Started Stims

Yesterday I went to the RE for my suppression check. Ovaries, lining, and bloodwork were all good and they had me start my stimulation meds last night.

I am taking Follistim, Novarel, and Lupron. I am not having a good time with the side effects so far. I was up all night with pretty severe pain in my left breast. Hopefully this passes quickly. Taking 3 shots a night is not all that fun either. I have a lot of bruising on my stomach. At least no one else will see it. Now that the complaining is out of the way, I STARTED STIMS!!!! Things are moving quickly. Hopefully ER is soon!

My next monitoring appointment is in 2 days. I'll update with our progress.

Another monitoring update...

Day 2 of monitoring didn't start out very well. Started out with a post coital test which was horrible. My CM was so thick that the sperm were stuck in it and not moving. This was not what my RE expected to see with an estrogen level of 168. I did have a very nice "I told you so" moment because I've been telling him over and over again that I have CM issues. Now he believes me. I love being right. I gloated for a good part of the morning over that.

Ultrasound showed that some of my follicles shrank and others didn't grow at all. I'm currently at: 15, 14, 13, 11, 10.

I was told that I was in pretty big danger of having my cycle canceled to poor response. *cry* I was in pretty poor spirits as I left the office and prayed for most of the day that my estrogen levels cooperated and would keep me in the game.

Thankfully, they didn't fail me. My estrogen rose to 240. Yay!

So they upped my Follistim dosage to 150 tonight. Triple my original dose! Yikes! Mr. Sunflower Bud is getting very good at giving me shots. While I was so proud of myself for doing 2 whole shots myself, I chickened out after that. He's gotten a more steady hand and it didn't even hurt at all tonight. And I had to have 2 shots instead of just 1, since I had to switch to a new cartridge.



I go back in again in the morning for another monitoring appointment and another post coital on Thursday morning. That post coital will determine if we will need to do IUI.

So more prayers tonight that my follicles kick into gear already and my estrogen rises a ton! I'm on day 7 of stims now.

Stupid Estradiol.

The nurse called me this afternoon and told me that my Estradiol level was very low for as many follicles as I have. It was only 168. She said that indicated that only one follicle was most likely functioning.

Naturally, I was completely upset. After all of this, we get ONE follicle??? *sigh*

They upped my Follistim to 75 for tonight and I go back in tomorrow morning at 8am.

We're also doing the post coital test tomorrow, which means we have to get up early in the morning to have sex. I haaaaaaate morning sex. UGH. I am so not a morning person. But there is some concern about my lack of cervical mucous. The nurse said it should definitely be noticeable by now and it's not. So here's hoping for some answers there.

Hoping for better news tomorrow. Maybe a nice spike in Estradiol and some growth of 2 more follicles. *crosses fingers*

Definitely responding!

I had my first monitoring appointment today. 5 nights of Follistim so far. I have 5 follicles. 16, 15, 13, 12, 10. The nurse said there is a risk of being canceled (they cancel with over 3 good size ones). I'm to do one more night of Follistim and go back tomorrow to see how they look. Hoping only the larger ones grow large and the smaller ones stay under 16. Still waiting on my blood test results.

My lining was at a 5, which she said was still pretty thin. They like to see at least 7 for triggering.

Since there is also a significant absence of cervical mucous, they may be doing a post coital test tomorrow as well.

Ow!

Okay so I have to take my Follistim injections between 3-6pm. I had the pen all prepared and ready to go at 3pm. Watched the instructional video. Got all skeeved out watching the girl giving herself the shot. Walked away. Breathed a few times. Came back and psyched myself up to do it!

Couldn't do it. Got it right up to my skin and just shook.

Gah I hate shots!

DH got home and watched the video and did it for me.

It BURNED!!! I didn't expect it to hurt but it really did. I'm hoping today's won't be so bad since it will be room temperature and not cold this time.

All for a good cause... I'll keep reminding myself that!

I must be dreaming!

Um, we get to cycle this month!

Went in for my baseline this morning and had myself fully prepared to find some kind of cyst or tumor or something that would cancel the cycle again. I didn't even bother paying attention to this ultrasound this time.

When they didn't draw blood, I knew it was a bust and they found something bad. So I waited for the nurse to tell me they were calling in a script for birth control pills or scheduling surgery.

Because, you know... I'm so incredibly optimistic.

Color me shocked when the nurse sat down with the schedule for when to start the stims and what days, times, etc and what day to come back for my next monitoring appointment.

I burst into tears. hahahahahhaa. She was so surprised that she didn't even know what to say. I blubbered and apologized and said that I was SO prepared for the cycle to be canceled that I was overwhelmed with emotion to find out we were actually going to be able to start!!!

I start with 50 IU of Follistim tomorrow and every day until I go in Monday for my monitoring appointment.

SO NERVOUS!!!!

And, of course, I'm not expecting it to work.

Pre-IVF Appointment

I just got back from the RE where I had my pre-IVF appointment, which consisted of a catheter check/mock transfer, more bloodwork, and injection training. I also got my IVF calendar.

