I wish I had written this a long, long time ago but it took a friend cycling to make me realize how important the following information will be for those of you going through IVF, IUI…. Do not ever let your follicles get too big. My former RE likes to trigger when the cohort (most of the eggs) are measuring 17. The simple fact is that eggs (especially older eggs) often will not have great outcomes if they get much larger than 22. Heck, even 20. If you are doing an IVF cycle and you notice that most of your eggs are in the 18 or 19 range then you should have triggered…plain and simple. Do the research and see what happens when your follicles get too big…
When in doubt you need to question. Try a low dose cycle for the heck of it (you can always convert to an IUI). I find it interesting that I produced the same amount of eggs on 300 menopur/300 follistim as I did with a 150 menopur/150 follistim – sometimes more isn’t better…in fact, sometimes more is not good at all. Just a little PSA.
Let me know if any of you have had bad results with large follicles (or the reverse and don’t forget your age!). Good luck to everyone trying….
I keep meaning to post IVF # 4 – 6 and their stats, etc. You know, just in case someone really wants to hear about my ovarian response to gonadotropins. Actually I learned a lot from reading about other people’s cycles. I probably wouldn’t have my son had I not come across a blog back in 2006 where a woman had zero fertilization of 17 good looking eggs – thanks to her I made sure we did ICSI on each cycle and had good fertilization.
Unfortunately this blog is turning into one long moan and I am sorry to say that there isn’t much I can do about it. I’m not the kind of person who can wait and see. I need to know what I am facing.
So here I am facing a deep dark hole – I am 8 weeks today. Yesterday, at 7 weeks 6 days, the embryo measured 7 weeks exactly – 7.2 days if you use another measurement. I have earned my google MD….and over the past 24 hours I’ve become an expert on reading fetal ultrasounds prior to 9 weeks gestation. So the facts are that I measuring behind – to be precise, the embryo is measuring (the CROWN RUMP LENGTH or CRL) exactly 1cm. This corresponds to a gestational age of 7 weeks exactly (there is a plus or minus of 5 days but….I received this reading from two different techs so I’m going to trust it). Last week I measured 3 days behind and now the gap is widening. This could mean a number of things.
1. Abnormality. Triploidy/other chromosomal abnormality in the embryo seems like a reasonable diagnosis for slow fetal growth.
2. Sac size not growing fast enough to accommodate growing fetus. My sac is measuring 5 weeks 3 days (which translates to 2/3 days ahead of the embryo). I won’t bore you with the minutiae but basically this is a death sentence.
3. Blood flow problems. I have a blood clotting issue. I am on lovenox injections once per day to keep my blood clot free and flowing. Hopefully this is working because these shots are a mother. My legs are bruised and battered and quite frankly, I spend a good deal of my day dreading them. When my husband does the injection it definitely doesn’t hurt as much. I’m such a wimp that I SLOWLY stick the needle into my thigh and then even more slowly inject the fluid. I don’t think I’ll ever get used to giving myself injections.
The good (there are some glimmers of hope here):
1. The embryo is a girl. Read this: The longitudinally collected observations showed that CRL in female fetuses was significantly smaller compared with that in male fetuses
2. Late implanter. Could be – I did have lowish betas and who knows when I actually conceived on an IUI cycle (though I suspect it was within a 24 hour period of November 4th).
3. Tech error. Again, highly unlikely that two techs are going to come up with the same measurements.
So I guess I just have to wait until Monday’s ultrasound. I have to remain hopeful that growth will be consistent and that the heartbeat (154 bpm) will remain strong. The prognosis isn’t good though – from every story I have read of women in the same position…probably 80 percent resulted in miscarriage.
I don’t know – am I? I thought I was 6 weeks tomorrow but who am I to argue with my RE? Sorry for the lengthy absence but I’ve had nothing to say. In times of stress I tend to retreat and shut everyone out.
I was doing fine, actually. I fully intended to wait until Friday the 5th of December for my ultrasound but…I woke up this morning and scheduled an ultrasound. I KNEW it was too early but my curiosity and nervousness got the better of me. And, as expected, there was no heartbeat. All that could be seen was a gestational sac and a yolk sac. My RE assured me that this was completely normal and that early ultrasounds are discouraged for this very reason – it just causes more stress. He instructed the nurses to prohibit me from having another ultrasound until next week – which made me laugh. When I quizzed him about my need to do IVF in the future (I mean…IUI did work and IVF did not) he told me that I basically got lucky (I’m not sure I agree with him but that is another story). Then he rolled his eyes and reminded me that I should focus on the good news and not start planning for the failure.
Before some wise ass tells me to “think positive” and stop being so negative – I would like to say just one thing. It is easier to fall from a chair than a cloud. I read this on my IVF message board and couldn’t agree more. So back off and understand that my negative thinking is protective. Thanks. And to all my friends who call and email and worry about me – I’m fine. I just don’t feel like talking about it. I’ll be back soon, I promise.
