Dr. Angel

The sun is shining.
I look for the good in the day, knowing it will be a long day. 

Turning to Hubby I say, “Can I just sleep all day today and then when I wake up it will be egg retrieval time?”

He laughs. I’m sort of serious. 

My drive to Shady Grove is full of fear and I call a friend who reminds me that I don’t have all the information and to just stay in the day. 

My stomach doesn’t have the same uncomfortable bloated feeling as it does a few days ago and I fear it’s because I lost the follicles. 

My arm is pricked for what I truly hope is the last time. 

Upon my arrival, I see the friendly, caring eyes (I’m sure she is smiling under her mask) of Dr. B. 

She greets me and asks how I’m feeling.

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She listens.

I share with her my fears and am wondering if it’s possible that I’ve lost some follicles. 

She assures me that my hormone levels were too low for ovulation to have occurred and then offered to have me do one more ultrasound monitoring to see. 

I gladly accept. 

She cares for me and my feelings. How refreshing to be seen and heard by a doctor. 

In minutes, I’m looking at 8 beautiful black circles in my right ovary and 8 beautiful black circles in my left ovary. 

They are all there.

We don’t know the egg quality yet but I can see that everything that was there a few days ago is still there with just a little more growth. 

I am at ease. 

Dr. B calls with the results from my bloodwork and all looks good and we are ready to go!

I will pack up, rest up, and be ready for the retrieval tomorrow at 8:45am.

Thank you, God.

Medication Day 17

Medication: Azithromycin (2 tabs)

Follicles: 28, 25.3, 21.9, 20.9, 20.3, 20.2, 19.3, 18.9, 18, 16.9, 16.7, 16.6, 16.5, 15.7, 14.9, 13.8

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!

The Final Push

I just returned from my monitoring appointment and I am waiting to hear if tonight we will trigger the HcG for us to our retrieval in 2 days… or if we will do one more day of medications to give those littler follicles time to grow to maturity.

I am at peace. Whatever your will is, God. I will accept it.

24, 20, 20, 18, 17, 16, 15, 15, 15, 15, 13, 12, 12, 12, 10
12 follicles above 12.5
We had 17 follicles there were 12.5 and above with the first IVF cycle.

——

We just heard from our nurse. One more night of medications to give those smaller ones a little extra time to grow.

We are tired. We just want to go home.

We also know that one more day here could make the difference between a whole other cycle so we are willing to be patient and just be here for the time that is required.

We change our flight (again), I assess our food to make sure we have enough, and we readjust our mind to the inconveniences this change in plan means for us being able to get back home and settle in to our regular days.

Medication:
Cetrotide: .25
Gonal F- 400 IU (use all the remaining pens!)
Medication day 14, cycle day 16

———

I went in for the ultrasound today and it looks like we are ready to trigger!

24, 24, 21, 21, 20, 19, 19, 17, 17, 17, 15, 15, 14, 14, 14, 9

Ovidrel and Trigger Shots for Fertility Treatment

Dual Trigger Instructions at exactly 8pm tonight:
– Leuprolide- 80 units into the belly
– HcG (Chorionic)- 1 ml solution into powder… mix… and inject the mixture into the hip/butt

Tomorrow:
– Morning blood work to confirm my hormone levels are where they need to be
– Take Azithromycin (2 pills) at dinner

The following day:
– Retrieval is scheduled for 8am. I need to arrive there at 7:30am
– The usual pre-surgery instructions: nothing to eat or drink after midnight- brush teeth only
– We will need to get the sperm collect prior to coming in anytime between 5:30am-7am (Good morning to Hubby!)
– After the retrieval, I am expected to be picked up around 9:30 in the office
– Recovery after the retrieval is to rest. It’s expected to feel groggy until meds get out of my system. Common to experience cramping and abdominal pain, Tylenol is recommended.

We will hear how many eggs were fertilized from the physician on the day of the retrieval.

The following day, we will hear from the nurse how many of the eggs were fertilized.

Five days after that, we will learn how many of them made it to day 5 blastocysts and were biopsied. The PGS biopsy results will come back two weeks after the biopsy.  

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!

~~~~~~~~~~~~~~~~~~~~~

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!

~~~~~~~~~~~~~~~~

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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