Triggering tonight!

I can't believe it's time already.

Today was my final monitoring appointment. The RE said everything looks great and I will be triggering tonight! That puts the egg retrieval on Wednesday morning. The nurse should be calling this afternoon with the exact time that I take the trigger shot.

Stims were not too bad at all. I had a headache one day, and I am extremely bloated. I did end up with a skin infection that I am guessing was from all the hormone changes, but that is almost cleared up and isn't causing me any discomfort anymore.

I tried to keep track of how many follicles there were this morning, but honestly there were so many I lost track! My lining was at 11.1 and the RE said that was a great number. I am glad that there have been very few issues during my cycle. I guess we are lucky that MFI was the only thing that was keeping us from getting pregnant.

I will update after the retrieval. Hopefully I have lots of eggs!

Let the wait begin!

Wednesday's monitoring appointment was a bit better. My follies grew to: 18, 14, 13, 13. One dropped off so they didn't even tell me the measurement. My E2 took a nice leap to around 350 which they were very pleased with. The nurse told me that it indicated that there *could* be more than one egg. That would make me happy because I was a bit bummed at only one good follicle.

They had me trigger Wednesday night at 7pm. I shoved a bag of frozen corn down my pants to numb that butt cheek good and cold. Mr. Sunflower Bud seemed to really enjoy doing that shot. I only cried just a little bit. :) I am so not a needle person at all.

I'm hoping that the 14mm follie caught up to maturity by ovulation. I'm having cramping pains on both sides so hopefully that is a great sign of ovulation on both sides. The 18 was on the right and the 14 was on the left.

Thursday morning was the second post coital. This test was not good. My cervical mucous was much better than it was on Tuesday. Dr. P said it was clear and flowing and he was very pleased with it. However... the majority of DH's sperm were not swimming around freely. Instead they were staying in one place just shaking like they had been electrocuted or having a seizure. Dr. P let me see this under the scope and it was the weirdest thing. Mr. Sunflower Bud's sperm analysis was "donor quality" so we were perplexed by this. Dr. P believes that one of us has a sperm antibody that is causing the sperm to react this way. He estimated that only around 10% of the sperm on the slide were actually swimming properly.

So... our chances for this cycle working are much lower than we anticipated. We're giving it our all with sex twice a day until Saturday but we're really just kind of looking at it as a learning cycle. They will be better able to adjust my dosage of Follistim next cycle now that we now I need to start out at a more aggressive dose since I didn't respond very well to the lower dose this cycle.

We're also scheduled for IBT testing to determine if one of us has the sperm antibody. Mr. Sunflower Bud has to have another SA since it's been a year since his last one and they are also going to do infection testing on him as well.

Going forward, Dr. P said that we will go straight to IUI and will not consider TI anymore due to the "shaking sperm" problem.

As is in my nature... I've already started testing out the trigger because I just enjoy seeing 2 lines on a test. Already getting lighter, yay! Hopefully it won't last the whole 10 days.

An Overdue Update

Hola! I apologize for not updating sooner, but we've had spotty internet service and have been super busy exploring this amazing country. I am in LOVE with Costa Rica. We haven't even left yet and I already can't wait to come back!

First things first, let me get you up to date on our medical progress. I had my follie check on Wednesday, July 7th and it was a little disappointing. I had 7 follicles that were measuring between 10 and 14 mm, and my lining was a measly 4 mm. I will be honest and say that I was positive that I would have over 10 follicles. I had 8 at my last failed IUI, and now I am doing stronger meds and for a longer amount of time. I teared up in the bathroom as I was changing, but Dr. Perez assured me (as did my friends who are in the know with IVF) that it's QUALITY over quantity. The follicles are growing together, and it's much better to have a few great eggs than a bunch of mediocre ones. The lining was definitely a concern, as I knew it probably would be, and Dr. Perez prescribed estrogen patches to help it along.

My second follie check was today, and the great news is that my lining is 7.4! That's the same as my last IUI, and the thickest I've gotten it. Plus, I still have a few days for it to fatten up even more before transfer. Today Dr. Perez only recorded 5 good sized follicles, so some decided to stop growing or maybe there are even some hiding. I am in a great place mentally right now and I am totally trusting that everything is going to work out. I know my 5 are rock stars!

