Finally got the call from the nurse – presumably after a significant amount of conferencing between doctors and nurses about this sticky situation. Some of the typical options in this situation – the half-dose trigger, or retrieving and freezing – aren’t very good options for me with my severe egg maturity problem. But damn was I worried, sitting here all day waiting for someone to call me.

My E2 levels are as I expected, at 6500. So they’re not going to trigger me tonight. I coast tonight (just lupron, no stims or menopur) and go back in tomorrow to check my E2 levels again. If they’re around 5000 then we trigger. If not, we wait another day. She said they really want to transfer me this cycle (ie, not have to freeze and wait because of OHSS) so they’re just going to let me coast until things come back under control and then trigger and retrieve.

Hell, maybe my eggs will appreciate the extra day to grow up. They had better frickin take advantage of this, you hear me eggs?! You think REALLY HARD about how you can use this extra time. I suggest reading some books. Get in a college education. Learn all about spermies and embryos and how you can contribute to the greater good.

So I wait another day. Perhaps it’s just not possible for me to have a cycle without some kind of unexpected disaster to strike. Maybe this will get it over with so we can be pleasantly surprized at fertilization. (Ahahaha. Yeah, that’s the sound of me laughing hysterically.)

Surprizingly I still don’t feel all that uncomfortable. I mean, yes I’m bloated, and yes I’m a little tender around my midsection, but I still don’t say it’s that bad. I get the feeling that people kind of expect me to be curled up in the fetal position, moaning. Other than being a little more deliberate when I sit down and stand up, I don’t notice much difference. (Though I will say I’m not too fond of the cat standing on my belly right now. Especially the fat one.)

My belly itches from where I got my last few shots.

My body apparently craves the appropriate things. The other day I wanted chicken noodle soup. Today I wanted peanut butter. I just kind of go with whatever it wants. (Unless it wants chocolate. Because it is a TRICK!! Okay, okay, I still eat it. But it’s with the full knowledge that it is a trick. I swear.)

Today was a stressful day, me getting more jittery by the hour as time stretched on and no phonecall came. Tomorrow doesn’t look to be any better.

I believe that this is one of those cases where ignorance is bliss. I feel like if I had just taken the nurses optimism at face value I would just happily be puttering around coasting, waiting for retrieval. I just happen to know just how bad a high E2 level is, how overstimmed cycles get cancelled and overstimmed bodies get OHSS. I know too much to pretend that it’s all going to magically be okay.

My E2 did not go down. (However, it was not as high as I thought it was – apparently yesterday it was only at 6050, not 6500 – that is a good thing.) Today it’s… 6051.

However, the head doctor – the one in charge of my case – has decided that I should trigger anyways. Retrieval is set for Thursday morning, 9am. I take my trigger at 7pm tonight, giving me that 38 hour interval that has the potential to make all the difference.

Now I’m not really sure why he decided to trigger me today and not yesterday. I don’t think the nurses do either. Maybe he’s worried that waiting longer will hurt my eggs, maybe he just thinks that waiting longer won’t help the E2. I’m really not sure why yesterday we waited and today we don’t, but there’s obviously some reasoning behind it.

My levels are not at a crazy level – but they’re certainly within the risk range. However I just looked at my first cycle levels, and on trigger day they were 5500, so not that much lower… and if I got any OHSS that cycle it was supremely mild.

But more than my health I am worried about my poor little eggs. How many there ends up being retrieved is not nearly so important to me as how many – if any – are mature enough. Will the early trigger be enough? Did my eggs get a slow enough start to be good quality? Friday is going to be the worst wait yet.

Onward to retrieval.

I actually feel better today than I did yesterday. I slept just fine last night (whereas the night before I was tossing and turning quite a bit due to the pressure every time I tried rolling onto my stomach – which is usually quite frequent).