Catheter Check/Mock Transfer
- No one told me this part would hurt!!! I guess I never really asked either, but OUCH. The pain was comparable to my HSG, but the cramping is still going. Basically, the RE puts in the catheter that they use to do the embryo transfer to get an idea of where she is going with it for the real thing. She also used the vag cam, as if I wasn't already uncomfortable enough.

Bloodwork- This was our infectious disease panel. Mr. Sassy Bud got to partake in the blood drawing fun also. Too bad the nurse wouldn't give him the pink bandage like I requested.

Injection Training
- The first three injections I will be taking seemed like no biggie (Lupron, Follistim, & low dose HCG). The post ER drug, on the other hand, NOT fun. PIO- Progesterone in Oil- is painful and the needle is big.

IVF Calendar
- Basically I have one more week of BCP, a few days of Lupron, and then I start my other meds to stimulate my ovaries. Timing wise- I could be PG by Thanksgiving, depending on my response!

I don't have to go back for monitoring until next CD1, which should be about 2 weeks from today.

Steps in a new direction

We met with Dr. P this morning to discuss my latest blood test results. My slightly elevated FSH coupled with my low progesterone this month leads him to believe there is ovulatory dysfunction going on. My mother went through menopause early at 38 and he said that this may be the case for me as well. So in his words, "We can't drag feet here."

I'm to call as soon as I start my period (in the next few days) and then they will have me come in for my baseline appointment. At that point, they will call in to the pharmacy of my choice (they gave me a list of 4 they recommend) to order my meds. I'll be on a low dose of Follistim to start out conservatively and see how I respond, ramping up if necessary. Then I'll be going in daily for ultrasounds and bloodwork after a few days on that to see how I'm responding. Once ovulation is imminent, I will be triggering with 10,000 miu of Novarel HCG. And then taking vaginal progesterone suppositories until either I'm not pregnant or until 12 weeks of pregnancy.

He said that there is a 22% chance of conceiving with this protocol with my history.

He also said he doesn't feel IUI is necessary but would do it if we wanted. He feels we would be wasting our money though so I agreed to give it a shot with TI this month and see what happens, maybe move on to IUI next cycle.

He didn't even feel the need to really discuss IVF at this point, saying he doesn't feel I'm a candidate for it yet and we'd worry about it after a few cycles of this.

So... that's where I stand. A little nauseous about the cost but knowing it will be worth it.

Injection class = check!

Today Mr. CB and I went to the injection class to learn how to do the injections for our next cycle. We got there and the nurse brought us back to the conference room and had all the supplies laid out on the table. I found out I will be on follistim, and we're using an injection pen. It was really easy to learn how to use, and I'm confident that Mr. CB and I will be able to figure it all out once we start. When my RE gave me the estimate for the cost of an injectable cycle, she said it would be $1500-$2000. That was definitely a little bit stressful, so we were really excited to find out that the amount we need will be $750. Still a lot of money, but half as much as we thought!

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One of my biggest worries is overstimulation. When I asked the nurse what would happen if I had too many follicles, she said the cycle would be cancelled. I didn't know if they would be able to convert to IVF or what. I really don't want to spend over $1000 on meds and doctor visits only to be cancelled at the last minute. The nurse said I would be on 150IU per day for five days. Since I don't have any problems with ovulation or follicle growth I worry that this will be too much. I am just going to trust in the doctor and know that they know best.


The only issue that I don't know if the RE has addressed for my upcoming cycle is my lining. It's bad timing, but my RE that I've been working with is on maternity leave so she didn't have any input on my meds for the next cycle. I asked the nurse today about my lining, and if the follistim will be enough to get it to where it needs to be or if I need to take something else to boost the thickness. She said my doctor is returning from leave on Monday so she will talk to her and find out.


So now it's just a waiting game. I should start my period the first week of March, then I will go in for a baseline ultrasound and get my medication ordered. The amazing thing to me is that I usually don't ovulate until around day 17. But on the follistim, I will take the medicine from cycle day 3 to 7 and then should be ready to trigger! So my 27 day cycle will be cut down to about 19 days. Crazy.


Today when I got home, I checked the mail and I had a package from Worry Bud! She sent me the cutest little penguin, a prayer card to keep in my wallet and a sweet card. With all that she is going through right now with her IVF, I am so thankful that she is also thinking of me and what I'm going through. I love you Worry Bud and am praying for amazing news for you in a couple of weeks!

2nd Follie Scan...

So after 6 nights of stims with Follistim, Menopur and Lovenox I added Ganirelix last night. At my u/s this afternoon I had 10 follies on my left about 11mm and at least 10 on my right around 11mm. So far my RE says we are right on track for an ER over the weekend. He is also watching my E2 levels closely to make sure I don't overstim. I start antibiotics tonight and I go back Wednesday. My IVF girls on the bump/nest were right, once you start the stimulation phase it does fly by...

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Until Next Time,

Follie Scan Friday

First Follie Scan
So Friday 1/29/10 I had my first early Follie check. After 3 nights of stims for IVF #1, there are many small unmeasurable follies on my left and right ovaries. Dr. B expected this since I have PCOS and he expected that I would not have anything measurable yet. Follies become measurable once they reach 10mm.

