I had my annual exam with my midwife today. Yet again I was reminded how much I love her and that office. The office itself is quiet, comfortable, organized. It’s modern and nice without being stuffy. And the midwife… well, what can I say! I love her! She’s always so bubbly and excited. She gives me this impression of really knowing what she’s talking about. And even though she needs to consult my chart while talking (I mean, it’s been a year since I’ve seen her) she speaks to me like she knows me. I can’t explain it – she’s just very personable, and just makes me immediately like her and trust her.

The nurse who took me in back and asked me the usual questions hit the jackpot with, “Are you on any medications?” I laughed. She didn’t see what was so funny. She couldn’t spell them. I don’t think she had a clue what they were, either. The midwife did though… she asked who my RE was, chatted a little. She hopes to see me again soon.

While giving me my breast exam, the midwife asked if I do self exams. I said yes I do. She continued palpating and said, “They feel a little…” Her brow furrowed as she searched for the right word. “… hormonal.” I laughed.

She said everything’s looking very healthy, and I’m all set until next year… unless, of course, I manage to come down with a case of pregnancy. (I wonder if that’s sort of like me and chicken pox…)

I do think I’m feeling my ovary today… but strangely it’s my left one that I’m feeling, the one that had less large follicles. It’ll be interesting to see how the next few days go for me. I mean if I’m due to trigger on sunday or monday there really isn’t many more days left!

Oh, and note to self: choose injection sites farther away from my belly button. Tonight’s was the second one that seemed to have hit a nerve straight into my belly button. What a weird, painful feeling that is. (I have a very sensitive belly button.)

And now it is time for sleep, because I have a bridal shower to go to in the morning and I am exhausted. Yawn.

Early morning ultrasound after a late night out does not bode well. I did NOT feel well sitting there in the room, waiting for them to come in. And no, I hadn’t been drinking… I was eating. A bridal shower and then going out to dinner…. I ate a ton of food and oh boy did I regret that this morning. My stomach was doing backflips and gurgles and I had to sit there half-naked for over 10 minutes. Ugh. But luckily once they got in and we got started I was fine… just sitting there waiting with nothing to do but think of how bad my stomach felt wasn’t good.

The “bad” news (and I say “bad” because it’s not really bad news, it’s just not great news) is that I’m not fully baked yet, so no retrieval on tuesday (which would have been ideal for both Den and my schedules). But I have a ton of follies in there… more just keep joining the party. I don’t know the exact count because for some reason I thought they could give me a run-down afterwards, but they showed no inclination of doing so. When I asked how many she said, “33 total” but that includes a lot of small ones.

I was watching intently as the ultrasound tech measured each one… I have a bunch on my left that are 15-20mm, all squashed in there, along with several at 10. On my right they average smaller, with several of them at 14-15mm, then I remember there were 9 at 10mm and about 4 or 6 less than 10. So, given my memory of events, I’d say that of the 33 half are pretty good size and half are too small. Given that last ultrasound I had 6 on my left and 8 on my right that were all 10mm, my left side has been a bit of a hog and they grew bigger, while the 8 on the right are being somewhat lazy.

I also have some “free fluid” in my left ovary, I don’t know how bad that is? Between that and the bunches of big ones on my left explains why I’ve been feeling my left side but not my right. I don’t know, for some reason I thought it would be worse. Maybe it’ll get worse…. but even if it does, it won’t be horrible for more than a day or two. I guess this whole process has been a lot easier than I expected/feared.

The Dr was there and she said that she’ll call me after they get my E2 results back, but that I’ll need another day or two before trigger. I only have two days left of menopur, but she said it shouldn’t be more than that. So we’re looking at a Wednesday or Thursday egg retrieval… I’ll find out later this afternoon what day I need to go back in for another ultrasound. She also said they’ll probably be reducing my dose a little bit again.

I forgot to post… while I was napping today the doctor called and left me a message. My E2 was at 3484, and she wants me to coast tonight (no follistim) and come in again tomorrow morning for another ultrasound. She seems to think I’ll be ready by tomorrow… we shall see! That would mean a Wednesday retrieval.

Tomorrow morning I’m going to write things down as they’re scanning me (which will be interesting to do from flat on my back – maybe I should bring a pencil), and I think I’m also going to ask if I can have a picture of one of my ovaries for my scrapbook. I try describing it to Den and he doesn’t really get it. I find it truly fascinating! I mean, I was amazed when, during my clomid cycles, I had four follicles in one ovary. I thought it was crazy looking! Now my poor ovaries look like giant distended balloons packed full of bubbles. :lol: I’m really shocked that I don’t feel more than I do.

