Thursday, January 31, 2008

the update...



today is day 3. of the 11, we had
grade 1: 0
grade 2: 0
grade 3: 4
grade 4: 4
grade 5: 3

evenly split between icsi and ivf. grade 1 is the best and grade 5 is the worst. we transfered two grade 3's (the ones above) one icsi and one ivf. they will grow out the other 6 and will freeze them if any make it to blast but they told us not to get our hopes up.

i questioned why i went from 50 follies to 23 eggs and they said usu the follicle:egg ratio is 90%. however with hyperstim, coasting and ant.agon all of which i got or had, it drops alot. he's seen as low as 25% follicle:egg but most are around 50%. he said the coasting intentionally kills some off.

lessons learned for next time i guess. still, i'm trying to remain hopeful and optimistic but not too hopeful or optimistic. i was really hoping for some to freeze so i'd never have to stim again, but then if this cycle works i'll get over it pretty frikking quickly.

love to all my cycle sistahs.

Wednesday, January 30, 2008

kvetchy post (no egg update)

this is going to be a whiny, kvetchy post in which i give no info on the state of the 11, because i don't have any. which brings me to my first point of contention:

1--the non-responsiveness/non-customer orientedness of my clinic. there are advantages...it's cheaper since it's partially covered by the military...but there are significant disadvantages. the constant rotation of care providers. no-one answering their phones. no one calling me back in anything like a timely manner (like, 3-5 days goes by). they act like they are sort of doing us a favor by providing the service. if this cycle doesn't work i'm strongly considering leaving. i think i'd rather pay more money and have someone who at least acts like they give a crap than deal with this 'you'll-take-what-we-give-you-and-like-it' military mentality. to wit: i called to see how the 11 were doing. i would like to know if any/all were still there. it's not crazy; i put ALOT into this, and i'm on edge here. when someone finally answered the phone they said that there were no updates and they would let us know tomorrow at our appt. basically the only way we hear anything before then is if they all go kaput. and here i thought it was customary to be told how things were going on a more or less daily basis. oh well.

2--it could be the OHSS, but i ended up with far more diminished returns than i thought we would. 23 eggs from 50 follicles seems like a big loss. the rest i guess seems more reasonable: 19 mature from 23 eggs; but then i'm suprised again that only 11 fertilized normally. if they keep dropping at this rate, there won't be any left. i was hoping with 50 follicles that i'd end up with some embies to freeze (and thus NEVER have to go through a stim cycle again) but now i'm not so sure we'll have any. it's weird to go from a relative superabundance to a relative dearth in just a few short days.

3--and speaking of ohss, i'm symptomatic and it sucks. i got albumin in my iv on monday to ward off ascites but my stomach really is just unimaginably bloated. and it hurts. and when i laugh my entire stomach hurts including my sides and my shoulders. and i'm afraid to mention it for fear they'll cancel transfer. i'm hoping the fluid will just get resorbed sooner rather than later.

4--no one told me how much it would hurt to pee the day of retrieval but it did. all day.

5--of course, this could all change in a flicker if tomorrow's report is good

Tuesday, January 29, 2008

fert report

23 retrieved
19 mature
11 fertilized.

that's all for now.

Monday, January 28, 2008

so far...

23 eggs of usable size retrieved
e2 7800
OHSS mild right now, got albumin in the IV at retrieval to try and prevent any worsening of the hyperstim.

i think i'd have had better follicle : egg ratio if i weren't so hyperstimmed. i am not sure if there's any factual basis to that though, have to look it up. it's done now, there can only be lessons learned for next time.

fingers crossed that all 23 fertilize and go on to make me and my hubby proud parents of our own soccer team plus second and third string backups.

Saturday, January 26, 2008

ant.agon, i'm sorry i doubted you.

e2 down by HALF!
this is incredible, unless they switched my sample with someone else's. :P
trigger tonight with all 10,000 units HCG.

i found this old picture of me and my sister. i'm guessing we're 11yo and 9yo but we might be 10yo and 8yo. awwwww...

the rollercoaster continues

50+ follicles today
the largest was a 21. i didn't track them all, but most were around 14-16 with several 17-18 and a few 20's.
e2 pending
some fluid around the r ovary and in the pelvis
:(

i picked up another ant.agon/ganril.ex shot today. pending the e2 i'll either trigger or take the gan.rilex. one of the dr's who was not familiar with my case reacted with utter horror when i told her the # of follicles i had. i wish i hadn't said anything. another dr who is familiar said they've been talking about me the last few days. never a good sign. these dr's i ran into in the hall, since the wanding was done by a resident that i've never met before...again.

i had a nightmare yesterday that i was in the car with my sister and mother...i was squished in the back seat. the car was on an overpass, and took a sharp zag through a concrete chute into open space. the falling sensation was incredible, i literally felt myself adhered to the ceiling of the car as i fell. i woke up with a start and wondered if my R ovary had ruptured.

i also failed to appropriately set my alarm for 545 and i woke up late...but at 6am. amazing.