I have to set my alarm for 3 AM tomorrow to do my trigger shot, then we fly to Panama early Monday morning and egg retrieval is set for 3 PM, Panama time! I can't believe we are already here! I am super excited, but nervous as well. I've never been under any kind of anesthesia, and the unexpected does make me nervous. But I know everything will turn out just right. I had already looked up my estimated due date in anticipation of having my ER on the 12th (just trying to be positive =), and it would be April 4, 2011. That is my Granny's birthday, and she passed away over 6 years ago. She was the most amazing woman ever, and I know for sure that she will be looking over us through this huge event in our lives.

Our adventures in Costa Rica have been unbelievable. After we left the volcano, we headed to Monteverde, where we ziplined through the rain forest and over huge mountain valleys, and also hiked in the Monteverde Cloud Forest. We saw the rare and famous quetzal (a bird that people from all over the world travel to CR to see) and hiked to the continental divide and a waterfall.

We headed next to the beach and Manuel Antonio. We visited the national park with a guide and saw a ton of sloths, monkeys and even a boa constrictor. We hit the beach for the afternoon where Mr. CB had a chance to surf and had some amazing meals. The best part of the stay there was our visit to La Reserva, where a friend has an amazing house. It was between rentals so we were able to enjoy the infinity pool for the entire morning and then had a couples massage on the back deck. It was ultimate relaxation, and just what we needed to relieve some tension before heading to Panama.

Now we are in San Jose and plan to spend tomorrow in the city checking out some historical sites, the market and finding a fun place to watch the World Cup final. Then bright and early Monday it's off to Panama for the next step of our adventure! We have internet in our apartment in Panama and I'll be on bed rest that first night so I will make sure to update you on our ER.

Pura Vida!

I Don't Even Recognize Myself: AKA Monitoring Update #2.6

I'm not going to hem and haw and try to be all literary with this blog post. I'm just going to stick to the facts. And the fact is I'M A FREAKIN' ROCKSTAR!!!

Jem is truly truly truly outrageous!

My E2 yesterday was 1130. I never even got that high last time AFTER trigger. I bet I get to 2k after trigger this time. My highest E2 last cycle was between 1000 and 1100. This is CRAZY!! My lining is 17 and trilaminar. Like i've said - my lining doesn't seem to be my problem. At all.

Measurements... check out these babies!!!!

• left ovary: 23x17, 18x17, 19x16, 17x14, 25x16, 19x17, 18x15, 19x19
• right ovary: 19x17, 19x17, 20x16, 19x16, 23x14, 18x13, 19x18

Dr Z thinks we're going to get 12 mature eggs at retrieval!!! Oh, and speaking of retrieval; it's going to be Wednesday. I'm triggering tonight!

So, now I'm just waiting for the call. Sometime this afternoon, Nurse F will call me with the details for my trigger and retrieval. The trigger has to be given at an EXACT time. I was able to find someone to work for me tonight, so I can leave at 7pm and be home by 7:30pm. Hopefully, trigger will be after that, but i'll take it to work with me, just in case. One of the nurses has done IVF, and she knows that i'm cycling. I'm sure if I need her to, she can trigger me.

Is it weird that I'd rather have Mr DB do it, instead of a trained nurse?

Who cares... I can't believe it's happening!! And I can't believe my ovaries are working! It took maximum doses for 10 1/2 days... but it's working!!!

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Trigger is tonight!!

On BCPs for IVF now!

Literally hours after my last post AF arrived & the beginning of my IVF journey began! As soon as AF arrived, I called my IVF nurse. She wasn't in that day, so I called the backup nurse & left a message. The other nurse called me back in about an hour & told me everything I need to know to get this cycle started. She instructed me to start BCPs on Friday, January 8th and continue them thru Thursday, January 28th. I also scheduled my mock embryo transfer & injection training course for next Friday, January 22nd. If all goes well at the mock transfer, then I will be accepted into my center's Shared Risk program. That same day, I will plan on applying for the loan to cover the costs of my cycle(s) (after Mr. Worry Bud & I put down about $2K, it'll be just about $20K). Once we get the receipt from our Dr.'s office, we will submit it to our FSA to get reimbursed for the $10K.

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The nurse also sent me my IVF calendar: I start Lupron injections & baby aspirin on January 26th; my estimated Egg Retrieval (ER) is February 13th (the day before Valentines!) & my estimated Egg Transfer (ET) is February 16th (the day after my Mom's birthday & days before Mr. WB's!). I am hoping to have lots of good looking embryos on day 3 & hopefully make it to a 5-day blastocyst transfer. At our IVF consult, we discussed the risks with our RE & he agreed with our desire to transfer two embryos vs. the one he originally recommended! So, hopefully our busy month of February will end in happy birthday news for both my mom & Mr. WB!!

