I’ve been slacking… I know. So now I’ll give you all the IVF updates. Spoiler alert: We’re getting very close to egg retrieval.
Ok, so all the way back on 5/3 I started birth control pills to down-regulate my reproductive system. This was done to prevent me from producing the hormones that would allow my follicles to “recruit” eggs for potential ovulation. We do this for IVF so that when we’re ready, we’re basically starting with a clean slate, and we can incorporate the medications to make my ovaries do what we want, when we want.
I took my last pill on 5/22, and two days later on 5/24 I had my down-regulation ultrasound and bloodwork to make sure that I was, in fact, down-regulated. My labs were good, and my ultrasound showed ten antral follicles, meaning that there are ten potential follicles to produce ten potential eggs for this IVF cycle. This number really is a guesstimate though; some people get more eggs, but some get less. Sometimes there are follicles there that are too small to see on the ultrasound, but once the medications are started they end up growing and producing good eggs. On the other hand, sometimes follicles just don’t grow, or maybe some are empty. The labs they draw, mainly estradiol (estrogen), are supposed to give a better idea of how many eggs there are, and whether or not they’ve grown enough to be retrieved.
So, backing up to the day of the ultrasound, this is also the day I started a medication called Lupron, which is meant to keep my body from ovulating on its own. If I ovulate before they go in to get my eggs, it’s too late. I was also very eager to start my medications apparently, because I accidentally started them a day early (doh!) I wasn’t supposed to start until 5/25, but I started on 5/24. The doctor said it was no big deal, and that I would just start my “stim” medications (the ones used to stimulate egg growth) a night early (the night of 5/26 instead of the morning of 5/27). So starting on Friday night (5/26), I had to take a shot of Lupron and a shot of stim medications each morning and each evening. Yes, that’s four shots a day.
On Monday 5/29, I had my blood drawn to see how things were progressing. My estradiol was higher than they expected, which indicated that I might have been stimming too quickly. I guess the doctor wasn’t concerned though, because he kept my medication doses the same (they are normally adjusted based on ultrasound and lab results).
Yesterday (Wednesday, 5/31- after 5 days of stim medications), I flew to AZ to continue my monitoring with the actual fertility doctor (I had been doing everything else near home in VA, and he was receiving all of my results to create/adjust my protocol as necessary). My ultrasound with him Wednesday morning showed that I was, in fact, stimming very quickly. I already had 17mm-19mm follicles (they typically consider them ready around 20mm, and they grow about 2mm per day). My estradiol levels seem to have leveled off some, but they still indicated that we were just about ready to go already. The last two times I did IVF, my follicles weren’t that big for about 10ish days (I don’t remember exactly, but I know it was no where near this quickly.)
So, you may think “That’s fantastic! You’re responding well!” Well…. not necessarily. When eggs grow too quickly, there is potential that they’ll lack quality. Yesterday (5/31) we added in human growth hormone at a whopping $615 for five days-worth of doses. That’s supposed to help with quality and overall maturation, so hopefully everything will be ok. Today (6/1) I went in for another ultrasound and blood work. The good news is that all my follicles are about the same size, which is one of the most important pieces of this process. If they’re not around the same size, we end up missing out on eggs because we’d either have a few mature ones and a bunch of non-mature ones, or the mature ones end up over-maturing waiting on the smaller ones to catch up, in which case it’s possible for the entire cycle to be a bust.
Today the doctor counted five follicles, all ready to go… I feel optimistic that there could be more hiding in there somewhere, but if we end up with five good eggs, and they produce good embryos, than I’d say we’re doing ok. Remember last time I only ended up with three embryos, and only two of them were considered “ok”.
So at 7 pm tonight I took what is called the “trigger shot”. This is a shot of HCG, the hormone produced in pregnancy (and which turns pregnancy tests positive), to give the eggs their final boost before the doctor takes them out.
Fun fact: If I take a pregnancy test tomorrow morning, I’ll be really pregnant. But not really. On Saturday morning (6/3) at 7am I will be put under anesthesia to have my follicles aspirated, and my eggs removed. They’ll combine them with my husband’s sperm to create embryos, and then the plan is to let them grow for five days and then biopsy them for genetic screening. They will then be frozen while we await the results of the screening, and then later on down the road I’ll fly back to AZ to have them transferred to my uterus. Our initial plan was to do two of these stim/egg retrievals back-to-back, but that may or may not be happening. For now, we’ll see how things go with this retrieval.
I promise I’ll post another blog on Saturday after I’ve recovered from the egg retrieval. It might be a very short/quick update, but there will be a post.