Add the Trigger Meds!

Day 13– Waking up to what feels like a bowling ball resting on my stomach. Is this what it’s like to be pregnant and have to pee every 30-minutes?

The weight of carrying these full follicles is getting heavier and it’s as though gravity is pulling my belly button down to the ground.

My right ovary seems non-existent in my body as I move around but my left is as though there are water balloons squished up in there.

Is today the day we will pull the trigger?

It’s possible and yet I don’t want it to be too early if there is a chance the little ones will still grow to 17 or 18mm. Remember, 18mm is mature and anything smaller may not produce a healthy, viable egg.

I get a pinching prick into my arm. My poor vein is so yellow and bruised.

Into room 3 I go for another monitoring.

As the nurse closes the door for me to undress, I fall to my knees. “God, I surrender this outcome to you. Help me be calm and accepting of what you are doing inside my body.”

A delightful sonographer joins me in the room and we begin.

Sure enough, we have big black circles on the screen. She measures 11 follicles ranging from 9.6mm to 24.8mm, wahoo!! Then comes the left, a little smaller but that is not new information. Eleven follicles there too, measuring from 11mm to 20mm, yippee!

I have 22 follicles measured total with 8 follicles being of mature range (above 18mm).

There are 7 that are either 15-16mm and they ‘might’ grow to be 18mm by the time we retrieve, or they might just be too shy.

I give those over as I can’t do anything about it.

Ok, I’ll be honest, I really want to stick myself with some of the drugs I have at home, even just a little bit just to give that extra boost.

I tell on myself to Hubby so that I can see how insane that would be.

I’m not the doctor, I have never been through this before, and I don’t know what I’m talking about.

I just have to trust. Sit back and trust.

I bet we trigger tonight, so I’ll wait for the call from our nurse to confirm.

Oh my goodness… Thank you body for responding so well to these medications. I don’t know what the quality of my eggs is in there, but I have done everything I can to help them be healthy.

I’m so grateful to be at this point in this journey!

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6 hours later

We receive a call from Nurse Christine. Wonderful news as she confirms 21 follicles with at least 15 of them being a mature size, yippee!!

Tonight, we will trigger!

She has our instructions for the medications.

Stopping all Gonal F, Menopur, and Cetrotide we turn towards the trigger shots.

Since I don’t have a period without medical intervention, Dr. O’Brien decides to use a dual trigger method. I will inject myself with Lupron and hCG tonight and visit the clinic in the morning for blood work to make sure it’s all absorbed and properly ‘triggering’.

There is a hesitation of using the hCG because it could cause the ovarian hyperstimulation syndrome (OHSS).

Dr. O’Brien decides to go with a small dose of hCG and will add more tomorrow if my blood work shows my body is not responding.

After a quick tutorial of how to mix the sterile water with the white powder medication, change the needles and draw just the exact amount prescribed, we say our goodbye.

We spend the next 2 hours waiting to hear from the scheduler to know what time to give the trigger shots tonight (which will be 36 hours from the retrieval time).

Trigger shot at midnight TONIGHT for a retrieval of noon in 2 days.

On we go!

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I fall asleep to help the time pass and wake up at 11:55pm to get ready for the shots. Hubby stayed up and mixed the solutions for me so all I have to do is prick and return to bed.  (What a great Hubby, such support.)

The hormones rush through my body and it takes me an hour to fall back asleep. Finally, I do, one day closer.

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Let the tears fall

Dr. O’Brien pushed our egg harvest (retrieval) by two days since my body started off with low estrogen. Typically, day 12 is when we prepare for the trigger shot to force ovulation, but today is another monitoring day.

Hubby comes with me so he can see the beautiful follicles we are growing.

My stomach region is more sensitive and I feel the pressure mounting as I move.

Thankful, I give praises and I know the follicles are growing.

Another prick of my bruised veins and then into the monitoring room.

This is Hubby’s first time to see and I’m excited for him to experience this.

Sure enough, we have pretty black circles and round shapes front and center on the monitor. The right side is showing off with follicles measuring from 14-22mm. The left is still a bit shy with the majority of follicles measuring around 14mm.

Our nurse explains that although women are born with all the eggs they will ever have, they still need to mature. The maturation process happens within the follicles. Mature eggs are said to be in follicles that measure between 18-22mm.

Although we count at least 15 measurable follicles, only 5 of them are mature.

My heart drops.

We will most likely go one more day to give the smaller ones time to grow.

I pray that we go one more day as it seems too early to trigger now.

Tears begin to fill my eyes as I fear we won’t have enough mature eggs to move through the next steps of the process.

I am scared that we have done all of this and we won’t end up with a good harvest.