My next ultrasound is scheduled for a week from today – Monday. I have absolutely no idea how I am going to keep my mind occupied but considering I have a very active toddler, I’m sure it won’t be hard.
I know better than to pee on a stick at 9 days past ovulation. But I did and you guess it! Nada.
Most people would wait until their blood test but I like to soften the blow. Makes it easier. Even though I know I still don’t have the answers I seek – I’d rather expect the worst. So here I am – expecting the worst!
Blood test is on Monday. I’ll pee on more sticks tomorrow am.
I’ve scheduled my polyp removal, tentatively. Had a long chat about insurance coverage (and am excited about the fact that we can probably do 3 more IVFs before it starts to really suck the life out of our bank account)….what else did I do?
I cleaned the sink! Flylady.net is my new thing – because I am a procrastinator and I’m just way too creative and intelligent (her words not mine) to pair socks and organize kitchen cabinets.
My husband came home drunk last night after poker with his bosses. Kept me up nearly all night as he forgot his key…
He was very excited to read about the lady whose boobs won’t stop growing – so, if you are out there – and I KNOW you are (because I see that someone has done yet another search for BOOBS WON’T STOP GROWING” today)….let us know how things are going. If you want to know what I really think about your boobs growing – you are either 15 years old and suddenly have hit your growth spurt, you are pregnant OR (and this is pretty common with me) you are about to get your period and you are eating way too many curly fries.
I’m getting this injection 1x per day in the rear end. The shot is long – in fact, here – have a look – the longer syringe is the the one – it is about 1.5 inches long – long enough to hit the muscle. Trust me – it is scary to look at and the oil goes in painfully slow…. What I love the most about these shots is that the oil forms a hardened lump underneath my skin – after many shots I start to get a little shelf on my buttock. It takes a very long time to go away. About six months, actually.
I’m still feeling crampy and I have dark blue veins covering my breasts. Then again – I’ve been here before only to have it disappear but for now, something is trying to do something. I’m sure of that.
Sorry for the delay – after all the excitement (and I mean excitement!!) of November 4th I’ve been feeling exhausted and a bit muted.
Where was I? Oh – November 4th, 2008 – election day and insemination #2.
The morning started out horribly – basically a disaster. We’d arranged for C to take his sperm to the clinic at 7:30am to be washed and I was to show up at 9:30am for insemination. At 7:50am C told me that the task was impossible….there was no way he would be able to produce another vat of semen. He tried and failed. I started to google “life span of washed sperm” and the results were confusing – it seemed that 24 hours was the maximum …and I was due to ovulate SOMETIME that day – if we didnt’ have another batch to greet these eggs on ovulation – the entire cycle might be a bust. I started to get a bit hysterical but caught myself. Poor C did not need the added pressure…and so I told him to go to work, get a few things done and return around 10 to try again. In the meantime I prepared myself to vote. Lines were long in Atlanta and I didn’t want to get stuck in a five hour wait. My friend Amy and I went together with Alex in tow. As we voted, C returned and worked on getting a sample…
Voting was a great experience – never before have I been this excited about a candidate. I worked hard to get Barack Obama elected – talking to just about everyone I met, haranguing our Republican handyman and all of my Republican friends.. I registered about 20 people to vote and worked on the phone banks (very not like me). By November 4th I was ready for this election to be over.
When I returned to the house C informed me “I was able to get some sperm for you but it was very difficult – in fact, I think I’ve bruised myself” which made me laugh.
Two hours later I went to the clinic and was told that C’s specimen was over 80 million sperm – which is just amazing considering he had similar numbers the day before. In they went….and now we wait. I think I did ovulate later that day….on election day. If this did work – what an amazing day to be conceived!
So far I don’t have many symptoms – which is natural you might say but every single time I have been pregnant I’ve felt certain things early on – from the day after conception. I do feel like my uterus has something in it – a certain fullness…and my breasts are killing me but that could be the side affect of the progesterone.
Anyway – muted post but I’ll write more when I am less tired (hey, good sign!)…and tell you about my amazing election night party – and the break-in we had at the house this week (while C was away in California and I was alone with our son).
I’m still pissed off about Prop 8 and feel like it is time to get more involved in helping my gay and lesbian brothers and sisters in their struggle for equality.
Today we did our first of two sperm injections. We had to take our son with us – which proved to be a huge nightmare. I’m very sensitive to the feelings of my fellow infertiles and strongly believe that a child has no place in a fertility clinic. It never really upset me but had I had several failed cycles, I don’t think I’d be able to bear seeing one at the doctor’s office. Anyway – he came along for lack of child care options. C and I took turns keeping him occupied and tried very hard not to let him tear the entire waiting room apart (no luck). C gave his specimen and we then went to McDonald’s to wait for them to prepare the sperm – spin it free of white blood cells, crappy sperm, etc. When we arrived back 2 hours later they were ready for me. When I saw the nurse she said, “well your husband has a great sample for you – he has 85 million sperm ready here”. My jaw nearly dropped to the ground. 85 million post wash! That is 120 million pre wash – just insane. Let me put it this way – you only need 20 million post wash for an IUI to have a good chance of being successful. The nurse advised me not to tell him because, as she said, he would get a big head. I agreed…but ended up telling him. I’m not sure why I did this because I’d much rather have him believe that his sperm are the reason we are doing these procedures but, I guess it isn’t anymore!