It felt so monumental to be sitting there with my ovidrel tonight. I stared at the clear liquid contained within the syringe, wondering how such a small amount of something can be so hugely pivotal for so many things. Is the timing going to be the key? Is using the ovidrel rather than the hcg going to prevent OHSS for me? Such a big moment, but such a non-moment – it felt like any other daily injection, yet it wasn’t. We both stared at my belly for a moment afterwards. “So that’s it, huh?” I lay here, concious of – yet seemingly unconnected to – the processes that have been started within me.

We’re committed now. I know things can change, and change drastically in a short period of time, but once I got the go-ahead for the trigger shot the retrieval was set in stone. Tomorrow should be an easier day for me to get through than the last two, simply because I have a timeline now, I know what the next step is. It’s a relief.

Like KC reminded me, this whole cycle has been one huge hurdle after another: the insurance approval, the tight timing, and then overstimming and just trying to get to retrieval. The next big hurdle is THE big one: egg maturity and fertilization. The one I’m most worried about.

Today was a pretty hairy day as far as my concentration level goes. I don’t think I’ve ever had to error correct that many things at the bank!

I felt a little bloated and tender, same as yesterday. Which is to say, not much. Monday was worse.

But then I came home… and I ate dinner. And for whatever stupid ass reason, I decided to have brie cheese on crackers, with milk, and then follow that up with a lovely desert of gummie bears. Let me tell you, NOT A GREAT COMBO. Especially when you’re stuck burping it up for the next several hours.

I’m starting to think it’s the milk. I’ve felt pretty good since I stopped drinking straight milk, instead choosing to drink only water. And when I drink alchohol (and thereby get sick) it’s always a mix with milk or cream. So I’m wondering…

Other than the stomachache that has me burping and my intestines gurgling nastily, I feel fine. Ovaries tender? Sure. Swollen? Sure, I look a little pregnant – can’t suck it in anymore. I’d say that’s pretty normal… or maybe quite mild considering how swollen with follicles my ovaries are.

I’m excited for tomorrow, but at the same time I’m not really wracked with nerves. And I don’t know why. Shouldn’t I feel giddy? Anxious? Anything? I guess I just know exactly what to expect from the procedure. What I remember of my past retrievals are the following: painful IV tries; warm blankets; comfy bed; excitement; oxygen mask; being pleasantly loopy for hours; waking up to the news of a good number of eggs. Other than the IV it’s all pretty positive.

The part that I’m very unsure about is fertilization. I just don’t know what to expect. It could just as easily be zero embryos or 4. I just don’t know. Friday will probably be a very nervy day, waiting for the phone call. And yes, I’m going to be at work. That will be fun.

I’ll have my phone with me tomorrow to update when I can… or when I get home, though I do intend to pass out cold when I crawl into bed. (I’m always very sleepy after anesthesia.)

I’m just a big jar full of jelly beans. How many do I have??? Could be 20, could be 50. So take a guess! How many eggs in total will they retrieve from my poor overstimmed little ovaries on thursday?

Winner(s) will get a shiney graphic for their blog and the satisfaction of knowing they are psychic.

GUESSES:

Em (mrslady1975) – 10
Tash – 12
Delen – 15
Becky – 17
Kery – 18
Cori – 19
Julia aprilmiracle – 19
Kelly – 23
Eden – 23
WaterBishop – 24
Eveline – 24
Shannon – 25
Emerald Rose – 26
Mel – 26
Karen – 27
N – 28
Karla – 28
Leigh – 28
Ali – 29
Caba – 30
Holly – 31
Kel – 31
kRenee – 32
Amber Nicole – 32
JuliaKB – 37
Lyanna – 38
Manda – 41
KC – 41
Marie – 42
Malky B. – 48
Andrea – 50
Cynthia – 73

Replacing the twitter feed with the posts from that day and the day following.

