring appointment wasn't at all what I expected. I hoped I'd be triggering sooner, but apparently not. The brash nurse - who needs to be reminded that she can't gesture with the hand that is maneuvering Wanda - said firmly, "You're not ready." (I think she could see the rebellion on my face: "Yes I am! Yes I am!" like a 2-year old. "Come on, follies, prove me right!") But alas, it was not to be.
I'm disappointed, but I don't want the RE to retrieve immature eggs for the sake of my comfort. We've come too far, these follies and I. Most of the follies are around 15 mm and they need to be at 18 mm. We're almost there, but not quite. The follies are in the slow cooker, which might not be a bad pace after all.
Yesterday, my lining was at 11, and they saw 9 follies. Today she measured 12 follies around 15 mm in size "with a couple more that might be ready by retrieval." Compared to the last cycle when we only ever saw about 8 right up until the end, things are looking up. Still only 2 follicles on the right, and 10+ on the over-compensating left ovary.
My estrogen must be through the roof, because they insist on close monitoring, and seeing me every day, tomorrow included. They have me almost coasting tonight, but not quite. Just 75 units of Gonal-F. I listened to the dosage message the nurse left on my cell phone three times, because she mumbled and I couldn't believe she said "75" and not "175." Just 2 clicks, that would be a piece of cake!
Tonight might be my last encounter with the Gonal-F pen... should I write "for this cycle" or "forever?" Either way, I might jinx it.
Showing posts with label Lupron flare protocol. Show all posts
Showing posts with label Lupron flare protocol. Show all posts
Thursday, March 19, 2009
Tuesday, March 10, 2009
New plan! IVF/ICSI #2
Unfortunately, the only thing that has the potential to lift me out of this funk, is also the very same thing that could pull me deeper into the depths of despair. Attempting another cycle is the ultimate Catch-22. I *might* be damned if I do, but if I don't, I'm *certainly* damned.
How can I not give this another shot? If it wasn't for the money, I probably wouldn't have hesitated at all, but paying everything out-of-pocket makes this an agonizing decision.
Being the "leap of faith" kind of gal that I am, I found myself in the RE's office yesterday requesting that they change my beta bloodtest to a baseline for IVF/ICSI#2. The nurse practitioner looked at me somewhat shocked, but then obligingly did an u/s. This is how you know you've had too many u/s: when you start ASKING for them! :P
I hate that I was right, but AF had reduced my lining to 2.something (down from well over 10). There were about 10 antral follicles, and no cysts. Woot! (Forgive me, I'm trying hard to keep focusing on the silver lining.) It was cute how she counted on her fingers to figure out when I could start stims again.
I might be able to start stims for cycle #2 as early as tomorrow, if my progesterone level peters out enough by then. I'm going back for another blood test, and should know if I have a green light by the afternoon.
Typically, they make you wait out a cycle, but since I have severe Endo, I don't want to have two periods before I can try again. They suggested following the same flare protocol as it worked well for cycle #1. I'll be starting with 300 iu of Gonal-F instead of 150, but other than that, it's the same (Lupron 0.05 daily, Ovidrel trigger).
Right back in the saddle. Yeee-haaaw!
How can I not give this another shot? If it wasn't for the money, I probably wouldn't have hesitated at all, but paying everything out-of-pocket makes this an agonizing decision.
Being the "leap of faith" kind of gal that I am, I found myself in the RE's office yesterday requesting that they change my beta bloodtest to a baseline for IVF/ICSI#2. The nurse practitioner looked at me somewhat shocked, but then obligingly did an u/s. This is how you know you've had too many u/s: when you start ASKING for them! :P
I hate that I was right, but AF had reduced my lining to 2.something (down from well over 10). There were about 10 antral follicles, and no cysts. Woot! (Forgive me, I'm trying hard to keep focusing on the silver lining.) It was cute how she counted on her fingers to figure out when I could start stims again.
I might be able to start stims for cycle #2 as early as tomorrow, if my progesterone level peters out enough by then. I'm going back for another blood test, and should know if I have a green light by the afternoon.
Typically, they make you wait out a cycle, but since I have severe Endo, I don't want to have two periods before I can try again. They suggested following the same flare protocol as it worked well for cycle #1. I'll be starting with 300 iu of Gonal-F instead of 150, but other than that, it's the same (Lupron 0.05 daily, Ovidrel trigger).
Right back in the saddle. Yeee-haaaw!
Friday, February 20, 2009
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.
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.
Wednesday, February 11, 2009
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.
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.
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