Friday, July 29, 2011

I probably shouldn't have started to do research on the success rates of Day 3 embryo transfers in women of my age. Instead I am going to go lay down with Chris and take a little nap.

4 little indians.

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So yesterday I headed out to West Lake in the early morning and the doctor confirmed that I was suffering from OHSS. He classified it as a moderate case but confirmed that yes, I was probably feeling really really shitty. An ultrasound showed very enlarged ovaries and pockets of fluid in my abdomen. Not fun. We talked at length about the fact that the symptoms would continue to get better, but if I was to get pregnant I could expect that the symptoms might return and might be way worse. He said that with severe OHSS he would recommend freezing all the embryos and doing the transfer after the OHSS was resolved but there is the matter of weighing that with the success rates of frozen embryos vs. fresh embryos. We decided that we would wait and allow my body to continue to recover before the embryo transfer on Saturday.

I drove to work and almost immediately got a call from the doctor. Ok, to back up a little - we had 9 eggs harvested on Monday and 6 were fertilized (using assisted fertilization where they injected a sperm into each egg) and they had been dividing happily in the lab - and he was hoping we could wait until Saturday, when they had reached blastocyst stage, before we did the transfer. But... he & the embryologist had become worried about the progress of the embryos. Some had stopped growing and the others were not growing at a rate that made them feel confident that they would survive until Saturday so he recommended that we do the transfer as soon as possible.

I wrapped up my work stuff and drove back out to West Lake. Of the 6 embryos - 2 had stopped growing at 5 cells and the others ranged in size from 6-9 cells. He recommended that we transfer the 4 that were larger than 5 cells, so we did that...

The transfer itself was pretty hard. I had to drink a huge amount of water so that I would have a full bladder during the procedure but, of course, things took longer than expected so I was sitting around with a huge full bladder. Eventually we moved into a surgery room and did an external ultrasound - causing lots and lots of pressure on my bladder. Then there was a lot of trouble getting my uterus lined up properly with the speculum - problems caused by the full bladder and the enlarged ovaries. Eventually we got the speculum right and a catheter inserted into my cervix and the transfer of the embryos was a quick process. I had to lay still for 10 minutes before I was allowed to get up and pee. PHEW! A pee has never felt so good! I stayed for another 30 minutes or so and then headed home. I'm on bed rest through the weekend.

The doctors and nurses seemed surprised that Chris was not with me for the transfer. If it had been Saturday, he would have been there - but with a surprise mid-week/mid-afternoon transfer it wasn't really feasible and really - why did he need to be there?

So now we wait...
I'll write a more extensive post tomorrow. For now: a diagnosis of moderate OHSS (on the mild/moderate/severe scale) followed by an early afternoon transfer of 4 embryos! Wow! Totally crazy day. And now I can't sleep. :(

Wednesday, July 27, 2011

OK, I feel really horrible.

I haven't felt well since the procedure on Monday and I'm not sure if it is normal or mild/moderate OHSS. I've had a lot of bloating and pain in my abdomen. I finally made an appointment to see my doctor - he wanted to see me today but I can't go today so I'm going first thing in the AM. I am very uncomfortable and in a fair amount of pain all the time. It sucks.

I've been hoping that it would magically go away, because I don't want to have to postpone the embryo transfer later in the week. The thing about OHSS is that there isn't much we can do about it but it can become life threatening at some point AND pregnancy can make it way way worse. So...

I've been doing a bunch of research and most studies show that pregnancy rates don't vary significantly between using fresh vs. frozen embryos. But I don't want to wait, I want to do it now.

I'm discouraged and depressed - which is compounded by the fact that I feel really bad. Although, I must admit that I haven't been taking any pain killers to help with the discomfort. Chris keeps telling me not to be a hero, but I've just been really really wanting it to get better so I've been in a bit of denial overall. Also, I think I might have a really high pain tolerance - so maybe I am a lot sicker than I am allowing myself to feel. Not sure.

Tuesday, July 26, 2011

I just heard back from the doctor.

Of the 9 eggs that were harvested - 6 eggs were mature, and 3 were immature.

Of the 6 that were mature - all 6 were fertilized!!!

This is good news!

Now we need to wait and see if we are going to do a day 3 transfer or a day 6 transfer (either Thursday or Saturday).

The doctor said he was really pleased with the result.
The procedure yesterday was rough.

It was a small surgery setting and I was put under for the procedure. My doctors - a father and son - have just opened this office in West Lake and I was their first surgery in the new facility. Things went smoothly - but they were only able to collect 9 eggs. We were all hoping for more.

The pain, when I woke up, was really intense. A lot worse than I expected and I was in pain for most of the day yesterday and into today. Today I am bloated, in pain and cranky.

Also I thought I would hear back from the doctor's yesterday about egg fertilization - but there was no call, so now I'm feeling really paranoid and worried.

Overall, I don't feel well, and I'm worried.

I'm back at work today but would have preferred to take more time off. Today I started on estrogen patches and a progesterone vaginal inserts. No baths or swimming for the next few weeks. No baths might be the hardest part for me.

Monday, July 25, 2011

6:40 AM. Heading to Westlake for egg retrieval. The last 24 hours have been uncomfortable, sporadic pain in my lower abdominal cavity. I'm dressed in comfortable clothing and brought some socks, as directed. Nervous.

Sunday, July 24, 2011

Today is the only day during this whole process where I don't have to take any drugs (outside of my normal daily stuff - including a prenatal vitamin and a baby aspirin). No injections today.

Chris did a good job of giving me my big injection last night. It didn't hurt.