We have 2 embryos!!!!! 9:12 AM Dec 12th from mobile web

I am so scared that one isn’t going to fertilize. 7:47 PM Dec 11th from TwitterFox

Eating a complete meal not such a great idea right now. Oh so uncomfortable. Bleh. 7:18 PM Dec 11th from TwitterFox

Dr mentioned another research paper he read which has something else to try next time – using a different type of drugs. There’s still hope. 4:32 PM Dec 11th from TwitterFox

Dr. Just called to let me know the initial evaluation of my eggs… only one is mature enough to ICSI. I’m disappointed, but not surprized. 3:45 PM Dec 11th from TwitterFox

And the winner was: 38 eggs!! 9:54 AM Dec 11th from mobile web

Had nightmares all night that they wouldn’t let me do the retrieval. But I feel better so it really was a stomach ache! 6:05 AM Dec 11th from TwitterFox

I went about my day with a decided lack of enthusiasm. Relief, yes – excitement, no. We got to the hospital on time, got myself undressed and situated in the bed with blankets covering me. Then the fun part: the IV.

The nurse said she was pretty good at IVs. I watched as she used some novacaine to numb the area, then used a small needle to carefully thread into my vein. She liked it. I was relieved it went so well. She taped it all on and I relaxed.

Then she frowned at the drip. “It’s slowed down.” She pushed gently at the IV in my hand, and apparently it started up again. After fiddling with it for a few minutes she ended up taking all the tape off and re-taping it… and that was enough. I was starting to resign myself to getting stuck again, not my favorite thing in the world but par for the course.

Of course after that I didn’t so much as move my left hand.

There was a ton of paperwork. Roughly 4 different people introduced themselves and went over paperwork – the same list of questions. Have you eaten today? Allergic to anything? Any history of heart or blood problems? Finally everything was done and they got me to walk into the OR.

Layed down on a very funny looking bed, head on a pillow. Arms out to my sides, then she covered them and the rest of me in really warm blankets – ahhhhh, I love that part! Legs in stirrups. Then they said it might sting a little as the medication went into my IV. Yep, I felt a little burn… very slight… and then a very very happy buzz. I drifted off.

I woke up much quicker this time than the last two times – I remember it used to be such a struggle to get and stay awake. This time I was lucid quite quickly. I felt a lot of cramping, though, which I do not remember from last time, so they gave me some pills to help with that. No sense in being uncomfortable if I don’t have to be.

Someone came by to tell me they had gotten 38 eggs! I wasn’t surprized by that. Neither was the RE who came by a bit later (actually she mumbled something about expecting 45).

I had juice and saltines, they unhooked me from the IV, and got me up to pee. By then I felt well enough to get dressed and get going. Den went to pull up the car and the nurse walked me out and off we went!

After we dropped off my prescriptions we went out for brunch. Yummm, I treated myself with a big waffle with strawberry and whip cream. I love those damn things.

I came home, posted a little, then ended up drifting off in bed for a long nap.

I woke up to three voicemails. Apparently I had forgotten to turn my phone ringer back on after we left the hospital. One was from my dentist, reminding me about my appointment on Monday. One was from my mom, asking if I was okay and could I please call her back. And the third… was from the doctor. The head doctor.

You know how sometimes you enter a state of suspended expectation… where you really just have no hopes or thoughts? That’s kind of how I was. Especially when he said, “Unfortunately I don’t really have good news for you.” I feared he would tell me they were all bad and nothing could be done. But he said one is “possibly mature” – that the lab thinks they see a polar body (what is this “thinks” and “possibly” thing??), and they’re going to ICSI it. Then he went on to say that what they’re going to do is select 10 eggs to do traditional IVF with. That is to say, they’ll put them in petri dishes with some sperm and see what happens. The rest of the eggs they’re going to re-evaulate in the morning to see if any have matured so they can do ICSI still.

