So the retrieval was yesterday morning.
It was ok. Apparently there is some scar tissue or maybe endo around my right ovary. That made the retrieval on the right side a little more difficult. I'm not even going to go there right now because I have asked two different doctors( at two different clinics) about a laproscopy and both have said there is no reason to do one, no indication it would tell us anything.
Anyway Dr. ClinicDirector was fabulous. I loved him and he would warn me when he was encountering the scar tissue (that made him have to jab hard to get through) and finally said to the nurse, let's give her some more pain med. No reason for her to have to feel this.
Ahhh... lovely pain meds. And that was that, the scar tissue was on my right side which also happened to be the first side he did. I got the extra dose of pain meds after the third jab and everything after that was a blur. I thought we were only there about 10 minutes but Rick assures me it was almost 30.
As I was being helped out of the room, I asked how many we got. They told me 18. Even in my foggy state I thought that had to be a mistake. The wanding showed there were only 7/8 really mature and even if all the 1.6's made it, that would have only be 14. At any rate, I wasn't in the condition to argue and I fell asleep in the recovery chair. When I woke up and was getting ready to leave I asked again. The Nurse said 18!
Well, I spent most of yesterday trying to understand how they got 18. I figured that everything over 14 was probably immature.
Embryologist called this morning with fertilization reports.
Out of the 18 egg's, 3 were immature, 2 fertilized improperly and 12 fertilized normally. 1 is apparently hard to read. Embryologist thinks that maybe it was fertilizing as he got in this morning, although that would be late fertilization.
So, we have 12 (maybe 13) fertilized. He will call tomorrow with status update.
I am feeling much better today. Still very bloated and a little sore but nothing abnormal.
Thursday, September 28, 2006
Monday, September 25, 2006
Oh... and I was worried about my estradiol being too high. (UPDATED)
So today's wanding showed that the follicles did not grow much yesterday. Instead of being between 1.5 and 2.0 they were between 1.6 and 2.0. If we trigger and they do not grow between now and retrieval the 1.6's may not be mature and I would end up with about 7 retrieved.
But, given that my follicles did not grow, they are concerned by estradiol may pleateau. Did you get that! They are concerned that my estradiol may not go up today.
Apparently, if the E2 plateaus at this point it may be a sign that everything will start dropping and the follicles will shrink. I have never, ever heard of this.
They are concerned enough that if my E2 has not risen from yesterday they are going to trigger me tonight despite the fact that there preference would be that I stim for one more day.
I won't know until I get the bloodwork results this afternoon. At this point, retrieval could be Wednesday or Thursday.
I am trying not to stress, 7 follicles sounds like a very low number to me (remember I had 19 last time) but I am trying to remind myself that I came into this with a quality not quanity attitude and I wanted a much lower follicle count.
Update:
Just heard from my nurse. My E2 stayed the same and so I will trigger tonight and retrieval will be 9:00 am on Wednesday morning. Dr. ClinicDirector has agreed to do both my retrieval and my transfer, even if I have to transfer on day 3 which is Saturday. There were at least 6 follicles today that were 1.6. I am going to hope and pray that some of them grow by .2 in the next40+ hours so that they will be mature. Estrogen level topped out at 8,011 ( 2182 as measured in US) which is at least 4000 less than last time.
But, given that my follicles did not grow, they are concerned by estradiol may pleateau. Did you get that! They are concerned that my estradiol may not go up today.
Apparently, if the E2 plateaus at this point it may be a sign that everything will start dropping and the follicles will shrink. I have never, ever heard of this.
They are concerned enough that if my E2 has not risen from yesterday they are going to trigger me tonight despite the fact that there preference would be that I stim for one more day.
I won't know until I get the bloodwork results this afternoon. At this point, retrieval could be Wednesday or Thursday.
I am trying not to stress, 7 follicles sounds like a very low number to me (remember I had 19 last time) but I am trying to remind myself that I came into this with a quality not quanity attitude and I wanted a much lower follicle count.