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So once I got home from Dr. B on Friday night I dropped to 300iu Follistim; added 75iu Menopour and continued 40mg Lovenox. Sunday night I will add 250am of Ganirelix, which will prevent me from ovulating before my Egg Retrieval. I will be on these dosages until Monday when I meet with with Dr. B. again.

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In the Mix With Menopur
Menopur is an LH drug that you have to mix yourself. So far I have been on Follistim only, which is an FSH drug. Mixing the Menopur for the first time was very interesting. Nurse K gave me an instruction packet and I also looked at a Menopur injection video on youtube lol.

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Until Next Time,

First Follie Check!

So yesterday (cycle day 11) I had my first follicle check with Dr. B! I took Femara cycle days 5-9 and Follistim every other day. In addition, Dr. B has me on 1500 mg of Metformin every day for my PCOS.

My first stop at his office was into the lab to have my blood drawn by Nurse K, to check my estrogen and progesterone levels.

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Next it was time for my ultrasound with Dr. B. and I was praying that I would be responding well to this particular protocol. Sure enough the ultrasound revealed 3 follies all size 14.

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Dr. B's Instructions:

Take the final 150iu dose of Follistim Monday night
BD on Wednesday
Return for final Ultrasound and Trigger shot on Thursday
BD on Thursday
BD on Friday

Looks like Mr. Blessed Bud and I are in for a busy week...

Until Next Time,

Cycle 2 Underway Again!

So Cycle #2 is underway again since I got the all clear from Dr. B. This cycle we are doing the following:

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2.5 mg of Femara for 5 nights

150 iu of Follistim every other night

Ovidrel Trigger

1500 mg of Met every night

and Timed BD

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I have my first Follie check this afternoon with Dr. B and I pray that this cycle goes smoothly and that we get a BFP! I will have an update about how this cycle is progressing soon...

Follistim.....CHECK!

So tonight was my first injectable and it wasn't as bad as I thought it would be!

DH was able to come home earlier from work and do it for me. Thank god he did cause I think it might have been a huge FAIL.

Lets hope that the Clomid and Follistim do the trick and my follies are nice and big at my monitoring appt. on Thursday!

Grow follies, grow!

The life of an IUI patient....

I will preface this my saying that every IUI patient is different. Not every woman will use the same protocol (types of meds, doses etc.) but, this is a little insight my "agenda for the next couple of weeks.

Upon, finding out that Monster cyst was gone I was sent to meet with a nurse that went over all my meds. Thanks to the Infertility board on thebump.com, I was pretty much "in the know". The nurse was surprised. I totally think I deserved a sticker.

Anyway, here's how it's gonna go....


CD 3-7: Clomid 100mg


CD 9: 150iu of Follistim (done in the stomach below the bellybutton on either side)


CD 12: We will go in for a monitoring appointment. At this appointment the RE will determine how big the follicles are and whether or not we are ready to trigger. The trigger is a shot of Ovidrel. Ovidrel is used to trigger the release of a mature egg.


If the follicles are not ready then we will need to keep going back until they are. Once we get the thumbs up the shot goes in. It will be done the same as the Follistim.



The day after the trigger, we will go in for the first IUI. For those who are unfamiliar with what an IUI is here is a description:

1. The woman usually is given medications to stimulate development of multiple eggs and the insemination is timed to coincide with ovulation - release of the eggs.


2. A semen specimen is either produced at home or in the office by masturbation after 2-5 days of abstinence from ejaculation.


3. The semen is "washed" in the laboratory (called sperm processing or sperm washing). The sperm is separated from the other components of the semen and concentrated in a small volume. Various media and techniques can be used for the washing and separation. Sperm processing takes about 30-60 minutes.


4. A speculum is placed in the vagina and the cervical area is gently cleaned.


5. The washed specimen of highly motile sperm is placed either in the cervix (intracervical insemination, ICI) or higher in the uterine cavity (intrauterine insemination, IUI) using a sterile, flexible catheter.

The intrauterine insemination procedure, if done properly, should seem similar to a pap smear for the woman. There should be little or no discomfort.
Most clinics offer for the woman to remain lying down for a few minutes after the procedure, although it has not been shown to improve success rates. The sperm has been put above the vagina and cervix - it will not leak out when you stand up. Source

My RE does this B2B (back to back), meaning we will go in for the first one and then come back in the next day and do it again.

Once the procedure is done I'm sent home to wait. Hopefully during this waiting time all of Mr. Love Bud's little soldiers are having an easy time finding the egg I worked so hard to grow and release. You'd have to think 5 million+ sperm could find one tiny egg?!

The RE's office likes to wait 16 days before having you come in for a Beta. The reason for this is A) you might get AF before then and B) making sure there is sufficient time for the HCG shot (Ovidrel) to leave your system since it can cause a false positive. For the most part that shot is gone in about 11-12 days so I will have taken an HPT by then.

So there it is. My life for the next 2 weeks! If all goes well we'll find out around our anniversary that Little Love Bud is coming. If it does well.....I'll find a nice big bottle of wine and celebrate that way!