The BIG Mess Up

I thought that was my last shot before retrieval and I thought that was the shot that would ‘trigger’ me to ovulate. 

Maybe I should correct that statement. 

My doctors thought these things. 

My skepticism has been kept at bay for the majority of this stimulation cycle until it came to the trigger shot protocol that was outlined for this round. 

The previous two rounds, the protocol called for a dual trigger shot which is the typical Lupron with the a-typical HCG shot. 

When we were going through our last round a few months back, my nurse was not as familiar with the Dual Trigger because the Atlanta office rarely (if ever) prescribes this protocol. 

I know my Maryland doctor from the first retrieval in 2018 had a reason for me to have a dual trigger so I was surprised to learn that this protocol is A-typical. 

Either way, I questioned the fact that we weren’t going to do a dual-trigger this time. 

I was assured by the medical team that it was not necessary and I believed them. 

Yesterday when I gave myself the single shot, I was leery, but really wanting to trust the medical team so although I asked the IVF retrieval scheduler “what if my bloodwork comes back tomorrow with abnormally low levels showing the trigger shot didn’t work?” She assured me that this rarely happens and if it does then I would just get another shot. 

I trusted her and went on with giving myself the Lupron trigger shot at 9:45pm. 

Twelve hours later, I am being pricked for what I think is the last time to give a blood sample. 

I thank the phlebotomist who I have befriended over these past weeks and wish her well. 

On with my day I go, until I receive a call from the office. 

Dr. B is on the line. 

“Oh no, something is wrong”, flashes through my mind. 

Usually Nurse Emily calls me. The only other time Dr. B called during the cycle was last cycle when she told me we had to push the stim cycle a few more days and to expect low numbers. 

She has the same low, calm, steady tone in her voice. 

“Just rip off the Band-Aid” I wanted to tell her. I knew something was wrong. 

She proceeds to very gently and apologetically explain that the Lupron trigger did not work and in fact I was correct in the first place. 

My body did not produce the HCG needed to trigger ovulation and therefore did in fact need the dual trigger shot. “Duh”, I thought, “my body doesn’t produce hormones period… why would I all of a sudden produce this one?”

Trigger Shots: Need, Importance, Procedure & Side Effects

“Oh no! This cycle is canceled, it’s all messed up” enters my mind. 

Dr. B shares that we need to do the trigger again tonight with the HCG medication and move the retrieval one more day. 

Anger and frustration pulse through my body and I share a bit of this with her. 

She accepts my emotion and apologizes again for not looking more into my initial lab work done many years’ prior at CCRM. 

We walk through the labs and she now sees where Dr. O in Maryland was tipped to see that I needed the dual trigger. Dr. B’s heart is heavy and I can feel her remorse through the phone. 

I understand the mistake and am grateful we can still save the cycle by having the retrieval the following day. 

We say our good byes and I prepare for one more day in this incredibly uncomfortable state of being. 

I’d like to say my mind has been clear since hanging up the phone. 

Quite the opposite. 

  • What if the follicles grow too big over the extra 24-hours and we lose follicles?
  • What if the follicles grow too big and the egg quality diminishes?
  • What if the bloodwork doesn’t come back normal tomorrow and we have to cancel the cycle?
    What if… what if… what if…?

I tell my worries to Hubby and friends and am mostly met with encouragement and solace. 

All I can do is trust in the process and believe that his is not a surprise to God. He knew this all along, right?

I turn my thinking to- what if this is exactly what is needed for a few of those smaller follicles to grow and the eggs to be mature?

What if the very egg God wants to use for the embryo was too small to retrieve and needed just one more day?

I have a choice what to do with my thoughts.
Today, I am choosing to look for the good and believe that God is in the details. 

Medication day 16

Medication: HCG 10,000 at 8:45pm

Trigger shot!

Medication Day 15

My lower abdomen area feels heavy. 

My silhouette gives shape to a trimester two pregnancy belly. 

My stomach feels bloated. 

The morning Cetrotide shot hurt more today. 

The sting of the needle in my skin. 

It must be the bruising. My stomach area has been poked too many times this IVF cycle and it appears to be rebelling. 

This will most likely be the last shot I give myself in my abdomen. 

I waddle up the stairs as I feel the pressure inside. 

I remember this feeling from the first IVF round and in some weird way, I’m embracing it. 

The swollen, bloating, heavy feeling means there are follicles in there. 

Big follicles. 

That’s what we want- more big follicles filled with fluid and hopefully eggs. 

The monitoring appointment revealed 12 follicles over the size of 15mm!! Yippee, this is what we want to hear. 