My emotions take over and I let the tears fall. I know I am on major hormones but these tears seem so raw and real. tears.png

God, what are you doing?

What else can I do to help these to grow?

How can I ensure they are all healthy, vibrant eggs ready to meet their partner in creating a baby?

I can’t do anything more than what I’m already doing.

I feel helpless.

I have no control what my body will do.

Although modern science is incredible to get us to this point, this is where God shows his stuff.

God, I surrender. I am so scared that we have done all this and we won’t end up with a single viable embryo.

Even more scary to me is that we do all this and we end up with one embryo and we miscarry or we have a full-term pregnancy and then we don’t have any additional embryos for later children.

My mind is full of what-if’s and I don’t wanna’s and me, me, me.

During the acupuncture appointment, I rest my mind.

Allowing myself just to be in this space of pity and sorrow.

Sometimes I just have to give myself permission to wallow. It’s easy to push the feelings aside and get into the positive or the ‘all will be well’ mindset, but it doesn’t honor my emotional reaction to information.

Allow me to be sad and scared.

I don’t stay there much longer as Hubby and I talk and we see that this is God’s plan, as are all children.

This journey is not mine to write. I just get to be along for the ride.

The nurse calls and gives us our medication instructions. Increase the Gonal F, keep everything else the same.

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God, I trust you. I know that although IVF is a medical process, becoming pregnant and delivering a child is a miraculous gift from you.

May I be open to receive what you have to give.

Gonal F- 175IU
Menopur- 225 IU
Cetrotide- .25mg

Bruising and Increasing Pressure

Day 9- “Good morning”, was said with a prick of the needle into my stomach.

I began taking Cetrotide this morning to help pause my body from going into the ovulation phase and will continue at night with the Gonal F and Menopur to help the follicles grow.

Bright and early this morning, Hubby and I head to Shady Grove to meet with Dr. O’Brien for our consult. UNADJUSTEDNONRAW_thumb_86ef.jpg

She is a delight and informed us that we are on the right track.

Since my estrogen started off so low (50 on day 4), we are 2 days behind the protocol she originally outlined, making our retrieval 2 days later and therefore disrupting our travel plans back to Colorado.

God, help me be flexible. I’m not doing all of this just to botch it in the end over a change of travel days.

Change of travel days means a change of PTO at work and meetings and scheduled appointments.

Just another sign that I’m too busy during this season.

I relax and embrace that this process is not exact and that my body is responding just as it is supposed to. I keep praying for healthy eggs inside these follicles, regardless of how long it will take to grow them.

Dr. O’Brien has no concerns for what she is seeing and is very pleased with how my body is responding to the medication and process.

Our prayers are with God’s will and modern medicine as we continue this walk of faith into the unknown.

We spend the rest of the day playing tourists in Washington, DC. To the Holocaust Museum and then the Bible Museum. Such an amazing experience to be in the Nation’s capital and living with the freedom to explore history. Hubby continues throughout the city while I return back to Rockville, tired and depleted. I don’t think I’ll be doing that again as my body really is exhausted.

Gonal F- 187.5 IU
Menopur- 225 IU
Cetrotide- .25mg


Day 10–  I return for another prick of the arm for blood work and ultrasound. The follicles are growing (praise God!) and we are looking at a 16mm follicle on the right side as our front-runner. Many on the left are still in the 9mm range though, so we have some growing to do.

I head upstairs for my acupuncture appointment and she focuses only on my kidney today. She explains there are two sides of the energy, like 2 bank accounts, one is checking and one is savings. When the checking runs out, I dip into savings, but I don’t spend enough time replenishing the savings and before I know it I’m in major debt in my body. Today we are going to help rejuvenate the savings side of my kidney. Apparently, the kidney is the part of the body that is feeding my ovaries the blood and protein necessary so they are working overtime right now.

The needles in my stomach ZING as she puts them in.

“Is this because my stomach is so sensitive from all the shots?” I ask.

“No, it’s because these are for your kidney’s and right now they are tired so they are more sensitive.”

…Interesting.

I rest under the heat lamp and carry that same posture of quiet and rest into the remainder of my day.

Gonal F- 150 IU
Menopur- 225 IU
Cetrotide- .25mg


Day 11– My bruised vein greets the phlebotomist.

“Which arm would you like?” I ask.

“Either one works for me”. She responds.

How to choose between two bruises? I just have to suck it up and let her prick me again.

The ultrasound was more painful today.

Everything seems more painful today, walking, sitting, bending.

She inserts the ultrasound wand and I feel like she is pushing through tight muscles. The follicles are growing, causing my stomach to feel swollen.

Sure enough, there are eight follicles on my right side, the largest being 20mm and seven on the left with the largest being 14mm. Come on left side!!