Update:
Just heard from my nurse. My E2 stayed the same and so I will trigger tonight and retrieval will be 9:00 am on Wednesday morning. Dr. ClinicDirector has agreed to do both my retrieval and my transfer, even if I have to transfer on day 3 which is Saturday. There were at least 6 follicles today that were 1.6. I am going to hope and pray that some of them grow by .2 in the next40+ hours so that they will be mature. Estrogen level topped out at 8,011 ( 2182 as measured in US) which is at least 4000 less than last time.
Sunday, September 24, 2006
One More Day
So yesterday's estrogen was 6181.
Today's follie scan showed that we are almost ready to trigger. I had 8 follicles on the right side between 1.5 and 2.0 and 6 on the left side between 1.5 and 2.0. The overall count didn't change from yesterday.
The nurse predicts that tonight will be my last stim shot and then I will be prepped for trigger tomorrow.
For some reason my lining went from .95 to .88. Nurse didn't seem concerned about it, said that they look for .8 and greater so I am fine. I am concerned though, why would it go down?
Today's follie scan showed that we are almost ready to trigger. I had 8 follicles on the right side between 1.5 and 2.0 and 6 on the left side between 1.5 and 2.0. The overall count didn't change from yesterday.
The nurse predicts that tonight will be my last stim shot and then I will be prepped for trigger tomorrow.
For some reason my lining went from .95 to .88. Nurse didn't seem concerned about it, said that they look for .8 and greater so I am fine. I am concerned though, why would it go down?
Last time on trigger day my E2 was 12,300.00 so we should be well short of that even if it is highter than I would like. I would really, really like tomorrow's estrogen to be 7500 or less.
Dr Replacement. is recomending another blast transfer (assuming we get that far again). That will give me 6 days for my estrogen to fall before transfer. He says if I start showing any signs of hyperstimulation they will recomend freezing and waiting for a frozen transfer but otherwise his recomendation is to do a fresh transfer even if E2 is higher than we would have liked. As he pointed out, it's not likely an either or scenario. If we assume that things will go along the same route as last time, we can assume that I will be able to do a fresh blast transfer and a couple frozen blast transfers. Given the success rates of fresh vs. frozen he doesn't think I should cancel a fresh transfer unless I am having symptoms of actually OHSS.
I am keeping my fingers crossed and drinking lots of Gat*orade.
Saturday, September 23, 2006
Cycle Day 10
Today I had 28 follicles. 14 on each side. The right side mostly ranges from 1.4 to 1.7 but there is one at 1.8. The left side ranges from 1.7 to 1.0. I think there are probably 8 or 9 that will be retrieved on the right but probably only 4 or 5 that will be retrieved on the left.
Estrogen yesterday was 4,405. Not sure what today's was but given the increase in follicles I would imagine it jumped again. We will find out tomorrow morning.
I was read the "gat*orade" riot act today. Same as last time, drink at least 1 litre a day. Gat*orade or V*8 juice (apparently equal in sodium) but I hate V*8 juice so I will stick with Gat*orade.
I am not sure how I am feeling. I had really wanted to not produce so many follicles this time. But we didn't increase the dose, and actually reduced it considerable as soon as things started to vamp up. Maybe my body just really doesn't want to cooperate. Maybe I will have to accept that.
My guess is that they will try to get those 1.4's to 1.8 before triggering. Given that they usually grow by .2 a day, I would guess 2 more days of stimming before trigger.
Estrogen yesterday was 4,405. Not sure what today's was but given the increase in follicles I would imagine it jumped again. We will find out tomorrow morning.
I was read the "gat*orade" riot act today. Same as last time, drink at least 1 litre a day. Gat*orade or V*8 juice (apparently equal in sodium) but I hate V*8 juice so I will stick with Gat*orade.
I am not sure how I am feeling. I had really wanted to not produce so many follicles this time. But we didn't increase the dose, and actually reduced it considerable as soon as things started to vamp up. Maybe my body just really doesn't want to cooperate. Maybe I will have to accept that.