I'm not feeling great, but also not incapacitated.

Tomorrow 7:15 AM we'll be in West Lake for egg retrieval!!

Saturday, July 23, 2011

Things are getting interesting around here.

Last night I started feeling really bloated and cranky. Which Chris seems to find hilarious - apparently I'm a riot when I'm cranky. So far he hasn't gotten tired of it, so I'll take that as a blessing.

We made a trek out to West Lake this morning to our doctor's new fertility clinic. I had my final ultrasound and then we went to south Austin for a blood draw.

My ovaries are packed full of giant follicles. Chris said they they looked like pomegranates. The doctor noted that he was surprised that I wasn't in major pain. I'm really not - but I do feel really fatigued (and the above noted bloating and crankiness).

On a side note, I think I should get the prize for WINNING at responding to fertility meds.

WINNING!!

Seriously.

Tonight I'll need to get an injection of human chorionic gonadotropin (HCG) which is given 35 hours before egg retrieval. The timing is really important, from what I can gather. Chris looked a bit gleeful at the idea of getting to stick me in the ass with a giant needle. The doctor even drew little x's on my backside so that he'll know exactly where to shove it.

The trick now is to try and avoid going over into ovarian hyperstimulation syndrome (OHSS).

I came home and lay down with Chris and ended up taking a long nap. When I woke, there was a message from the doctor telling me that my estrogen level is at 5419. I think that might be a lot. And he directed me to only take 1/2 the dose of HCG, instead of the planned full dose.

I'm a bit worried to be honest.

The plan from here is to take the HCG shot at 9:00 PM tonight and then report to the clinic in West Lake at 7:15 AM on Monday morning for egg retrieval.

In the meantime I'm going to go get myself a lime slush from Sonic, take it really easy and try to be forgiving of myself if I am feeling cranky or shitty.

Friday, July 22, 2011

more than 20!!!

My 3rd ultrasound/blood draw was yesterday.

I have more than TWENTY eggs that should be big enough to harvest on Monday.

The doctor called me later in the evening, after my blood work came back, and advised that I reduce my meds a little today. No more morning doses and a smaller dose in the evening. We are trying to prevent over-stimulation.

We have one more ultrasound/blood draw tomorrow and then we go in and harvest the eggs on Monday.

YIPPPEEEE!!!

Tuesday, July 19, 2011

Ultrasound #2 was today.

I have 16 follicles over 10mm (and a bunch under 10 mm). I'm an egg making MACHINE!!

My belly is all bruised and sad looking from all the injections, but I don't mind.

I'm getting kind of excited.

Monday, July 18, 2011

I'm becoming very adept at this injection thing. 2 injections, twice per day.

I showed Chris the whole process and ended up hurting myself a little because I was trying to be all cool and make it seem like it was all easy peasy lemon squeezy - and I went too fast and OUCH OUCH. It hurts, not a whole lot, but it does hurt. I wanted to go OWWWWW but I didn't because I was playing it cool...

He seems a bit horrified by the whole thing but he is being such a good sport, especially when it comes to having to abstain in order to obtain a sample. This is not a man who likes to abstain, at all. In fact, abstaining makes him a bit mean but also really funny. The longer he abstains, the funnier he is. The other morning he came with me to my ultrasound appointment and he was being so freaking funny that I was crying. (It is far better to be sitting in stirrups with a paper sheet over your junk crying from laughter than crying from pain/sorrow). His Death Star analogy about his sperm meeting my egg had the doctor rolling too. Go Chris!

I think I'll keep him.

Sunday, July 17, 2011

Injections, day 2. So far, not bad at all. No obvious side effects.

Saturday, July 16, 2011

What $5688.08 worth of medications looks like in real life.

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Injections started at 8:30 AM this morning. It wasn't bad at all. A bit complicated and fiddly but not bad.

Friday, July 15, 2011

Chris and I went down south this morning and got the IVF process kicked off.

We had to sign a bunch of legal paperwork in relation to ownership of any frozen embryos. We decided if I died, he gets them (with no pressure to use them, permission to destroy them). If he dies, I get them. If we both die - they are destroyed (in order to avoid any strangeness in passing them along to our family who would probably be hard pressed to figure out what to do with them). And if we split up - I'm keeping them but he is totally off the hook for any financial liability were I to use them to make some babies. All seems pretty reasonable, right?

I went and got blood drawn and had an ultrasound. I have 20 follicles!! Go me!

My estrogen is low enough that I am cleared to start the medications tomorrow.

HERE WE GO!

Thursday, July 14, 2011

What $5688.08 worth of medications looks like from the perspective of my insurance company

Menopur Pwd/inj W/q-cap 1's 75 Iu
Insurance paid: $1626.94
I paid: $35.00

Vivelle Dot Patches 8's 0.1mg/d
Insurance paid: $40.87
I paid: $20.00

Needles, etc.
Insurance paid: $0
I paid: $0.40/$6.80

Pregnyl Mdv/inj 10ml 10,000u
Insurance paid: $0
I paid: $55.34

Endometrin Vag Supp 21's 100mg
Insurance paid: $255.62
I paid: $35.00

Follistim Aq 975iu Cart 1's 900iu
Insurance paid: $2838.62
I paid: $$773.49

Tuesday, July 12, 2011

I just got back from my first appointment for the IVF cycle. I have a second appointment on Friday for an ultrasound/blood draw and the medications start on Saturday.

I got back to the office and got a call from the pharmacy - the medications are going to cost $933. HOLY SHIT. But without my insurance, they would cost more then $5000.

HOLY SHIT.

That hurts. Now to figure out where to come up with $933.