Since I won’t be home until late tonight I’m popping on from work to give everyone an update. This time I wrote down what the ultrasound tech said outloud, so I have a slightly better record. I also asked her for a photo of one of my ovaries, which they did, so I’ll scan that in later. Most women who have been through IVF are probably pretty familiar with it, but I think it’s so cool looking.

Okay, my rundown:

Left side has 14 total follicles. The big ones are 19, 18, 17, 16.5, 16.

Right side has 17 total. Big ones are 18, 18, 17.5, 17.5, 15.5.

I think that’s all the ones she scanned, but she was mumbling a bit to herself so I might have missed a couple. In any case that’s 10 big follicles. Could be better. :? I hope they get more eggs. But I only need one, right? One blast.

Anyhow they’re all big enough so I’m triggering tonight and my retrieval will be Wednesday morning. I’m waiting to hear what time I’m scheduled for (and thus when I need to take my trigger tonight).

It’s unfortunate my morning was so screwed up… I woke up late, rushed out the door, the tech said apparently everyone in Western Mass needed an ultrasound this morning as the wait was very long, which made me late for meeting my client. So I was stressing out in a big way. Tried to focus on my breathing and everything, but as usual once they started scanning me I focused on that and was fine. I just hate the sitting there, waiting.

I got my call yesterday while at work. My E2 yesterday was 5521 and I’m scheduled for retrieval at 8:30am on Wednesday. I’ve made arrangements at work to go in today and have thursday off (and I usually have wednesday off) just in case I need that time to recouperate. I probably will be fine on thursday, but an extra day can’t hurt. (It seriously is fabulous having a supervisor who is completely up-to-date on everything. It saves a lot of explaining when I need a day off!)

My trigger shot was at 8:30pm last night. In some kind of fitting irony, it bled afterwards and is bruising… and it perfectly matches the still-fading bruise from my first stims shot. It’s even in the identical spot on the opposite side of my belly.

No more shots!! Can you believe that? I can’t. I think I’ll miss getting everything together every PM and mixing it all together. It really helped me feel productive. After the retrieval I move on to estrogen patches and progesterone suppositories. Mmmm, fun.

Oh, and here’s the ultrasound of my ovary. Remember that this is just a cross-section of one ovary! All those little black spots are follicles. It’s really neat to see her wand over the ovary and have all these black spots come in and out of view. (click for bigger version)

I also forgot to write that the U/S tech was talking to apparently a student U/S tech who was in the room with us. And she was saying how it’s good that my ovaries are long, because if they bloat up sideways it’s a bad risk sign. So apparently long and lean is the name of the game. (They look funny to me.)

And they (nurse and U/S tech) kept saying that I have a nice long torso, which is helping me out and is probably why I’m not feeling a lot. Because I’m not… every once in a while I get an ache, usually from my left ovary, but other than that I’m feeling remarkably little.

Oh, but… my boobs hurt. A lot. They’ve been tender for a few days… but this past day they have definitely gotten worse!

My stomach says OW. It’s definitely bruising up all purple, and it is very very tender to the touch. Sleeping on my stomach? No-go. In the grocery store I reached up and forward to grab something and my stomach bumped the cart handle right on that spot and I nearly jumped out of my shoes. Doh. I hope this goes down soon.

Also, my boobs are continuing to be Not Fun. Just walking my dog out to the woods without wearing a bra was painful. (I rarely have to wear a bra, my boobs just don’t bother me very much, even if they are a C-cup. So this is very weird to me. And irritating.)

And yet my ovaries, where everyone said I’d be so uncomfortable by this point? Don’t bother me at all. Go figure. Snort. My body can’t do ANYTHING right.

So I found out something tonight that is making me wonder about labor and delivery. I was talking to a friend who lives in this area and it turns out she’s been seeing the same RE office as I am, though she hasn’t been in a couple of years. She mentioned that the office also has a ob/gyn group in that office… different set of doctors and nurse, same waiting room and office. (Which explains the old woman who was in the waiting area the other day. THAT confused the hell out of me.)