My guess is that they will try to get those 1.4's to 1.8 before triggering. Given that they usually grow by .2 a day, I would guess 2 more days of stimming before trigger.
Friday, September 22, 2006
Good News .... I Think
Ok, today's scan was .... encouraging. I didn't gain any follicles so it appears the drastic cut to stims worked. The follicles also didn't grow any since yesterday so perhaps the reduction was too great?
The follicles also mystically got a little smaller and switched ovaries. I am thinking that may be the 2 wand maidens measuring differently and writing the follicles in the wrong column.
Today's results:
Right: 1.5, 1.5, 1.4, 1.4, 1.4, 1.3, 1.3, 1.3, 1.3, 1.3, 1.1, 1.0
Left: 1.5, 1.3, 1.3, 1.3, 1.1, 1.1, 1.0, 0.8
This makes more sense to me since it is my right side that feels more swollen and sore.
I don't have my estrogen level yet but I am hoping that since I didn't add any follicles and they didn't grow that perhaps my estrogen stayed the same......
My lining is now at .91
Thalia, I wondered about not doing a fresh transfer too. Here are my thoughts. Although my estrogen went to 12,000 last time and I ended up with a crap load of follicles, I did not hyperstimulate in terms of I did not have significant fluid retention after retrieval or transfer. I also did not manage to stay pregnant. I had 7 frozen day 5 blastocysts. We did 2 frozen transfers and never got pregnant. My very unscientific and unsupported theory is that the poor little things were completely wigged out on estrogen and therefore the quality of the embryo's was compromised from the get go. Of course, the embryo's were graded "perfect" and most had very little fragmentation, reached blast stage, and survived the thaw so what the hell do I know.
When I mentioned my "wigged out on estrogen theory" to my doctor. She just smiled and nodded and said, "hmmmm.... well..... it would be a good idea to try to keep your estrogen level down this cycle."
I believe my clinic says that estrogen level under 6000 is "standard" or "acceptable". I vaguely remember that from my last cycle. I can't remember if that was their general standard or their standard for people with PCOS who tend to "explode" at the end.
Those are my thoughts, I haven't really come to any conclusions yet. Of course, given the difference in success rates between fresh and frozen transfers, my preference obviously would be to have a fresh transfer if possible.
Lisa, you mentioned that your estrogen "exploded" at the end of your last cycle but you controlled it by dropping your dose. Was this the cycle that resulted in your pregnancy? I would be interested to know if people get pregnant and stay pregnant with elevated E2 levels?
UPDATED
****So I found this relating to Estradiol conversion******
How do I convert my Canadian Estradiol (E2) numbers to American measurements?
In Canada E2 levels are measured in picomols and in the United States E2 levels are measured in picograms. If you want to compare numbers, here is how to convert them:
Canadian E2 ÷ 3.67 = American E2
American E2 x 3.67 = Canadian E2
That means my 4000 E2 level would be equivalent to a 1089 E2 level in the US. It also means that Lisa's E2 level of 5000 with Julia topped 18,000 Canadian. I can't tell you how much hope that gives me.
Yup hope. Come on people, I can't remain an ostrich forever. I've got all those follicles waving at me every morning and each one whispers to me "I might be the one". Besides.... I need something to get me through the second retrieval.
The follicles also mystically got a little smaller and switched ovaries. I am thinking that may be the 2 wand maidens measuring differently and writing the follicles in the wrong column.
Today's results:
Right: 1.5, 1.5, 1.4, 1.4, 1.4, 1.3, 1.3, 1.3, 1.3, 1.3, 1.1, 1.0
Left: 1.5, 1.3, 1.3, 1.3, 1.1, 1.1, 1.0, 0.8
This makes more sense to me since it is my right side that feels more swollen and sore.
I don't have my estrogen level yet but I am hoping that since I didn't add any follicles and they didn't grow that perhaps my estrogen stayed the same......