I spend the rest of the day relaxing. Reading, writing and grateful there is an NCIS marathon on USA.

Gonal F- 187.5 IU
Menopur- 225 IU
Cetrotide- .25mg

Heading to our new home…

Day 6– Today’s drive to the doctor was a little more anxiety producing. I originally was scheduled to do my ultrasound at my OBGYN and then go to the local fertility clinic for the blood work with same-day results but when I entered into my OBGYN I remembered they merged with the University of Colorado and everything had changed. Including the price for the ultrasound. I quickly called the local fertility clinic and they added me to the list of appointments that morning.

A little poke of the arm for a blood draw doesn’t seem so bad after having it happen a couple times this week, not to mention the fact that I’m nearing 1 week of shooting medicine into my abdomen.

The ultrasound was a success.

At about 1:30MST I received a call from nurse Christine. We have 13 follicles that are present, with the largest being 8mm. Things are on track!

Ok, I’ll be honest. I wasn’t happy when I heard 13. In our ‘interviews’ with various fertility clinics, we would hear people throw around numbers like 20 and 30 for a goal range of follicles. I want more. The more follicles, the better the chance for having more blastocysts at the end of the entire process, right?

Maybe.

I spoke with a friend who works on the ‘other side’ of IVF in the lab and she mentioned that sometimes the more follicles means the less quality of eggs. We certainly don’t want that.

With this information, I’m able to return to that place of HOPEFUL SURRENDER.

God, I know you know what you’re doing.

You were the one who started this whole idea of reproduction through an egg and sperm and the creation of cells and development of chromosomes.

Who am I to question what you have already done?

H.u.m.b.l.e.    p.i.e.

I don’t know it all and I’m certainly not in control of this entire situation.

The only thing I can do is take the medications, eat healthily, take supplements and rest.

Telling on myself: I am tempted to give myself a higher dose of medication. I mean, it’s there, in my refrigerator, I could easily up the dose.

Thankfully I have enough sense to know that isn’t a good idea and that it’s best for me to stick to what my doctor recommends.

I back down from the charge.

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The next time we monitor will be with nurse Christine at Shady Grove in Maryland.

We are thrilled. Ok, I am thrilled. Hubby is supportive and also keeping his emotions level.

I continue to stick my stomach with what is now a burning sensation (Menopur) and I’m grateful the Gonal-F is not as painful.

Tomorrow we will board the airplane to Maryland!


Day 7– Here I am sitting on the airplane and I am so excited to finally be doing this. Hubby is cautious with his energy towards the trip to preserve his emotions. He is better at staying realistic as I am the true optimist (and sometimes a very fearful one) of the relationship. The way I see it, I’m just happy to be able to be on an airplane, taking the medication, and making progress towards a retrieval.

My charge is to keep my expectations low with the process as I don’t want to get too ahead of myself.

The plane takes off at 5:30pm Denver time. I typically give myself the shots at 6pm and my nurse instructed I continue giving myself the shots at the same time each night. This means I have to prepare and inject myself on the airplane.

It feels weird to be pulling out the needles, syringes, vials of solution and medication and laying them on the tray table.UNADJUSTEDNONRAW_thumb_86cb.jpg

The flight attendant walks by asking what I’d like to drink. I shrink for her to see the stash of drugs on my table. The man sitting on my left acts oblivious but I wonder if he is just trying not to wonder what I’m up to.

Self-conscious, yes.

I quickly prepare the needles and stick myself as quickly as I can.

I feel like I’m a druggy.

Get the hit and get rid of the evidence. Hubby puts the trash in his empty to-go container that was used to transport his burrito.

Come on drugs… do your thing!

We arrive late in the night, pick up our rental car and drive to the rented Airbnb, a basement of a nice couples house, our home for the next week.

I fall into bed, excited for tomorrow.

Gonal F- 187.5 IU
Menopur- 225 IU


Day 8– I arrive at the Shady Grove Fertility clinic with a little buffer built in for me to get lost. Hubby did a great job of finding a place in Rockville about 10 minutes from the clinic. I drive into what looks like an executive building and park in one of the designated SG Patient parking spots. In the rotating door and to the elevators, 4th floor. The doors open to a modern space with calming colors. This will be where I entrust the growth of our family.

Blood work to check my estrogen and an ultrasound. Looks like I have 13 follicles, the largest is 14mm with the majority measuring around 8-10mm.

I meet Dr. OBrien in person, what a delight. She reviewed the ultrasound and comforted me with positive remarks. Her hope is that we get between 15-17 follicles. With my age my ideal follicle count is 17. So much for me praying for 20+!

We will have our official consult with her tomorrow.