The thing is, when I looked up this group’s info on the web it said that they deliver at the women’s center… you know, the place I mentioned before as where I wanted to give birth at, as opposed to the actual hospital. When I asked my midwife where they deliver she said “***”, the hospital that includes the RE and women’s group. But I’m wondering if she meant specifically the hospital itself? I’m wondering if other obs can deliver at the women’s center, other than that group of obs? Questions, questions… ones that may have answers I don’t like. If it turns out the midwife only delivers at the hospital, not the birthing center, I have a hard decision ahead of me… which one is more important to me, staying with my midwife, or birthing in the women’s center?

I guess that’s a decision to be made at a later date – after I’m actually pregnant, and after I know exactly what the situation is. But it’s something I didn’t know about before.

:: ::

I am impatient tonight. Counting down the time. I’m excited about tomorrow, but not in a huge jumping-up-and-down way, but more of a focussed, determined, let’s-do-this kind of way. I want to find out how many eggs they get… how many fertilize… how many keep growing. I’m nervous about the IV though. Last time did not go well and that was the most painful part of my entire surgery. Here’s hoping it goes well!

I arranged with my cat job to have wednesday and thursday off (I usually work part of thursday) to recover… I worked today instead. And then of course I talked with my new client who wants me to work in his office for a day or two so I told him I can come in thursday (since wednesday is out of the question, and friday I’m busy all day). Well, at least it’s a seated office job, right? Just hope I’m okay to drive and concentrate. Everything I’ve read said I should be fine to work the day after the retrieval. But hopefully it will only be for a couple of hours!

ETA … Did I mention that the nurses/doctors think I’m a possible candidate for OHSS? (Ovarian Hyper Stimulation Syndrome – Not A Good Thing.) My E2 levels are over 5000 (even though I coasted that last day) and I have tons of follicles. They mentioned that it’s proably all those follicles that is causing my E2 to be so high. But they got me to take only a half-dose of the HCG trigger. She said something about it doing the job, but lessening my risk of OHSS. I’m only just now starting to get concerned about that. I forgot OHSS is an issue after retrieval (and not before).

We woke up at 6am with Den telling me to get out of bed and get in the shower with him, and that he wanted to leave by quarter to 7. It takes us half an hour to get the hospital and I was supposed to be there at 7:30… so I’m not really sure why he added so much time to his estimate, but probably “just to be safe”.

We got there with plenty of time to spare and went to the surgery center. I gave my name and she said I was supposed to be downstairs in the IVF unit… ah ha. Go down there, wander through to the end of the hallways like I was told, push through a curtain… and there was the whole retrieval suite. Wow, I didn’t even know that was there, lol! They immediately got me into a little curtained-off room, undressed and in one of those beds. I answered questions (“What’s your name? What’s your birthdate? Why are you here? You pass!”), signed some paperwork, and the nurse told me everything that was going to happen.

Then she went to do my IV. I had written on my paperwork and told her that last time it took four tries to get my IV started and she waved it off with a, “Oh that won’t happen this time. I’ll be doing your IV, and I have plenty of experience!” She was very nice, not snotty or anything. Just jovial. So she picked a vein on the side of my left hand, big pinch, etc etc. Then she says, “Hmm. I’m not sure I like that one.” She turned it on a little bit and asked, “Is this hurting?” It started to puff up a little bit. “Oh dear. It’s not supposed to do that. I don’t like that at all. I’m so sorry!” Apparently I have very small veins.

Luckily the second try worked and she taped it in and said she liked that one much better. So at least the success rate has gone up. But even after she taped it in place and left it was… twinging me. I could feel it tugging on my skin a little bit and it was just creeping me out something aweful. I am even more sure now that I DO NOT want an IV during labor. I know it doesn’t bother a lot of people – maybe even most people – but it bothers me to hell and back and I just do not want ANYTHING bothering me when I’m focussed on labor. I actually mentioned that to this nurse – or rather she overheard me tell Den “No IV during labor,” and she said that I’d have to have one anyways, for fluids, even if I didn’t want medication. We’ll see about that. I know people do manage to go through labor without one, and I intend to be one of those people, barring unfortunate circumstances. I do NOT like IVs.