My lining is now at .91
Thalia, I wondered about not doing a fresh transfer too. Here are my thoughts. Although my estrogen went to 12,000 last time and I ended up with a crap load of follicles, I did not hyperstimulate in terms of I did not have significant fluid retention after retrieval or transfer. I also did not manage to stay pregnant. I had 7 frozen day 5 blastocysts. We did 2 frozen transfers and never got pregnant. My very unscientific and unsupported theory is that the poor little things were completely wigged out on estrogen and therefore the quality of the embryo's was compromised from the get go. Of course, the embryo's were graded "perfect" and most had very little fragmentation, reached blast stage, and survived the thaw so what the hell do I know.
When I mentioned my "wigged out on estrogen theory" to my doctor. She just smiled and nodded and said, "hmmmm.... well..... it would be a good idea to try to keep your estrogen level down this cycle."
I believe my clinic says that estrogen level under 6000 is "standard" or "acceptable". I vaguely remember that from my last cycle. I can't remember if that was their general standard or their standard for people with PCOS who tend to "explode" at the end.
Those are my thoughts, I haven't really come to any conclusions yet. Of course, given the difference in success rates between fresh and frozen transfers, my preference obviously would be to have a fresh transfer if possible.
Lisa, you mentioned that your estrogen "exploded" at the end of your last cycle but you controlled it by dropping your dose. Was this the cycle that resulted in your pregnancy? I would be interested to know if people get pregnant and stay pregnant with elevated E2 levels?
UPDATED
****So I found this relating to Estradiol conversion******
How do I convert my Canadian Estradiol (E2) numbers to American measurements?
In Canada E2 levels are measured in picomols and in the United States E2 levels are measured in picograms. If you want to compare numbers, here is how to convert them:
Canadian E2 ÷ 3.67 = American E2
American E2 x 3.67 = Canadian E2
That means my 4000 E2 level would be equivalent to a 1089 E2 level in the US. It also means that Lisa's E2 level of 5000 with Julia topped 18,000 Canadian. I can't tell you how much hope that gives me.
Yup hope. Come on people, I can't remain an ostrich forever. I've got all those follicles waving at me every morning and each one whispers to me "I might be the one". Besides.... I need something to get me through the second retrieval.
Thursday, September 21, 2006
Oops I did it again!
So let's recap.
Day 5 - 1st IVF - 3 follicles
Day 8 - 1st IVF - 16 follicles
Day 9 - 1st IVF - 20 something follicles
Day 10 - 1st IVF - 32 follicles
Day 11 - trigger
Estrogen level ended up at 12, 304, cycle ended in chemical pregnancy and because I have nothing else to blame it on, I blamed the out of control estrogen levels.
Day 5 - 2nd IVF - 4 follicles - estrogen 1087
Day 6 - 2nd IVF - 7 follicles - estrogen 1194
asked to skip day 7 wanding and blood work
doctor agreed to skip but did not decrease dosage
Day 8 - 2nd IVF - 21 follicles - estrogen 4013
FUCK!!!!
Today had 11 follicles on left all between 1.0 and 1.4 and 10 follicles on right between 1.1 and 1.6
Was really hoping to keep estrogen between 4000 and 6000 this cycle. Obviously not going to happen.
My dose was pretty low to begin with and has been cut dramatically, more than in half. We are going to try to limit the estrogen as much as possible but really people, is there any chance we can keep it under 8000? I don't really think so.
I've got at least 4 more days of stimming, probably 5 in order to get the majority of the follicles to 2.0. I'm guessing I will be lucky to keep the estrogen to 10,000 given the way my body tends to explode at the end. At this point my retrieval will likely be on Tuesday which also screws with my plan to retrieve between Wednesday to Friday to ensure that new doctor would definitely be available to do my transfer. If we retrieve on Tuesday a five day transfer would be on Sunday - no guarantees that Mr. Big Shot clinic director will be available on the weekend.