On to the insemination, I normally don’t see my doctor during cycles – this is a large practice and the doctors all rotate for procedures. Of course I know my doctor and have had many chats with him but I am just not used to spreading my legs and finding him down there – if you know what I mean. It is so much easier when I don’t really know the person. So, in walks Dr. S – who is rather young and handsome and all of a sudden I realized that I had not even bothered to make myself acceptable for viewing (to put it delicately). The poor guy basically had my entire womanhood in all its glory right in his face – and I was cringing the entire time. In the middle of the procedure – after he had inserted the speculum – he asked the nurse to hold down on my bladder as he was having trouble inserting the long tube into my uterus. And then the nurse says, “oh be careful not to pee on the doctor”.
Oh darn – just what I had in mind to do.
I was so glad when that shit was over.
I was also glad that my doctor seemed stumped by my “excellent response” to low dose stims. When I asked him what he thought about all of this and how it could benefit future IVF cycles should I not get pregnant he said he would have to have a think about it. Well I already thought about it and came to the conclusion that I have spent thousands of dollars on medication and probably damaged perfectly good eggs because of a protocol that was all wrong for me. Thanks doc.
So – IUI part 2 is in the morning.
I just had my trigger shot. 8 follicles have grown – which is just amazing on such low dosages of medicine. I’m not comfortable at all – I feel like my ovaries are huge bags of rocks. My doctor gave me an extra night of stimulation drugs to get a few more to grow and it worked. Tomorow afternoon we will have our first insemination and then on election day morning we will have the second. I should ovulate at approximately 9:45am on Tuesday – 36 hours after the trigger shot. Again, I don’t have a great deal of hope – the odds are something like 8% to 17% that this will work- this was more an exercise in medication experimentation and I’m happy with the results.
I do have to pinch myself when I start daydreaming that maybe, just maybe we’ll get boy/girl twins out of this but that would be like the Mets winning the world series.
We now have approximately 5/6 follicles in the running..with a few more lagging behind. This is fairly shocking news for me – this is the same kind of response I have gotten on max stims. There is a theory out there (Dr. Schoolcraft in case you are wondering) that says more medication makes poor egg quality in older women. I am doing this IUI instead of an IVF to determine how my body would respond on fewer med dosages and so far we are seeing that perhaps I don’t need all that extra medication..and maybe even the high dosages have been hurting my eggs. I don’t have a great deal of faith in my husband’s sperm, however so this was always going to be an experiment. However! His sperm quality has dramatically improved (to the point where he is now considered a normal, fertile male rather than sub fertile). He has huge volume, motility and 14% normal forms (up from 5% a few years ago). Poor C will look forward to the day when he is allowed to sit in a bath again.
Looks like I am triggering on Saturday night…
I tried to vote today in Georgia but the line was about five hours long…and so I will wake at the crack of dawn on Tuesday and cast my vote for the only candidate in my lifetime that could inspire such action.
Up very soon – IVF #4, 5 and 6…..
Two weeks ago I failed IVF #6. It was a bit of a surprise for me but I’ll save that for another post. Today I am day 8 of an IUI cycle (intrauterine insemination). Normally I take a very high level of medication to stimulate my ovaries. I’ve never been on any other protocol…so this time I decided to ask my RE to lower my dosage in half to see how I might respond. So far it hasn’t been that bad. I’m on stim day 6 (have not taken the meds yet) and I have four measurable follicles. In fact, I’m quite pleased with this result. At the end of this cycle (Friday or Saturday) I’ll get a trigger shot and C’s sperm will be injected – two times, a few hours before I ovulate and then again the next day. Given our low rate of fertilization I don’t have high hopes but…you never know! It is all about hope and I’m trying to muster some up. In the meantime I am interviewing every IVF clinic in the Atlanta area. So far I’ve learned one thing – I’m my own advocate. Seems like the more you know the more you realize that this is just a crap shoot…you need to be on the right protocol of medications, have your body respond to those medications, have the Gods of fertilization on your side, a good thick lining and an normal embryo to implant in your uterus and continue to grow. It really does surprise me, given all the factors involved, that pregnancy ever happens at all…and yet most of the world doesn’t need all this – they just have sex. Remarkable!
If this cycle doesn’t work I’ll be having surgery in December to remove a polyp in my uterus..and then beginning IVF again in January.