Again, it really wasn’t surprizing news. After my last two cycles’ huge disappointment at fertilization, and this cycle’s overstimming, I just really feared the worst. I’m a little relieved we have one possibility, to be honest. I know it could go either way. But the one statistic on my side is that every mature egg we’ve had has made an embryo. I know I’m knocking on wood by saying that, but still, that’s my track record. So if it is mature… we should get an embryo. Should. No guarantees. We’ll find out tomorrow if we have anything at all to transfer.

Which is a shitty space to be sitting in. Just like last cycle. Just waiting to see if we have anything at all.

I did call the doctor back to speak with him. He apologised that the news wasn’t better, but I told him it’s honestly what I expected with the way the cycle went. I had hopes it would be better, but no expectations. Unfortunately it does seem that the extra 2 hours after trigger didn’t do much of anything. But he said he’s found another research article that talks about using a different type of drug to stim in low oocyte maturity cases (I thought he said HSG drugs, but I very well may have misheard that! Maybe it was HCG?). I’m really glad he’s willing to use me as a guinea pig… I’m happy to keep trying this until something works. Especially since it worked once.

As for how I’m feeling physically… I have not needed to take any more pain meds since I got home. I feel some twinges now and then, but it’s nothing much. I’m a little tender. I still feel bloated. But considering how many they got from me? Not bad at all.

This cycle has been a completely hellish roller coaster. I walked into work this morning feeling very… small. My boss excitedly asked me how it went yesterday, and I shrugged. I told her it went okay, but it wasn’t looking promising. How do you explain to people who have no concept of IVF just how dire things looked? How do you possibly try to illustrate that 38 is a fucking lot of eggs, and to have only 1 good one is beyond bad. It’s depressing.

I kept my cell phone close at hand and checked for any voicemail. I was very surprized when at 10:30 there was a missed call and 1 new voicemail. I excused myself and ran into the back to listen. It was the nurse. She said that they were ablet to inject 3 eggs (!!) and that two of those had fertilized. She said that she knew we had all hoped for more this time, but that we had “two good eggs and the lab was very happy this morning.”

Tears welled up in my eyes as I listened, pacing the small room. I was reminded of the day I got the news we were approved for insurance – same room, same pacing, same rush of relief and gratitude.

I’ve been thinking about how it could have gotten from one “could be mature” to them doing ICSI to three (presumably mature) eggs and getting 2 to fertilize. Obviously some eggs matured after their initial evaluation right after retrieval. Yesterday at the bad news it seemed obvious to me that those extra two hours before retrieval hadn’t done a damn thing. But now I’m looking at these numbers, wondering… What if those extra 2 hours did help enough for the eggs to be able to mature after retrieval? What if 2 hours just wasn’t enough, they need maybe 3 or 4? I know 4 would be pushing the limits of spontaneous ovulation, but it might be worth pushing to 3 hours next time. I also wonder, all those extra eggs, did they hinder the process? Would the numbers have been even better if the original 10 follicles had been the only ones? I’ll probably have a discussion with the doctor again later.

I will note here that I am very pleased with this doctor. He has displayed a willingness to try different methods of attack on my immature eggs, as evidenced by his on-the-fly plan yesterday of combining conventional IVF with ICSIing immature eggs on the off chance that something would work. He also has showed me he’s continued to research this subject and keep trying in future cycles. He has also impressed me with the way he speaks to me. He doesn’t talk down to me at all. Ever since I approached him with that research paper and plan he has seemed to share tidbits of research with me, speaking to me directly. I really, really appreciate that. I feel like he’s not just treating me like a patient, a number. For him to call me directly and offer up sympathy and possible things to try… well that means a lot.

It occurs to me that this is the first time we’ve had 2 embryos at the fertilization report. Remember that in my first cycle we didn’t find out about the second one until transfer – it had fertilized late. So the previous two cycles I spent the time between retrieval and transfer feeling very hopeless, wondering if our one solitary embryo was going to kick the bucket before we got to transfer. We’ve never had a spare. I’ve never felt like we had options, backup. Oh it feels wonderful!