FUCK FUCK FUCK
Day 5 - 1st IVF - 3 follicles
Dose increased and was told to come back on day 8
Day 8 - 1st IVF - 16 follicles
Day 9 - 1st IVF - 20 something follicles
Day 10 - 1st IVF - 32 follicles
Day 11 - trigger
Estrogen level ended up at 12, 304, cycle ended in chemical pregnancy and because I have nothing else to blame it on, I blamed the out of control estrogen levels.
Day 5 - 2nd IVF - 4 follicles - estrogen 1087
Day 6 - 2nd IVF - 7 follicles - estrogen 1194
asked to skip day 7 wanding and blood work
doctor agreed to skip but did not decrease dosage
Day 8 - 2nd IVF - 21 follicles - estrogen 4013
FUCK!!!!
Today had 11 follicles on left all between 1.0 and 1.4 and 10 follicles on right between 1.1 and 1.6
Was really hoping to keep estrogen between 4000 and 6000 this cycle. Obviously not going to happen.
My dose was pretty low to begin with and has been cut dramatically, more than in half. We are going to try to limit the estrogen as much as possible but really people, is there any chance we can keep it under 8000? I don't really think so.
I've got at least 4 more days of stimming, probably 5 in order to get the majority of the follicles to 2.0. I'm guessing I will be lucky to keep the estrogen to 10,000 given the way my body tends to explode at the end. At this point my retrieval will likely be on Tuesday which also screws with my plan to retrieve between Wednesday to Friday to ensure that new doctor would definitely be available to do my transfer. If we retrieve on Tuesday a five day transfer would be on Sunday - no guarantees that Mr. Big Shot clinic director will be available on the weekend.
FUCK FUCK FUCK
Tuesday, September 19, 2006
Cycle Day 6
Yesterdays E2 level was 1087.
Today's wanding revealed an extra 2 follicles:
Right: 1.2, 1.2, 1.1, 1.0, 1.0
Left: 1.1, 1.0
There were also several on the left and two on the right that she told me were .9 and a whole bunch of smaller ones, but they don't record anything less than 1.0. So right now we have 7 between 1.0 and 1.2 and about 12 between .9 and 1.2.
I asked if I could skip the blood work and wanding tomorrow so that I could accompany hubby on a road trip to Fort Wayne, Indiana. He is driving down today and driving back tomorrow. It is a 5-6 hour drive and I thought it would be nice for him to have company and for me to be able to sleep tonight!
They wouldn't agree until they saw today's blood work. They just left a message saying that it was ok for me to skip tomorrow and check in on Thursday morning (left a message so I don't actually know what the E2 level was) so I am off on a road trip. I am excited. Rick and I often have our best conversations in the car. I am a little concerned though that they didn't drop my dosage. It will be interesting to see what is there and what my E2 level is on Thursday.
Smarshy, I will do the game next post. I am actually trying to get Rick to do it because I did it last week but he's being shy....
Today's wanding revealed an extra 2 follicles:
Right: 1.2, 1.2, 1.1, 1.0, 1.0
Left: 1.1, 1.0
There were also several on the left and two on the right that she told me were .9 and a whole bunch of smaller ones, but they don't record anything less than 1.0. So right now we have 7 between 1.0 and 1.2 and about 12 between .9 and 1.2.
I asked if I could skip the blood work and wanding tomorrow so that I could accompany hubby on a road trip to Fort Wayne, Indiana. He is driving down today and driving back tomorrow. It is a 5-6 hour drive and I thought it would be nice for him to have company and for me to be able to sleep tonight!
They wouldn't agree until they saw today's blood work. They just left a message saying that it was ok for me to skip tomorrow and check in on Thursday morning (left a message so I don't actually know what the E2 level was) so I am off on a road trip. I am excited. Rick and I often have our best conversations in the car. I am a little concerned though that they didn't drop my dosage. It will be interesting to see what is there and what my E2 level is on Thursday.
Smarshy, I will do the game next post. I am actually trying to get Rick to do it because I did it last week but he's being shy....
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