Gonal F- 187.5 IU
Menopur- 225 IU

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Up to the 5th floor, I go to the Wellness Center at Shady Grove to meet my acupuncture lady. Although this is not required, I have found it to be insightful and calming. Hubby believes this to be more of a placebo but I truly believe in the combination of Eastern and Western medicine.

DaRae is a wealth of knowledge.

She hears what my food and supplement intake is on a regular basis and asks that I have less salad and more protein. She explains that salad is raw vegetables and it takes more energy for my body to decompose the raw vegetables, the energy that needs to be going towards making/growing follicles. Cooked vegetables are great (so I’m good there!)

She also explains that my body is making a large number of follicles and this takes more energy and protein.

Finally, she feels the different organs and comments that my body is tired. Her analogy is that I am a smaller engine trying to run like a large engine, a lot of output but not a lot of capacity to maintain it. She recommends that I rest more and let my body relax.

Interesting that I have heard this a couple different times now.

The last thing she recommends is that I eat more pork and less chicken and turkey. She explained the energy of a chicken and turkey is fast (just think about what they do when they are alive, running around) and a pig is lazy, sleeping and laying around.

With this, the meat of a chicken and turkey are warmer causing more acne.

Interesting concept.

I drift off to rest as she puts the needles in their proper place, moves the heat lap over my stomach and turns down the lights.

Nap time.

I spend the rest of the day around our Rockville home, even taking a 2-hour nap.

Rest my child. Just rest.

Gonal F- 187.5 IU
Menopur- 225 IU

 

Journey to Retrieval…

DAY 1- After 20 minutes of watching tutorials, I’m ready to become my own nurse. The shots will be in my stomach area so Hubby is off the hook for sticking me.

He sits there and helps me figure it all out.

Why in the world do they leave this in the patient’s hands, I don’t know. I’m scared I’ll mess something up. I watch the videos again.

My doctor friends offered to come to show me how to do it. I should have taken them up on it.

I clean the area on my stomach, prep the shots by mixing and ticking the side of the syringe, like I see in the movies to get the air bubbles out, grab a little fat and stick it in there.

Two times each night for the next 10 days… here we go.

I have such compassion for my girlfriends who have gone through this process. One of my friend’s had to give herself shots for her entire pregnancy and a couple weeks after. My word, what a sacrifice for a little life.

I become sleepy about an hour after the shot and then I start burning up about 2 hours after the shot. Is this what hot flashes feel like?

I can’t get to bed fast enough.

Gonal F- 75 IU
Menopur- 150 IU

DAY 2 & 3- Much of the same routine. Thankfully, I don’t have many side effects throughout the daytime. Just feeling the heat at night, plus waking up in a puddle of sweat at night. No big deal, just disgusting!

I feel I have become a pro at this whole shot thing. Minus the fact that I used too much of the solvent to mix the powder which left my stomach a bit distended with extra liquid. I won’t be doing that again!

The acupuncture appointments have helped calm my nerves and I’m hoping they are helping with the follicle growth too.

Tomorrow I go in for my next monitoring appointment. I’m a little nervous as this will be the first time we see how my body is responding to the drugs. I’m praying there are multiple follicles and that my bloodwork looks positive.

I can’t do much more for myself at this point. Eating healthy, getting good sleep, slowing down, and calming my mind. God, you do the rest!

Gonal F- 75 IU
Menopur- 150 IUIMG_0398.JPG

(Hubby thought it would be fun to have a ‘shot’ party… )

DAY 4 & 5- Monitoring first thing in the morning so the labs have enough time to get the report 2 time zones over to the clinic. I have the rest of the morning to pray that all is well and that I’m exactly where I need to be at this stage in the process.

At 3pm, I receive a call from Shady Grove. All looks good! She did say something about my estrogen being 50 (incredibly low for day 4). I don’t know where it needs to be but she asked that I increase the Gonal F to 187IU and keep Menopur to 150IU. How in the world did they come up with the number 187? Feels strange to have such a random number but maybe it’s the precise science that makes IVF such a miracle worker?

Excited, I prepare the shots. I have 75IU left in one Gonal F shot so tonight I will give myself 3 shots just so I don’t waste the medication.

Babies are being delivered by my friends all around me and I am trying not to fall into the self-pity. “They didn’t have to do all this to have a baby”. I notice I am more sensitive to well-intentioned comments.

God, I know you are with us on this journey. I’ll keep surrendering my anxiety over to you. I am so grateful we get the opportunity to do this treatment. I know you are with us and I pray that I may accept what you have for us.

The shots will continue at this dose for 2 more days and then I’ll go in for another monitoring appointment on Monday morning.

Happy weekend!

Gonal F- 187 IU
Menopur- 150 IU