There are two more on the brink of 15mm so they could grow to maturity over the next two days. 

Follicles: 26.7, 25.6, 22.4, 21, 19.3, 19.3, 19, 17.8, 17.5, 16.9, 16, 15.7, 14.7, 14.9, 12.9

We wait to hear the next steps.


Cetrotide .25mg

Tonight- trigger shot!

Pin on INFERTILITY - IVF - IUI

This will be my final shot that I put in my abdomen. 

In the past two IVF retrievals, I have done a dual-trigger and this protocol is different. I am a little hesitant to change what seem to have worked, and although I inquired about it, I want to trust the professionals. 

A very tender feeling comes over me as we have experienced just over six years of fertility treatments and this very well might be the last shot I put into my stomach. 

If we are graced with a healthy embryo, I will continue shots in my intermuscular areas such as my bottom, but for tonight, I can applaud my stomach and all the pokes and injections it has endured. 

Thank you, abdomen, for embracing these medications.

Tomorrow night- azithromycin (2 tablets)

The following morning- eggs will be retrieved from my body!

Slow growing ’round here

Medication day 10

It’s slower going these days. I thought for sure that starting off on the highest dose of meds would grow these follicles so fast my head would spin. 

Okay, maybe not that fast, but I did think I would at least be on track for a ‘normal’ follicle stim cycle. 

I’m not. 

They are growing, just not fast enough.

I had my appointment yesterday and instead of starting to go to my monitoring appointments every day, meaning that I’m getting closer. I’m still at every other day. 

I am not disappointed because this time I’m not surprised. 

I’m just scared that there won’t be many more follicles and the ones that we do have won’t grow. 

I’m scared to face the possibility that we won’t have another biological child. 

That the maternity clothes that I have loaned out to expecting friends won’t need to be returned. 

The excitement of news for other friends who share in this exciting journey toward parenting, won’t have a reason to be reciprocated.  

My thoughts grow dark as I begin to think that I am not a good enough mom to be gifted with a second. 

Or even darker, that Hubby and I are not capable of having a healthy family with another child and that God is protecting us from a future where our marriage is on the rocks. 

Either way, my thoughts lead me to “I’m not good enough”, “I’m not deserving”. 

I’m glad to know today that these are dark and not true thoughts. 

They are just fears mixed with emotion. 

Instead of wallowing with these thoughts, I pick up the needles and vials of medicine, click the Gonal-F pen until the number for the correct dose pops up and proceed to do my 1% in this whole process which is to give myself the medicine and relax. 

God- help me look to you when my thoughts grow heavy and dim. 


Cetrotide: .25mg

Gonal F: 375IU

Menopur: 225IU 

Follicles: 14, (12, 11, 11, 10, 10, 9, 9)

Medication day 11

Oh, how I cried on the way home from the appointment today. 

I could not stop the tears. 

I knew I needed to let myself flow with sadness and fear. 

What if we won’t get a healthy, viable embryo?

I am not ready to accept that we won’t get pregnant again. 

You may be wondering what caused the flood of emotion?

During the ultrasound, today, I only saw 4 noteworthy follicles on my right side. 

There were only four there two days ago… and on top of that, they are the same size as they were two days ago. 

I can’t believe my body is not responding to the medications. 

I feel as though my body is making a line in the sand saying, “I won’t make any more follicles”. 

Is my body rebelling against me?

The foods I eat, the supplements I take, the acupuncture, the naps, the walks… 

Nothing is working and I feel as though my body is shutting down from making any more follicles. 

I get the call from my medical team and they are happy with the overall progress, counting 15 follicles total right now. 

My left side is really stepping in it seems. 

I feel so defeated, so tired and yet not ready to let go. 

This is my last effort for a baby, come on body, keep working, keep pushing!


Cetrotide: .25mg

Gonal F: 375IU

Menopur: 225IU 

Follicles: 17, 16, 15, 13, 13, (11, 11, 11, 10, 10, 9, 9, 9, 7)

 

Medication day 12

Another day where I feel like crying, but there are no more tears in there. 

I spent some time with God this morning and really surrendered my grip about the number of follicles and the number of eggs and the number this and the number that. 

I don’t want to place stock in the numbers, the data, the science. 

I already did that last time around and came up empty handed with a lot of heartache. 

Every time I go to the doctors I don’t want to focus on the numbers.

I hear this small voice say “I’ve got something better”. 

What does that mean?

I feel the doom of dark clouds roll over my thoughts and my heart sink. 

In my life, I have learned how I hear best from God. 

It’s in these still moments that this little voice of peace comes over me. He’s here, I think.

