Today I think I finally turned a corner. I can see the finish line on the horizon and it has vastly improved my mood, and physical well-being. Yesterday at my monitoring appointment the doctor mentioned that she thought I was almost ready for retrieval, that she was thinking Thursday as a matter of fact (two days earlier than my tentative schedule). They booked me to come in this morning, just to check again, make sure everything looked on track, and schedule my retrieval.
I still have some rather massive follicles hanging out, a 31mm on the right, and a 26mm on the left. There are also several “normal” sized ones around 20mm or so, as well as 3 smaller ones at 15mm, 13mm, and 12mm. In total she counted lucky number 13 today, though I suppose there could be more that are hidden under the giants. All in all, majority of them are large enough for me to trigger. I am slightly disappointed in the number, as I had excpected to be a bit higher, especially since some of these follicles may hold over matured eggs. In my mind, I am figuring there may be 10 “good” ones, so say half of those fertilize properly (we are doing ICSI, so maybe that will up our chances), and then half of the fertilized ones make it to freeze. That’s only 2 or 3 embryos. And then how many will survive the thaw for an FET? What do we do if we use them up and no pregnancy occurs? That’s only my conservative speculations, and pessimistic views, but it makes me nervous.
I am still feeling pretty gross, a lot of fullness and discomfort in my abdomen, but I don’t feel nauseous which is a big win. I think a lot of physiological symptoms I’ve had lately related directly back to the anxiety I’ve been feeling over the course of my cycle. Each step it seemed like another hurdle appeared, and I began having anticipatory anxiety. Each day before my monitoring appointment I would have nausea and stomach upset (I was worried about being constipated from the meds, but it ended up being the opposite problem). Pepto-bismol , and ginger tabs became my breakfast. Eating became difficult (also due to the fullness I’m feeling, my stomach doesn’t have as much room).
Now that I know we will make it to retrieval (which was looking murky at times) I am feeling much more confident in this cycle. My retrieval was confirmed for Thursday, so I will be triggering tonight. Unfortunately, I was informed that it will be a freeze-all cycle, as my estrogen is through the roof. I was intending to ask the doctor about my estrogen levels today, as I was concerned about it being high and cause for concern of OHSS. From what I had read anything over 4000IU – 5000IU was symptomatic of OHSS. The first thing the doctor said to me when she came in the room was, “Did they tell you your estrogen levels?!”. Mine was at 20,000IU. When the doctor first told me this, I thought she had misspoke, and I repeated the number, dumbfounded. It’s a miracle I don’t feel absolutely awful from those kind of levels. Other than my anxiety induced symptoms, plus the distended belly, I have been pretty symptom free. Now that I am out of the throes of despair about the mishaps in my cycle, I can appreciate that my side effects have been pretty minimal.
Disappointing to know we will have to freeze-all and wait to transfer, but the clinic staff and doctors kept speaking to me as though this was the likelihood, over being able to do a fresh transfer, so I was mentally prepared. Some clinics have even quit doing fresh transfers all together, and my clinic is considering this approach as well. I think it will be good to have time to recuperate, physically and mentally, before embarking on the actual reason for all of this madness. I don’t know all of the details of how a frozen transfer works, but the IVF nurse told me that it is a two-cycle process. Obviously my next period that comes after the retrieval is going to be a bit wonky, so that doesn’t count to start my FET cycle. The nurse advised me that I should get my period 5 – 12 days after retrieval, and I am hoping for the shorter side of things. After that, my next cycle should start early to mid September, and at that point I am to call and advise them on CD1. Since it is to take two cycles, my second cycle for the FET cycle would start early to mid October. I am going away on a work trip for a week mid September, and then out-of-town again for a friends’ wedding at the end of October. Each trip could possibly pose a problem, again, all depending on how long it takes for AF to show up after the retrieval. There goes my mind, spinning months ahead again.
The trigger I am using tonight is not hCG, as when dealing with elevated estrogen level, an hCG trigger can exacerbate someone already at risk for OHSS. They are having me use decapeptyl as a trigger, so not to worsen my already elevated chance at OHSS. My doctor has recently started using it in place of lupron, as he finds lupron to be expensive, and he likes the results of the decapeptyl. It needs to be refrigerated, so it is currently hanging out amongst the lunches in my work lunch room fridge. I will be triggering with two syringes of decapeptyl, at 8:30pm tonight. I get a much wanted reprieve from any needles to the gut tomorrow and the Thursday is the big day! I am more excited than nervous right now, but ask me again tomorrow night. I’m sure I will be stressing. But for now, I can see the light at the end of the tunnel.