I also got a call from my insurance company regarding the medication prescribed for this cycle, which consists of:

• Lupron
• Menopur
• Gonal-F
• Novarel (HCG trigger)
• Azithromycin
  
• Endometrin

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I had to wait until Monday to get the cost of the meds from my insurance company, but I had the option of going thru another mail order pharmacy that my insurance covers & they were almost $300 cheaper! So, the estimated costs of the meds are going to cost a little under $350 including needles & shipping! I know that is it WAAAY more expensive for many other women undergoing IVF treatment, so I feel very blessed to at least have prescription coverage for the IVF drugs.

Oh & last, but not least, I am seeing an IF counselor for a one-on-one session this Friday, January 15th. I'm not sure exactly everything we will discuss, or even that sure of my expectations for the session, but I am very interested in any coping strategies she can suggest for the roller coaster of emotions that I know my upcoming IVF cycle will bring. My clinic also has a FREE IVF support group meeting next Thursday & I am considering attending that. I just want to make sure that I am emotionally as ready as possible since I believe that the mind-body connection is a very important & often overlooked component of IF treatment. That's all I got for now...thanks for all the thoughts & prayers - please keep 'em coming!

So that's what that was...

When I went to the doctor last Monday I had been spotting on and off since right after Christmas. My lining was thin, my follies were small and my trigger was cancelled. I continued spotting all week and then Friday I found myself with full-on flow. But if this was my period it was over 7 days early! The flow continued through Saturday and then stopped altogether on Sunday. I called my nurse this morning and after describing everything she thought it was probably my period, making today CD 4 and with that I had to schedule a last minute appointment to go in for my baseline sono and to get my prescription for my last month, last ditch effort of femara/estrogen patches/HCG trigger/progesterone. I go back on the 21st for my midmonth check. I've stocked up on pomegranate juice, cut out most alcohol (hey, I give myself two glasses of wine on the weekend...with all that I'm going through I deserve it!), have been listening to fertility meditation CDs and am trying to stay calm and stress-free so my body can be healthy and ready for a little baby to make itself comfortable.

Mr. CB and I also decided today that if all looks good on my midmonth check (a manageable number of good sized follicles and a lining over 7 mm) we will be doing an IUI this month. My insurance covers half of an IUI, so we figured we may as well do everything we can to maximize our chances this month.

In other life news, we are the proud owners of a brand new laptop! My old laptop was ancient by computer standards (bought in early 2003) and I have been feeling like it was going to kick the bucket any minute. I asked my family for Best Buy gift cards or "computer cash" for Christmas and we got enough to almost completely pay for it! It's a shiny black Toshiba Satellite with lots of ram and gigs and memory and all that computer stuff. I had our tech guy at work help me pick one out so I know it's good, but I just care that it has a big screen, surfs the web at a fast speed and burns CDs and movies. It's so much fun getting new big girl toys!

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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:

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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

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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.

A positive spin on side effects

When I was getting ready to write this post, I was planning on talking about the side effect hell that I am currently experiencing...but that would not fit in with the new, improved POSITIVE Chef Bud so I decided I needed to look at my side effects in a different light.

1. I am so short-tempered that even the smallest thing can send me into a tirade...which is good at work since I'm an assistant principal. If the students weren't scared of getting in trouble and being sent to my office, they definitely are now!

2. I feel nauseous and sometimes sick to my stomach...which is good since I wanted to lose some weight anyway and it's quite easy to not eat when you feel like you're going to throw up.

3. I am an emotional mess...which is good because when I get all weepy and sad, Mr. CB feels so bad for me and will do the dishes, bring me wine, walk the dog, etc.

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I am hoping that all these side effects mean my medicine is working and doing what it is supposed to do. We are on the same plan for this month as we were last month. I've already done five days of femara, I am on day two of five for the estrogen patches, the HCG trigger shot is currently being overnighted and I anticipate triggering on Monday night after my follie check/lining check on Monday morning. I also added in pomegranate extract pills to see if nature could give my lining a boost.


Monday is a big day. My appointment is at 9 am, and I usually just go by myself if Mr. CB has to work, but I asked him to make sure he could be off to go with me. I am terrified that I'm not going to have responded to the meds, and my lining will still be thin. I know I will be a wreck if that is the case, so I want him there for support. But of course I am hopeful and optimistic for a great ultrasound that shows a big, fat, fluffy lining that is all ready for Baby CB to get comfortable for the next nine months!