God is with me. 

I try not to argue and instead leave my heart open to receive. 

Many times, I’ll hear God answer with one of three responses:

  1. Yes
  2. Not now
  3. I have something better for you

I’m not always in love with the second or third response and yet I know that is a call for me to practice obedience in my ability to trust that God’s plan and ways are always so much better than mine. 

I’m not sure if ‘something better” means He is about to give us multiple healthy wonderful embryos or if this IVF round won’t be successful and something better means an adopted child or even bigger “something better” might mean I will get pregnant all on my own without all of this medication. 

Either way- I want to receive this word as a way to feel peace. 

God is in these details and I may not know how it will all work out but I can sit back and watch as He does his miracle work. 

Nurse Emily calls and I am to do one more night of medication and come in for a final monitoring appointment tomorrow. We are getting closer and depending on how some of these grow tonight, we might be close to triggering for an egg retrieval. 

Lord, your will be done. 

One win for me: I did not have the same expectations as I did last time around. I am not surprised that my body is taking a little longer to respond and that the follicles are s.l.o.w.l.y. growing. Getting the call from Nurse Emily today to say that we might have another day is no surprise and if anything, I welcome it because it means more time for those littler follicles to grow and potentially become our ONE (or more) babies!


Cetrotide: .25mg

Gonal F: 300IU

Menopur: 300IU (4 vials)

Follicles: 20, 19, 17, 15, 15, 15, 14, (13, 12, 12, 11, 11, 10, 10)

Medication day 13

We continue to do the do… morning shot of Cetrotide, blood work, ultrasound, wait to hear from Nurse Emily and two shots at night. 

It’s become such a routine and yet I am so grateful that I get to go through this each day. 

By me giving myself shots and driving to the appointments means I’m in the game. 

We are still in this!

Today, I got to meet Dr. Brahma in person. 

She is absolutely lovely. 

Her door was open and she was sitting at her desk as I walked by. 

I introduced myself and she invited me in with a warm disposition. 

We talked about this cycle and how she is liking what she is seeing with the growth. 

This was comforting. 

She also adjusted my thinking (again) with the fact that she is looking to get a little over 10 really solid good eggs, thinking between last cycle and this cycle we will have one wonderful embryo. 

I do have the same hope. 

With a spring in my step after meeting such a caring doctor, I returned home with another night of medications to give my follicles more nutrients to grow!


Cetrotide: .25mg

Gonal F: 375IU

Menopur: 225IU 

Follicles: 22, 21, 19, 17, 16, 16, 15, 14, 14, 14, 14, 13, 13, 11

 

Medication day 14

It’s a drizzly day here and it pretty much reflects my mood. 

I woke up feeling as though this seems to be dragging on, and yet I also welcome the opportunity for a few more follicles to grow in there to help the chances of a successful outcome. 

I give myself the Cetrotide shot, eat my breakfast and head off to another monitoring appointment. 

It’s possible that we will ‘trigger’ the ovulation process tonight and schedule the egg retrieval for 2 days from now… or we will do another night of mediations. 

I want to stay open… and I also want to return home to sleep in my own bed. 

IVF Cycle

It’s been wonderful to be with family and yet I am ready to return to my normal routine in the comforts of my home. 

I remind myself that this could be the last effort for a baby and one more day is worth a lifetime of having a child. 

As I lay there on the monitoring table with the ultrasound wand taking pictures of all the beautiful follicles inside of me, I have to praise God for this amazing gift of creating life and surrender what He will end up doing with these follicles. 

The sonographer is new and I have to block-out any fear that she doesn’t know what she is doing. 

Nurse Emily talks with me briefly after the appointment. She thinks it’s just too close to call and has a slight suspicion that Dr. B will go one more night on the meds. 

An inconvenience to use and our desires to return and yet worth the extra 24 hours if that will make all the difference in our future. 

At 2pm on the dot she calls.

One more night of medications with a certain trigger tomorrow night. 

We adjust all our plans to fit this additional day and look at the good in this opportunity. 


Cetrotide: .25mg

Gonal F: 375 IU

Menopur: 225 IU

Follicles: 25, 23, 20, 27, 28, 27, 16, 16, 15, 15, 15, 12, 12, 12, 11, 11, 10

More meds, more hope

Days 7 & 8

It seems like more of the same at this point. 

I went in for my monitoring appointment yesterday and was happy to see some follicle growth in my ovaries. 

There were six follicles total, three on each side- measuring approximately 10mm each so that is a good start but nothing to write home about. 

There are still quite a bit of smaller follicles that are too small to measure that we need to grow so I’m instructed to do much of the same. 