Friday, January 25, 2008

good news

clinic called...ant.agon and meno.pur tonight, sono and b/w tomorrow, hcg tomorrow night, retrieval monday? nobody said the c-word.

e2 for this morning: 6890. which is i guess what happens with 45 follicles. the doc this morning said (with a straight face, mind you) 'we're going to have to watch you for overstimulation.' ummm...ya think?

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in very sad news, please go give your support to the mama of lennox and zoe, who suffered a devastating loss today.

fun with e2

i'm waiting on today's level, which is likely to be in excess of 6,000. how can this be, since i stopped stims yesterday and am essentially coasting? because this morning there were 45 (!!!!) follicles between 10 and 18. i had 30 on the right (up from 18 follies two days ago)
2--18
4--17
1--16
2--15
2--14
and a bunch smaller.

the left, which had 8 two days ago, has 15.
2--17's
2--15's
2--14's
1--13
1--11
6--10's
1--9

they are going to call me tonight with the plan, but i picked up an ant.agon shot...has anyone ever used this to lower e2?

at least no one mentioned cancellation which i am of course really worried about. ptu! ptu! ptu! ward off the evil eye.

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i actually mostly feel ok except my abdomen feels bloated and tender. like, when my right heel hits the floor when i'm walking, i can feel it in my right lower abdomen. same on the left. also the weight gain, and general slovenliness. but i'm trying not to complain or say anything because i DONT WANT THE CYCLE *whispers* cancelled . PLeasE! i don't even know if i can explain how devastated i would be. :(

Thursday, January 24, 2008

coasting

today's e2 is 4,712...about 50% up from yesterday, but that's actually better...it was up 150% between mon and wed. b/w and sono tomorrow. no meds tonight except the lu.pron. worried that my poor follies will starve for want of fsh (plus unopposed lu.pron is no fun) but i'll take that over some of the other alternatives.

Wednesday, January 23, 2008

"like gangbusters" (updated)

RE referring to, of course, mighty righty. i am on day 7 of stims, including today, cd 10. i have 18 (!!) follies on the right, i think i had one 14, 5-6 13's, 5-6 11's and a smattering of littles.

i had 6 on the left, 2 11's, a 9, and 3 6's.

apparently, at least the right, responds well to stims. now we know.

he said they like the e2 to be about 200pg/dl on day 5 of stims, and mine was 3x that. so depending on what today's e2 is determines what happens next. for now they cut the dose of stims again, so i'm on 1/2 dose of bra.velle + full dose lu.pron in the am, and full dose bra.velle and full dose lu.pron in the evening. they want me to come in tomorrow AM for bloodwork but i'm trying to push it to friday because i have class an hour and a half away from the clinic at 0830. so i'd have to get to the clinic at 6am. and let us say...BOOOOO!

based in the info so far, it looks like retrieval (aka big sharp pointy stick in the vadge) sunday or monday. i've yet to find a compounding pharmacy in the area for my PIO, so that's my next chore.

what are the odds that LJ my cycle sistah and chaperone, would have her own date with the vag.inal needle of doom on the same day? crazy.
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ummm, OK. my e2 is 2958. i have to go get my bw tomorrow and i'm sure retrieval won't be later than monday.

Monday, January 21, 2008

MEH

my baseline was 5 days ago and my e2 was 12pg/dl, which is a good level for beginning stims. today, after 5 days of stims, my e2 is 973pg/dl...which is high. it's very hard to find good ranges for what an e2 should be after 5 days of stims and day 8 of the cycle (and if you know of any, please let me know!) but from what i can gather, the acceptable range is from 100pg/dl to 500pg/dl at this point. so i'm to continue the lu.pron and bra.velle at current doses and stop the men.opur.

in other cycle news, i think i gained 5lbs in one week. so, that plus the high e2 of course i'm all worried about OHSS, and having the cycle cancelled, and other completely undesireable outcomes. i feel like i can feel my right ovary (the good responder). but now i can't tell if i can feel it, or if i just think i can because i'm all freaked out. meh MEH meh.