To answer the question that everyone is asking: we are only putting back one. Den would probably put two back, but I am not willing to risk twins – not after ending up with a stillbirth after a very low risk singleton pregnancy pregnancy. You can tell me twins are low risk all you want, but I am far too aquainted with how “low” risk does not mean “no” risk. I’ll be terrified enough as it is next time without adding more to it. But beyond that, we know transferring just one embryo has a very good chance of working for us, as it worked before. I am pretty confident at this point that the reason for our infertility is entirely my egg maturity problem – in other words, it is NOT an implantation/lining issue. One embryo is all I need. Especially if it’s a really good looking one, like Devin’s embryo was.

We will be freezing the second embryo, so if this time doesn’t work we can just thaw out our frosty and do a frozen egg transfer – much easier on my body, especially given my body’s tendency to overstim. And that is very exciting to me. I feel positively giddy at the very real possibility of having a frosty. After last cycle I really never thought I’d ever get one – it seemed like I was doomed to doing a fresh cycle every single time. Plus statistically it actually makes more sense. I believe the last statistics I saw for my clinic was the pregnancy rate for single embryo transfer was a little more than 50%, the success rate for 2 embryos was 66%. So you have a higher overall chance of success by doing two consecutive single embryo transfers than doing one transfer with 2 embryos.

I am so looking forward to Sunday. I’m excited to put one little jellybean back inside me and begin the dreaded two week wait. I feel like we really have a chance now… and I know anything can happen and it does come down to pure luck, but oh my wouldn’t that be a fantastic christmas gift?! Going by the same pattern of my last two cycles, my beta should be exactly two weeks after my retrieval… which would be… Christmas day. Yeah. I’m assuming they will schedule it for the day before or day after.

I feel like celebrating, but unfortunately I don’t think I’ll be doing much celebrating the next couple days. My ovaries are pissed. I am so sore… I was walking very slow at work today, very gingerly getting up onto and off of my chair. They just feel so huge, so tender… it’s like they finally realized what was done to them and they’re throwing a fit. I’m incredibly bloated – I look quite pregnant, lol.

If it is OHSS it’s very mild for the time being. I’m wicked bloated and have some aching pain, but that’s not very surprizing given how many eggs they got out of me. I did gain a couple of pounds as of yesterday evening, but that can probably be attributed to the fluid I received via IV. I have no nausea, no further weight gain since yesterday, no trouble breathing, peeing or eating. So I’m okay with this. I’m just taking it easy and getting friendly with my heating pad.

And when it comes right down to it I would gladly suffer for a few days – hell, even a few weeks – to get some good embryos. So I’m far from miserable… it’s just another price to pay to get closer to our goal.

I have been continually amazed by the support around me (us). On my forums, here in blogland… you all bring me to tears with how excited you get when things go good for me, and how upset you get when things go badly. It’s not just a bunch of people driving by to say “Well shucks, that sounds aweful.” I feel your love and support, your caring. And I thank you for it.

On two different forums I was a member of a due date group throughout my pregnancy. I have heard from other babyloss mamas on different forums that they often feel unceremoniously removed from their pregnancy group – even though they spent many months there. I am grateful to say that I absolutely do not feel like that. One of my groups just approached me to ask if it was alright if they used Devin’s picture in their little group siggie, that they want to include him and the other babies who were lost because it just didn’t feel right to leave them out. I really choked up. Thank you for not forgetting me. Thank you for not leaving us behind.

There are a lot of people out there who really can’t understand why I spend so much time online, and why on earth I would want to share private things online. They don’t get it at all. But look how rich in friends I am. Look how much support I have. It’s amazing.

I look forward more than anything to sharing my next pregnancy with you all – with my friends here in blogland and my friends on my forums.

Oh, and also, I don’t know if I ever mentioned it, but could the person/people who sent me this fabulous shirt let me know so I can properly thank them?? It was the perfect thing to wear to retrieval!

(Me after retrieval – tired, accomplished, and hopeful.)