Staying Positive

I had a bad week. I felt really yucky at the beginning of the week from the estrogen patches I had been on since last Saturday. I was OK with it though, thinking that it would be worth feeling crappy when the patches did what they were supposed to do and thickened up my lining. But at my appointment on Wednesday, I got the bad news that my lining was only 5.4 mm. I just couldn't believe it...I think the u/s tech had to repeat it twice because I was so shocked. It's a good think that both Mr. CB and I were off work that day, because as soon as she walked out of the u/s room I started crying and I was really glad he was there with me.

I did have a good size follicle (20 mm) so they told me to still do my HCG trigger Wednesday night and have timed intercourse Wed, Thur and Fri. We're going through with the plan and will also start progesterone on Sunday, but I feel like I'm just going through the motions. I hate that this process has turned from a husband and wife making love to create their child to a clinical, forced, stressful process. I am trying to have faith and be strong, but as the months go by it gets harder and harder.

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I'm doing my best to stay positive. I wasn't very good at it on Wednesday and Thursday but I just needed some time to process everything and get back to my happy place. I'm just going to keep putting my trust in God and know that there is a plan for us. And I know my doctor is doing everything she can to help us. So now I wait the end of this cycle out, hope for a miracle, and if no BFP then we will see what the RE has in mind for next month.

Cycle 9, Cycle Day 12

So I'm almost at the mid-month point of this cycle. I'm surprised at how quickly the past two weeks have gone by...very unusual for me! I think I've done a better job at not thinking about TTC so much and have not stalked my chart on FF every few hours. =) So far this month, I've done my 5 days of femara, and today is day 3 on the vivelle dot patch. The patch is estrogen, and the doctor said it should help make my lining thicker. I go on Wednesday for my follicle and lining check, and I hope they have good news for me. If all goes as planned, I should do the HCG trigger shot Wednesday night which means ovulation before the week is over.

Like every other cycle, I have high hopes for this month, but at the same time I just can't picture myself getting a BFP. Hoping that I get a great Thanksgiving surprise!

I have to give myself a what???

Last Friday I had a follow-up appointment at the RE to discuss my test results from last month and to talk about our plan for the next few months. Everything was perfectly fine from my bloodwork (I don’t have HIV or syphilis, yippee!) and the HSG was clear. She did say the doctor noted that my uterus is asymmetrical and that my right tube filled with the dye a lot quicker than the left because of how the uterus is shaped. But she didn’t seem too concerned so I am not worried about that.

She then outlined the plan for this month. First off, a switch from clomid to femara. Apparently one of the side effects of clomid is thinning of the uterine lining, and since my lining was already thin during my last ultrasound, Dr. M. doesn’t want me to take clomid. Next, in the middle of my cycle I am going to go in for an ultrasound to check out my follicles and lining. Once the follicles are a certain size and look ready to be released, I will give myself an HCG trigger shot that will basically cause my body to ovulate, and Mr. CB and will do it like teenagers. Four days after the shot I will start progesterone suppositories twice a day. And hopefully all this craziness will end in a BFP.

I am totally fine with doing all of this. If my doctor told me that running around the block naked would help get me pregnant I would do it (ok, well maybe not quite that far, but you know what I mean). I will do what it takes to have a baby, but I do wish it weren’t quite so darn complicated. If the ultrasound on Monday shows that my follicles aren’t big enough, I will have to keep going back in until they are ready…and will have to keep paying $70 for each visit. Don’t even get me started about the shot. I’m not sure how that is going to work since I’m totally needlephobic. I told Mr. CB he will have to give me the shot (his response was “I hope that I’m mad or annoyed with you so I can take some pleasure out of stabbing you with a needle”…he’s a sweetheart). Then two weeks of progesterone goo leaking out of my vag. Not to mention any side effects that might come from all the medication. What happened to two people having lots of unprotected sex to get pregnant???
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In my non-TTC world, Mr. CB and I will be home this weekend for the first time in SIX WEEKS! We travel all the time, especially during football season since we have FSU season tickets. There is a home game this weekend but we decided that we are just worn out from all the weekends out of town and we just want to hang out together, at our own house, with no plans. So this weekend we will be sleeping in, working around the house, watching movies and relaxing. I can’t wait!