Last Thursday Tony and I headed over to Dr. C's office for our IVF and Injection class. For the first hour one of the nurses, Sarah, sat down with us and went over the results of my ovarian assessment report. The results were good folks. Better than they had anticipated. This means that it should be easier to simulate to ovulation but more difficult in that they have to be careful not to over-simulate. She also went through our time table and stressed that all of those dates (that I put up in my last post) are just estimated and I only have a 50% chance of hitting them. Odds are that I will be close to those dates, but they will proceed according to how my body is responding to the medications.
What this means is that I will start my medication on schedule next week Tuesday, the 15th. I will stop my birth control as scheduled on the 20th. And on the 23rd I will go in for my baseline ultrasound and bloodwork. This will be the guideline of how my ovaries are reacting to the medications once I start them three days later on the 26th. I'll inject as directed by my calendar for four days and then I will head back to the office for another ultrasound bloodtest combo (which I will refer to as U/S-BT from now on to save myself from typing that everytime). Later that same day they will call me and tell me how things are going and direct me further on my medication. I will continue on the Follistim and Menopur, I just won't know at what the doses are until the 26th. Then two days later I will head back in for another U/S-BT. And later that day they will call with my new doses. And two days later I do it all over again. Lather, rinse, repeat...
Now this can change. If I'm developing slower than normal, I won't go every two days, I'll go every three days. And conversely, if I'm developing faster than normal, I'll go in every day. Sarah explained that these appointments are going to be super quick. I'll probably only be there for 15 minutes. Because of that, these are not appointments where you can ask questions about anything that isn't urgent. Its in and out. She said that they can feel hurried and impersonal and that's only because of how many they have to get through. Picture 15-20 ultrasounds from 8 - 10 am. With a nursing staff of two and one Dr. C. That's a busy morning for sure. She told me that later in the day, as they make the phone calls, they will be in a better position to field any non-urgent questions.
So, here I am, earning some serious frequent flyer miles at Dr. C's office and they get to U/S-BT to their hearts content. And all the while I'm injecting this and that, taking this and that. So one day, after one of my short and sweet progress report appointments, I will get a phone call telling me I am ready. This means that my ovary's follicles look nice and my bloodwork confirms it. When this happens I'll have about 36 hours until my retrieval.
They will schedule my surgery and 35 hours beforehand Tony will get to take out any of any frustrations he has with me by giving me an hCG intramusclar injection in the ass. Yes, you heard that right, my husband gets to shoot me in the ass. (The day of my retrieval he'll also start injecting progesterone in oil in my soon to be very tender hiney.) hCG will help mature the eggs for retrieval. Timing in this is super critical. Too soon and I'll ovulate the eggs they want to collect and my ovary will be empty. Too late and my eggs won't be ready for retrieval. So this is not a shot I will be able to put off until its more convenient. This one will have to happen exactly on schedule.
If I'm in the 50% of the population that sticks to schedule, this will happen on December 7th. But there is a strong possibility that is could happen anytime before or after that, probably within a few days. This poses a little bit of an issue with my work schedule. Retail and last minute day off do not go well together, but it can't be helped and we will just cross our fingers that the timing works. And if it doesn't... I'm going to have bigger things on my mind. Like making a baby :-D
At this point Sarah sent us to the lab end of the practice. The guy that actually will introduce Mr Sperm and Miss Egg. Mr. LabGuy has been doing this for over 30 years and said that Dr. C is as good as anyone he's ever worked with and has fantastic success stimulating the ovaries. He talked to us about what happens during the retrieval. Dr. C will aspirate a follicle and collect all of the fluid. This fluid will (hopefully) contain and egg and the cells that "feed" it. Everytime he aspirates a follicle the fluid retrieved will be turned over to Mr. LabGuy. He will then verify that there is an egg by doing a simple visual inspection, these guys are large enough to see without assistance.
This egg, and all eggs successfully retrieved, will be labeled with my name and date of birth and a color that will be assigned to me. They will aspirate all the follicles that have developed. Not all of these will contain viable eggs. But hopefully we will get enough. Once everything is collected they will place Tony's "sample" and my eggs on our own shelf in an incubator. After a few hours Mr. LabGuy will introduce them in a plastic petry dish with a growth medium. After about a day they will check them. At this point normal fertilized eggs should have two nuclei visible. If there are three in any they will discarded for having extra chromosomes. If they have not fertilized, they will be discarded. And someone at the lab will give us a call to let us know how our future possible babies are doing.