Saturday, January 19, 2008

things your dr doesn't tell you about eyeveeff cycles

1--there will be bloating

2--and water retention

3--not to mention weight gain

4--and you can kiss goodbye any semblance of bowel normalcy you may have had prior to the art cycle. your farts are now equal parts involuntary, plentiful and deadly. they resemble nothing so much as chemical eff YOU from your poor beleaguered abdomen against all other living beings, and may, in fact, clear a room (strategy for dealing with said stinkbombs: deny, deny deny. the truth takes too long).

i feel like, somehow, i didn't know or no one mentioned that my relationship with my midsection would be completely different in a rather unpleasant way. besides the fact that i'm sticking needles into that poor bastard 2x/day. at least right now i'm visiting CL for the weekend, so he can take up some of the jabbing that needs to be done. he gets to shoot me in my back fat, which is really glamorous for all involved.

Wednesday, January 16, 2008

baseline=groggy

well, i had my baseline appt at zero-dark-thirty in the morning today, all the more special because i finished clinical at 2am the night before. the baseline was everything i hoped and more. i got venipunctured, dildocammed, and "chaperoned" by an obliging stranger that i picked up in the waiting room, just as they said i would. "himynameislauraiknowwevenevermetbut..." actually, i was sort of glad i did have a chaperone today. i had a lovely and patient dr, one who i've actually seen before which is a rarity at my clinic. he did one or two of our IUI's and he's really soft spoken and gentle.

these are good qualities, except when the problem is not being able to find your left ovary. my right ovary was very cooperative. it was right where it was supposed to be, and i think i had maybe 20 antral follicles. in the past when i've triggered i've almost always felt it on the right side. the left was just nowhere in sight. and really, the minutes do seem like DAYS when the legs are up and the dildocam is in. finally, failing to find the ovary with more conservative measures, he pushed on my stomach right above the pubic bone on the left, apparently hoping to scare my anatomy into place. i couldn't help but flinch. and i was suddenly, momentarily, very glad for the chaperone. thankfully, the ovary then decided to make a grand entrance and demonstrated it's near lack of follicles, clear disinterest in the process at hand, and whispered off behind a loop of bowel from whence it came.

then i was the chaperone for the stranger, who, coincidentally enough, also had a hiding left ovary. she got the same abdominal treatment i did, apparently to less spectacular results. the doc asked her if she'd ever had abd surgery and she responded 'only the tubal ligation, and then the reversal.' some little evil part of my brain immediately thought: 'well, it's obvious why she needs IVF, what the hell am I doing here?' the doc did eventually find her left ovary as well.

i then got a tentative schedule (the best part of all this so far). i start lupron and stims on thursday, back for more blood work next monday, and more bloodwork and an u/s next weds. tentative retrieval 2 wks from today. i argued passionately that as i give people injections nearly daily, i should be able to skip the injection class tomorrow at buttfugearly. the class won't help the mental block that comes with giving yourself shots and that's really the only part i need help with. thankfully, i was excused. i'll spend my hooky day smoking cigarettes and buying black lipstick, just like i know i should :).

i found out a short while ago (when we were paying the bill, actually...HA! Suprise!) that the clinic has automatically slotted us into the ICSI category because we are using a previously frozen sample. i talked to them about it today and they said that with a frozen sample, there's a 90% chance they'll do ICSI but it isn't 100% positive. i'm having a hard time with the ICSI thing. it seems that if they do ICSI, then whoever is the dr working that day is literally choosing our future child(ren). how do they pick? cutest sperm? fastest swimmer? only boys on tuesdays, only girls on wednesdays? i know it's stupid, but i'm BLAH about ICSI at the moment. it has it's place, and i can totally see myself a year from now typing in something about how ICSI is our last great hope, but for now it sorta weirds me out. it would be nice if the union of sperm and egg were not medically directed, even though most everything else in this process leading up to the union is.

there is some unmitigated good news in all this though: my last bcp was actually sunday night, since due to the short night i forgot to take yesterday's pill. SWEET!

Saturday, January 12, 2008

i know they are good for female kind but...



i *hate* being on the pill. seriously, it makes me feel like hammered poo. i don't know how i was on it for 15+ yrs (HA!) because it makes me nauseous and starving all at the same time. eating helps neither the nausea, nor the hunger. delightful. i didn't notice it before, but i guess in the 3 or so years i've been off the pill, i've recalibrated. and then, of course, there's the rich irony of being on the pill in and of itself.

i'm going to switch to taking it right before bed and see if that helps. cheeky bastards.

