Big News

I don't even know where to start!

Pre-Reading Vocabulary:

Trigger Shot: The shot I will take intramuscularly 36 hours before egg retrieval. James will administer this shot in my hip (right above my butt!).

I went in for my routine appointment this morning. My assumption was that after today's appointment, I would be told to come in for monitoring every day until the estimated egg retrieval date of Wednesday 1/14. I soon learned (once again) that it is not a good idea to make assumptions.

The office was much more crowded than normal today. When I was finally called back for blood work, a nurse that I have never seen before greeted me. I presented her with my left arm (the one with the sideways vein) and explained the direction of my vein (which was very difficult to see beneath the bruise above it). She had no trouble finding my vein. In fact, of all my blood draws- this was by far the best. I give her an A+. After the draw, I emptied by bladder like I am always told to but was then sent back out to the waiting room because there were several people ahead of me waiting for ultrasounds.

After some time, I was finally called back. I got myself ready and sat on the exam table. I was shocked when a man dressed in a shirt and tie entered the room. I have not had a male va-jay-j doctor in over a decade and I immediately felt uneasy. However, the man introduced himself as Dr. somebody and explained that a nurse would be in just a moment. I was intrigued and explained that I hadn't had a doctor perform an ultrasound yet and wondered if doctors always perform the ultrasound at this stage of the cycle. He told me that doctors don't normally perform the ultrasounds at all; it was just that they didn't have a technician in today. I then realized why I had been waiting for so long. I quickly learned that was no reason to feel apprehensive afterall, as he did an excellent and thorough job. He talked me through everything he was doing and I found myself engaged in an informed conversation with him the entire time. The nurse even asked questions, as I believe this was her first time witnessing this procedure. I am also guessing she was in there to protect him... being that he is a male and I am a female. On my way out (later) the nurse told me how impressed she was with my questions and how much I knew. She told me that I would never believe how uninformed some patients are. She cracked me up when she explained that some patients don't even know their birth dates!

So the ultrasound was a little more uncomfortable than normal because my follicles are growing. My right side is still behind my left... but the doctor measured three follicles on my right side (although one was still pretty small) and 5 on my left. He told me he counted 9 follicles total. I don't know what has happened to the others... but once again, he explained that they only need one egg! When I expressed my disappointment, he assured me that I was right on target.... then, he shocked the heck out of me when the told me that there was a good chance I would trigger tonight! "What?" I screamed. I know my protocol is only estimated- but in my mind, I had it that I would be triggering Monday night... triggering today would be 3 days early! I asked him about the size of my follicles and the largest is measuring at 20 (remember, they want them between 18 - 24) and the next two are at 19. The other 5 he measured are between 10 and 16. He told me we wouldn't know for sure until this afternoon and brought me to a more private waiting room to wait to speak with a nurse (oh... I got dressed first!).

While waiting for the nurse two great things happened.
1. My doctor, Dr. Timerick came out to talk to me and once again explained that she wouldn't know anything for sure until she saw the scans and go the blood work. When I explained that I was shocked about potentially triggering and that I wanted more than 3 follicles to be in the appropriate range, Dr. Timerick calmed me by telling me that depending on the results, she could potentially push my trigger day to Saturday. She pleased me further when she broke out the math! She told me that there was a 65% change she'd have me trigger on Saturday. I let my OCD shine when I quickly said, "Good, I love that number, it is the product of my wedding date, 5 x 13!"

2. While I was still waiting for the nurse to finish up with a patient, another couple sat down beside me in the private waiting room. Every time I see a patient, and more so, a couple I can't help but conger up the reason why they might be there. I found myself wondering if the man was the woman's father, or husband. When I learned it was her husband- I settled on the fact that his sperm is probably old and that is why they were there! Anyway, Dr. Timerick asked Elena (the woman) how she was doing and Elena could not hold back her smile and exclamation that they were both doing GREAT! I was a little surprised by her response but all the more curious. After Dr. Timerick left, through speaking with Elena and her older husband, I learned that the reason why Elena and her husband were so happy is because she is 6 weeks pregnant, with twins! Their first IVF cycle worked and she had just had her first ultrasound. I thanked them both for being in that waiting room with me and told them how blessed I felt to have met them at that moment. It was a wonderful way to enter this next stage of the process.

I was finally called back to meet with the nurse who explained the instructions for when I trigger. She gave me a handout with phrases highlighted and dates written on it. I asked lots of questions and couldn't wait to get back to school, get through the day, and hear from Joy.

Fast Forward Several Hours...
I couldn't answer my phone fast enough when Joy finally called at 3:53 p.m. She told me that everything looks great but they decided to give my body one more day. I told her that this is what I was hoping for and she was glad to hear that. I asked her several questions and she was more than happy to answer all of them. Here are a few things that were explained to me:

• My estrogen level is at 1073 (I love that number). The expectation is 200 per mature follicles.
• While they counted 3 mature follicles, there could be more. On average, they like to see 3 or more.
• The hormones I am taking do affect bathroom use (number deuce). For some it is not enough, for some it is too much. Fortunately (I think), I am the latter.
• I should not expect every egg to fertilize. 98% of the time, some eggs do not make it through the night. This is normal. It is very RARE that no eggs fertilize, but can happen.
• A day 3 transfer is no worse, nor any better than a day 5. It depends on the development of the embryos. I finally am ok with this answer.

We spoke for a while! Because the Columbia office is closed tomorrow, I had to make an appointment at the Rockville office. My mom is coming for the "weekend" tomorrow morning (with my nieces) so I made the appointment for 11:15 a.m. so she can join James and I. I was told to take my p.m. meds tonight and my 5 units of Lupron in the morning. I will receive a call tomorrow afternoon after my blood work and ultrasound have been reviewed with instructions for tomorrow night, which will more likely than not be to TRIGGER!

What the next few days look like...
If I trigger tomorrow night, it will be at a specific time that is 36 hours before I am to report to the operating room at Shady Grove (Rockville). My egg retrieval will be on Monday (time to be determined). James will provide his sample at home and we will bring it with us. After they verify who we are, they will put me to sleep for the procedure. I can't wear any jewelry, deodorant, lotions, etc.

I won't take any medications until after the retrieval and I will receive those instructions on Monday.

Either 3 or 5 days later, the embryos will be transferred back to me. This will occur either Thursday or Saturday. If it happens on Thursday, I will take off from school Thursday and Friday. If it happens Saturday, I am off through Monday anyway- so I won't need to take any days.

For two weeks, James will inject my hips with Progesterone in Oil which apparently is not the most pleasant feeling. At this point though, I am ready for anything! I say, "Bring it on!"

I know this has been a short novel- but it helps so much to get the millions of thoughts that are running through my head out! If you've made it this far in reading- I say "Kudos to you!" and "Thank you!" I know I tend to ramble. There are no words that could ever express my deep gratitude for your sincere interest in what we are going through. I am blessed with so many positive thoughts, kind words, and support! You are so much a part of the reason why I am actually so even and grounded right now... my support system has been unbelievable and I am so very thankful!

I am sure I'll write again tomorrow... with a million more thoughts! Until next time...