Sometime between day three and day five it will become obvious which embryos are the best. Either through process of elimination, or just from experience with their appearance. At that point they will book me for the implantation procedure. This will be another mystery date, but could fall on the 12th of December. I will not be allowed to work for four days. Again, this is not ideal in retail, but this is my baby we are talking about.
We both left with a better understanding of the process. I can't help but feel even more excited! Its getting so close, its starting to feel so real! It felt really real on Tuesday when I went if for my saline ultrasound. This was needed to really "see" the uterine lining. The process was simple. A vaginal ultrasound using the wand, which I've already begun to hate, and a catheter attached to a very large syringe of saline. Sarah had warned me to take 800 mg of ibuprofen before my appointment so I was sure it wouldn't be a fantastic experience. Personally I thought it sucked and was one of the most uncomfortable things I've ever had done.
First Dr. C inserted the catheter, which was also kind of a dry run for my implantation as a similar instrument will be inserted in the exact same place. Then Dr. C inserted the ultrasound wand and they added a small amount of saline. This caused a bit of pressure and cramping but worked to open the uterine cavity so the lining was visible. After about ten minutes of uncomfortable crampiness it was over. And they'd found two areas that could be a problem. Both of them were at the top of the ultrasound screen in little "clusters." One on the right the other towards the center. Neither were very big, and 99% of the time are completely harmless. But, the fertility medication can make these small, harmless polyps grow and become a problem. So I have to have them removed.
Sarah wanted to schedule this on Thursday, two days later. That was not going to be possible so we compromised and I will be going in for my first ever surgery on Monday at 6:45 am. I'm trying to focus on the positive in this. I get an extra day off that week. It's and outpatient procedure. It shouldn't hold up my IVF in anyway. And most importantly, its going to very similar to what will happen the day of my retrieval so that part of my stress from not knowing will go away. So wish me luck for Monday the 14th! On a completely side note, Tony and I might be moving. A friend of his family is a realtor and she has a client that is looking for a two bedroom, two bath condo in our area and he will be coming by to take a look on Sunday. Talk about a lot going on!
ps. They had to reduce my dosage of Metformin to just one a day thanks to ALWAYS being nauseous and diarrhea like I've never had in my life. For a month I dealt with that. No longer!
What this means is that I will start my medication on schedule next week Tuesday, the 15th. I will stop my birth control as scheduled on the 20th. And on the 23rd I will go in for my baseline ultrasound and bloodwork. This will be the guideline of how my ovaries are reacting to the medications once I start them three days later on the 26th. I'll inject as directed by my calendar for four days and then I will head back to the office for another ultrasound bloodtest combo (which I will refer to as U/S-BT from now on to save myself from typing that everytime). Later that same day they will call me and tell me how things are going and direct me further on my medication. I will continue on the Follistim and Menopur, I just won't know at what the doses are until the 26th. Then two days later I will head back in for another U/S-BT. And later that day they will call with my new doses. And two days later I do it all over again. Lather, rinse, repeat...
Now this can change. If I'm developing slower than normal, I won't go every two days, I'll go every three days. And conversely, if I'm developing faster than normal, I'll go in every day. Sarah explained that these appointments are going to be super quick. I'll probably only be there for 15 minutes. Because of that, these are not appointments where you can ask questions about anything that isn't urgent. Its in and out. She said that they can feel hurried and impersonal and that's only because of how many they have to get through. Picture 15-20 ultrasounds from 8 - 10 am. With a nursing staff of two and one Dr. C. That's a busy morning for sure. She told me that later in the day, as they make the phone calls, they will be in a better position to field any non-urgent questions.
So, here I am, earning some serious frequent flyer miles at Dr. C's office and they get to U/S-BT to their hearts content. And all the while I'm injecting this and that, taking this and that. So one day, after one of my short and sweet progress report appointments, I will get a phone call telling me I am ready. This means that my ovary's follicles look nice and my bloodwork confirms it. When this happens I'll have about 36 hours until my retrieval.