Continue with the medications as we have and rest up. 

It’s time to order more medications and I can’t believe how quickly the numbers add up. 

Shady Grove’s Shared Risk is great to the extent that a client can go through multiple IVF rounds in order to have a successful pregnancy. The downside though is the client needs to pay an outside vendor for the medications. 

Meaning, we paid for the medications last round… and need to shell out more money for the medications this round. Since I’m on higher doses of medication, the cost is higher. And this is not refunded if we don’t have a successful pregnancy. 

Oh, the cost for hope in having a new little life in our family. 

I call the least expensive fertility pharmacy I can find that works with Shady Grove, Encompass. 

They have come to know me now (it seems) and I slide my next order in to be received in the next day. 

As I give my credit card number, I repeat, “this is all worth it”, I remind myself. 

Time to relax and let my body grow these little amazing things.

I enjoyed another acupuncture session to feel as though I am contributing to the growth effort in some important way and am mindful of how much I am exhausting my body. 

Dr. Shu reminded me that I need to be very relaxed and to stay calm through this process. He also re-emphasized no working out aside from walking and to ingest warm foods and drinks. 

I must say, relaxing with a toddler is a hard suggestion to follow and yet I am being very mindful of how much I pick her up or bend down to be with her. 

My abdomen is swollen. 

It feels bloated and when I go to give myself the nightly dose of medications, I can see where the bruises are starting to form. 

There are little red dots all over my abdomen where I have recent poked and I feel myself just wanting to rub my skin gently offering some sort of condolences for the pain I have inflicted. 

Nurse Emily called with the monitoring report and it was as expected. 

Slow growing and we will see you in a few days to see how things progress. 

She did start me on Cetrotide which will help my body restrain from ovulating too early with the larger follicles they see on the ultrasound. 

We wouldn’t want that!

This means adding one more poke in the morning in addition to the pokes at night. 

My poor abdomen. 

Thank you for embracing these pokes, dear abdomen, for the hope and sake of a new little life. 



AM: Cetrotide- .25mg

PM: Gonal F- 375 IU

PM: Menopur- 225 IU

Pins and Pressure Points

The art of acupuncture. I’m not sure if it’s a placebo or if it actually has healing components but either way, I’m doing it. 

I started acupuncture way back in college when I was suffering from chronic shin splints. And although I didn’t heal from the shin splints, I think it had more to do with me not following my doctor’s suggestions to stop running then it did the acupuncture. 

I decided to try it again when we began our fertility journey six years ago and have really found someone in Denver who I trust. Dr. Melati at Herb & Legend is wonderful with her knowledge of the body and what it needs. 

She has treated me through our successful IVF cycle back in 2018-2019. Anywhere from supporting hormone function as we prepped for the egg retrieval, to supporting my body before and after the transfer of our now wonderful baby girl, to the pregnancy sickness that I experienced for 16 weeks to now helping my body release all the extra hormones from the unsuccessful IVF round a few weeks ago. 

Now she is helping me with the hot flashes I have at night because of the higher dose of medication to the headaches that seem to be nonstop throughout the day… in addition to increasing blood flow to my uterus for healthy follicle growth. 

Dr. Li Shu at Acupuncture & Wellness Center is also wonderful. 

I felt like I was in good hands as he got to know my story and really wants to help provide a good treatment for me in the upcoming days. 

After a few questions and some chat about the Shared Risk Program at Shady Grove (which he was very impressed with), he began to place the needles into my skin. Although some of the points were different from what I was used to from Dr. Melati, I felt as though I could trust his experience. 

How acupuncture could help coronavirus patients, study says

He checked my pulse and shared that it felt weak and that it would be a good idea for me to relax as much as possible these upcoming days and not work out. He encouraged me to treat my body well and give it a break. 

He then placed a heat lamp over my abdomen and explained that this will help the blood flow. He also encouraged me to drink warm water, tea and eat warm soup and to stay away from ice water. I laughed- there are very few days during the summer when it’s over 90 degrees that I will drink ice water so there is no issue there. 

He read me well- my body runs cold and I need to give it as much warmth to help increase positive energy and not deplete my body when it’s needing to focus on creating these follicles. 

He turned on the music and left me to doze off. 

After 45 minutes, he returned and proceeded to massage my back and spin, pinpointing different pressure points. 

I then sat in a chair and he massaged my head and neck stopping at certain points that were particularly tender. 

This guy knows his pressure points!“Go to any lengths”… and so I am.
I’ll return tomorrow for another hour of supporting my body as much as I can while it grows as many follicles as it can, as big as they can grow!