holy crap

I really don't have a more appropriate title for this blog entry.

After all of the roller coaster emotions of the past week - thoughts of being canceled, thoughts of having diminished reserve - I can't believe I was just told what I was told at the RE's office this morning.

I'm triggering tonight.

My lining went from 14 to 16mm overnight! This photo shows what a trilaminar pattern looks like:

photo credit

These are my follicle sizes from the last three visits:

• Monday: 16, 15, 13, 13, 13, 11 (Dr Z only counts the ones above 10)
  
• Wednesday: 19, 18, 15, 14, 14, 13 (6 small - meaning under 10; Dr B counts everything)
• Today: 22, 22, 20, 18, 18, 17, 15, 14, 10

photo credit

Yep - you read that right... 5 mature follicles!!!!!!! And with the way things have been going, I wouldn't be surprised if the 17 and 15 caught up by saturday.

I found this cool website that explains mature follicle sizes (remember, i'm on Gonal-F) and what happens after trigger:

• How big should my lead follicle be before I take my HCG shot?
  

A lead follicle should be at least 16 mm on an hMG like Pergonal, it should be at least 18 mm on a recombinant FSH like Gonal-F, and should be about 22 mm on Clomid. Occasionally Gonal-F can produce mature eggs in smaller follicles, in which case other measurements such as E2 and progesterone should be used to indicate maturity. (The difference in ideal size is due to the difference in mechanisms by which the medications work. For example, the mechanism by which Clomid works often takes a bit longer because it is indirect. Therefore, the follicle has more time to grow before the egg is actually mature).

• How much do follicles grow each day?
  

Follicles grow 1 to 2 mm a day both while taking ovulatory stimulants and after the HCG shot.

• Will smaller follicles "catch up" in time to release eggs?
  

Follicles generally need to be at least 15-16 mm to contain fertilizable eggs (although it is possible in rare cases for follicles to be as small as 14 mm and still contain fertilizable eggs). If the smaller follicles are close in size to the lead, they may "catch up" and release. HCG will usually result in most mature follicles releasing eggs. Otherwise, most likely only the lead follicle will ovulate.

I'm starting to think that sometimes Dr. Z is just TOO cautious. Like last week when he said, "i'm not worried YET". Today he said that tomorrow morning when I go in for blood work (they measure my estrogen again and my HCG levels, to make sure i've gotten enough of the trigger) he wants to see my estrogen go up, stay the same, or not drop more than 20%. He said if it drops more than 20% it's indicative of immature eggs that won't fertilize. I asked him if he expects that to happen. He said, "It shouldn't". Why couldn't he just say "no".

But it's not going to happen. Not with all of these follicles. Not after everything i've been through.

We're triggering tonight.

Retrieval is saturday.

Holy crap.