They will schedule my surgery and 35 hours beforehand Tony will get to take out any of any frustrations he has with me by giving me an hCG intramusclar injection in the ass. Yes, you heard that right, my husband gets to shoot me in the ass. (The day of my retrieval he'll also start injecting progesterone in oil in my soon to be very tender hiney.) hCG will help mature the eggs for retrieval. Timing in this is super critical. Too soon and I'll ovulate the eggs they want to collect and my ovary will be empty. Too late and my eggs won't be ready for retrieval. So this is not a shot I will be able to put off until its more convenient. This one will have to happen exactly on schedule.
If I'm in the 50% of the population that sticks to schedule, this will happen on December 7th. But there is a strong possibility that is could happen anytime before or after that, probably within a few days. This poses a little bit of an issue with my work schedule. Retail and last minute day off do not go well together, but it can't be helped and we will just cross our fingers that the timing works. And if it doesn't... I'm going to have bigger things on my mind. Like making a baby :-D
At this point Sarah sent us to the lab end of the practice. The guy that actually will introduce Mr Sperm and Miss Egg. Mr. LabGuy has been doing this for over 30 years and said that Dr. C is as good as anyone he's ever worked with and has fantastic success stimulating the ovaries. He talked to us about what happens during the retrieval. Dr. C will aspirate a follicle and collect all of the fluid. This fluid will (hopefully) contain and egg and the cells that "feed" it. Everytime he aspirates a follicle the fluid retrieved will be turned over to Mr. LabGuy. He will then verify that there is an egg by doing a simple visual inspection, these guys are large enough to see without assistance.
This egg, and all eggs successfully retrieved, will be labeled with my name and date of birth and a color that will be assigned to me. They will aspirate all the follicles that have developed. Not all of these will contain viable eggs. But hopefully we will get enough. Once everything is collected they will place Tony's "sample" and my eggs on our own shelf in an incubator. After a few hours Mr. LabGuy will introduce them in a plastic petry dish with a growth medium. After about a day they will check them. At this point normal fertilized eggs should have two nuclei visible. If there are three in any they will discarded for having extra chromosomes. If they have not fertilized, they will be discarded. And someone at the lab will give us a call to let us know how our future possible babies are doing.
Sometime between day three and day five it will become obvious which embryos are the best. Either through process of elimination, or just from experience with their appearance. At that point they will book me for the implantation procedure. This will be another mystery date, but could fall on the 12th of December. I will not be allowed to work for four days. Again, this is not ideal in retail, but this is my baby we are talking about.
We both left with a better understanding of the process. I can't help but feel even more excited! Its getting so close, its starting to feel so real! It felt really real on Tuesday when I went if for my saline ultrasound. This was needed to really "see" the uterine lining. The process was simple. A vaginal ultrasound using the wand, which I've already begun to hate, and a catheter attached to a very large syringe of saline. Sarah had warned me to take 800 mg of ibuprofen before my appointment so I was sure it wouldn't be a fantastic experience. Personally I thought it sucked and was one of the most uncomfortable things I've ever had done.
First Dr. C inserted the catheter, which was also kind of a dry run for my implantation as a similar instrument will be inserted in the exact same place. Then Dr. C inserted the ultrasound wand and they added a small amount of saline. This caused a bit of pressure and cramping but worked to open the uterine cavity so the lining was visible. After about ten minutes of uncomfortable crampiness it was over. And they'd found two areas that could be a problem. Both of them were at the top of the ultrasound screen in little "clusters." One on the right the other towards the center. Neither were very big, and 99% of the time are completely harmless. But, the fertility medication can make these small, harmless polyps grow and become a problem. So I have to have them removed.
Sarah wanted to schedule this on Thursday, two days later. That was not going to be possible so we compromised and I will be going in for my first ever surgery on Monday at 6:45 am. I'm trying to focus on the positive in this. I get an extra day off that week. It's and outpatient procedure. It shouldn't hold up my IVF in anyway. And most importantly, its going to very similar to what will happen the day of my retrieval so that part of my stress from not knowing will go away. So wish me luck for Monday the 14th! On a completely side note, Tony and I might be moving. A friend of his family is a realtor and she has a client that is looking for a two bedroom, two bath condo in our area and he will be coming by to take a look on Sunday. Talk about a lot going on!
ps. They had to reduce my dosage of Metformin to just one a day thanks to ALWAYS being nauseous and diarrhea like I've never had in my life. For a month I dealt with that. No longer!
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