I do however, love anesthesia. Sitting there waiting for my turn in the OR was the most annoying because my IV on my hand was bothering me and my stomach felt bloated (even though I just went to the bathroom), and there was nothing on the little TV. Plus of course the tension just from waiting and wanting to get on with it. But soon enough the anesthesiologist came in to check in with me, the embryologist came in to make sure we had signed egg freezing consent forms, and then the Dr came over to say I was ready to go. They helped me out of bed (with the IV in they had to carry that bag thing with me), I held the back of my “gown” closed, said goodbye to Den, and walked through some big doors. Then another door and into the operating room. They got me to sit and then lay down on the table/bed thing that was there, then the nurse wrapped me in warm towels (aahhhhhhh, so nice!!). I had to put my arms out to either side of me on the “wings” so that the anesthesiologist could put on the blood pressure cuff, finger clip thing, and then she put some stickies on my chest (for monitoring… something-or-another). They put an oxygen mask on me and the nurse kept babbling about Natalie Wood and how much she liked her and what a nice name it was. I, uncomfortable with the IV and the oxygen mask, was just hoping they sedated me really really quickly.

Next thing I know I’m back in my bed in the little recovery room, Den’s reading a paper beside me. I was groggy as heck. But, unlike with my lap I came out of it quickly. However later Den did tell me about a conversation I had with him after waking up that I do not remember, period point-blank. He also said that when I first started to stir my hand immediately went to the oxygen mask to touch it. I told him I didn’t like that damn thing – even heavily sedated I wanted it off. :lol:

So then the moment of truth. The nurse came in and told us that they had retrieved 24 eggs!! Wow!! I was thinking they’d get 15 or so, and I was really hoping I’d get closer to 20. But 24! We are both very excited by this… though Den said he’s not going to feel less anxious until we hear the fertilization results.

After I’d gotten up and successfully peed on the potty they took out my IV (YAY!) and let me get dressed. I was given instructions to take it easy and take pain meds if I felt I needed any (I still have the percocets left over from my lap – I only used 2 of them). I was also told that I’m okay to take advil/ibprofen until my egg transfer. They said some cramping is normal, same with a little bit of spotting, but if it becomes anything more than that to call the doctors right away. The Dr also spoke to me about OHSS… she confirmed that because of my age and response that I am at risk for it, so to definitely stay aware and let them know if I feel anything at all. She said even if we have a day 3 transfer, if I’m feeling a mild OHSS they’ll only put back one embryo regardless – and if I have moderate/severe OHSS they may have to cancel the transfer, freeze all the embryos, and wait until it goes away before doing a transfer. That would be a downer, but my health really is paramount. (OHSS goes away shortly when you’re not pregnant – but pregnancy can make it worse and last a lot longer.)

She said to expect a call around noon tomorrow to let us know how fertilization went, and to schedule our transfer. I guess if we have a good fertilization rate we’ll be going for a 5-day transfer (monday), if it’s not good it’ll be a 3-day (saturday). Fingers crossed that we get a great fert report and get scheduled for a monday transfer of one perfect little blast!!

This shirt is a must-have for my baby. Awesome!

I got the call today. It’s sunny out, I’m feeling relatively good – a little bloating, but nothing else to complain about. Den and I were joking around this morning… he said he won’t feel okay until we get the fertilization report and he knows his sperm did their job. I laughed and said I’m hoping for 15. All we need is 6 to go to blast stage, we’ll have plenty. An average of 75% of eggs retrieved will fertilize. 75% of 24 is a really good number.

And this is one of those times when average means jack shit.

The nurse said I feel good, I told her yes I do. No complaints. Then she said the results weren’t what they’d hoped. My heart sank. I’m thinking 5? 10?

And she says, “One fertilized.”

My brain stopped thinking. She kept talking. She said she’s sorry. She said that there was absolutely no indication that this would happen… nothing wrong with the sperm yesterday at all. She said the doctor is glad we went straight to IVF, as any IUI would be a waste of a lot of time for us.

Of 24 eggs retrieved – a great response – we now have one single embryo sitting in a petri dish. If it makes it to saturday they’ll transfer it then, a day-3 transfer. If it makes it. There’s a pretty decent chance it’ll arrest before then.

I’m just devestated beyond words. Somehow I think I’m more upset than if everything had gone perfectly and still not gotten pregnant. All those eggs were our safety net. If we fell on the wrong side of the 50/50 this time, well, at least we’d have a bunch on ice. This time… whether or not we actually even make it to transfer, there will be no frozen egg transfers.

I guess next time we’ll be doing ICSI. I keep telling myself that. We’re not out of the game yet. We have one more cycle paid for by insurance (though we’ll have to come up with the money for all the meds), and we can do ICSI and hopefully get past this fertilization problem.

And we still have that one embryo. I’m hopeful and terrified all at once. This one could be our miracle baby. Or it could leave us with absolutely nothing.