Friday, January 4, 2008

are you grateful to your parents?

i just saw sib*erian a*doption story on DHC and one of the couples portrayed seemed very very odd. besides the weird obsession with a blonde haired, blue eyed "american looking" kid (what does an american kid look like anyway?), they kept referencing the 35K they spent and how they were 'rescuing' their adopted daughter from her otherwise reduced circumstances. they took pictures of their daughter's homeland so that they would have visual evidence of the favor they provided her by adopting her.

now, i'm sure it is infinitely better to be raised in a family than in an orphanage. but i think that couple expecting their child to be grateful she was adopted by them is just a tad bit unrealistic. infants have no say in their birth or adoption. it just happens to them, the same as it happens to all babies. when was the last time anyone gave thanks to their *biological* parents for just being born? or for not being 40X poorer or twice as crazy as they were? seriously, all our parents are crazy, but they could have been a hell of a lot crazier, and then where would you be? if you expect the adopted child to be grateful for her adoption, then you must yourself be grateful for the circumstances of your birth...that you were born to relative priveledge in america and not to, say, a drug addicted sex worker on the streets of bangladesh. now, go give your biological parents a sincere, heartfelt thank you for creating you and not being worse than they were, and THEN maybe you can start wanting your adopted kids to start feeling grateful for their 'rescue.'

people's circumstances are what they are. all of us could have been born/adopted into better or worse, just as easily.

that couple sounded very concerned that after their 35K spent etc. that their teenage daughter would resent them and go looking for her "real" mother. i think if they spend her upbringing hoping she'll be grateful for her adoption, they may actually create that which they most fear.

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i also have a feeling that if i ever do have bio kids and i demand that they be grateful to me for the fact of being born at all because of all the time and heartbreak and expense and invasive vaginal procedures with cold steely probes at zero-dark-thirty in the morning and nowhere to park etc. involved with concieving them in the first place (to say nothing of carrying/delivering etc) well, i think they would be justified in saying 'i never asked you to do any of that!' which is 100% true.
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on a completely unrelated note, look at that cute little baby tushie!!! my teeth hurt it's so sweet :)

Thursday, January 3, 2008

getting way way way ahead of myself

today i was on a parenting board where a bunch of parents (only mothers, actually) were talking about how much work they had to do and how little support they get. stories abounded about fathers coming home from work and heading straight to the computer with nary a glance at the baby; of dads staying up late watching movies and then sleeping in the next morning while the mom was up with the baby all night; of offering to 'babysit' their own children for a few hours while mom gets some rest; of being mad at being left with the baby alone for a few hours while mom goes grocery shopping etc. now, mind you, i am aware that this thread was a rant, and that i was only hearing one side of it.

but UGH. it depresses me because i figure that if those women were divorced, they might end up with more help on average, or at least more free time. this is because the father would have visitation without the mother around. meaning, he would have to figure out a way to deal with the baby during his visitation, and she would have a set period of time in which she couldn't deal with the baby even if she wanted to. i start freaking out thinking about my overwhelmed and overworked future self and start planning the ways to prevent that from happening to me. images of signed antenatal agreements and firm contractual obligations dance through my head.

which, of course, is utter and complete lunacy. i have zero kids and i'm not pregnant nor am i in the process of adopting. i might not ever have this problem. who knows, maybe cl and i might be one of the (seemingly few) couples who actually manage to have shared childcare responsibilties that suit both partners. on the other hand, i could have a medically fragile kid who spends 3 mos in the NICU and i would give anything to be up at night doing the majority of the babycare because at least i'd be doing it and not his/her nurses. i could have a kid with a major disability that required even MORE work than i can currently even fathom. i could never have any kids at all.

i also recognize that seeing my mom utterly overwhelmed and miserable for years on end probably has more to do with my huge irrational fear of being overwhelmed with childcare responsiblities than anything that is going on in my current situation. i will say this for her...she got it done. she stepped in and deserves much credit. on the other hand, i would never EVER want to be in a situation as lonely and overwhelming as hers was. if my options were doing it all myself or never having kids, i'm not sure what i'd choose.

i also think i should worry about things that are more immediately pressing, like, where is my checkbook? where will i work next year? why am i not either a) buying exercise equipment or b) joining a gym? is this round of IVF going to work? i realized in the car today on my way to women's health clinical that even in the best circumstances, IVF doesn't work >50% of the time. that means the default is that it WON'T work. interesting, nu? i feel like right now i'm OK with it not working, but i wonder how many IVF cycles i'll be willing to try. 2? 4? 6??? and there i am again, getting way way way ahead of myself.

on to much better topics
my godnephews ryanbear...



...and andrew (doing his best jazzhands...he also does a mean zoolander 'blue steel')