Trigger shot done!

Well I went to bed about 10:30pm, and Paul woke me up at 12:05am to give me my HCG trigger shot (he hadn't gone to bed yet). So those eggies of mine should be ovulating at about noon tomorrow. They want to retrieve them prior to ovulation as it would be impossible to find them after they've left the follicles given they are microscopic in size. So I guess I technically had one injection today, LOL. But still that's better than 3 a day although intramuscular shots hurt more than subq ones do. My stomach is grateful though!

My prayer requests at this stage in the game would be that the Lord would:

1. Guide the doctor's hands tomorrow during the retrieval that as many of the mature eggs can be retrieved as possible with no other injury to me (ie. doesn't pierce an artery of mine with the needle or something like that!)
2. Guide those in the andrology lab as they select the sperm to use for the ICSI process.
3. Prevent me from developing OHSS which is certainly still a risk given the large quantity of follicles I have growing in my ovaries.
4. Enable the "correct" number of eggs to become embryos. Of course I am hoping it is in His will for me to become pregnant. If I do get pregnant the first try, (especially with twins or triplets) I will be hoping that we haven't frozen a large quantity of embryos. If I don't get pregnant the first time or only have one or two babies, we will do a frozen transfer later (sooner if I don't get pg than if I do obviously). However we don't want to have say 15 babies! Most people that I know haven't had ANY frozen embryos. If I get pregnant with the fresh transfer that's fine with me if we don't have any to freeze. I would never have any embyros destroyed so the other ethical option in my mind is to give any extra embyros up for adoption. That is NOT my preference however. So that is why I am praying that the Lord would direct the fertilization process and such so that just the right number of embyros are created (I have no clue how many is the "right" number for us but I know He does!).

Retrieval on Wednesday!

My E2 was 3,224 today so it was almost exactly double what it was on Saturday (which is my usual pattern to double every 2 days). Dr. Awad thinks that 25 of my follicles are mature. I am to have my HCG trigger tonight at midnight (what fun!) but then I get tomorrow off - NO SHOTS for the first day in 25 days. YAHOO! The shots will resume on Wednesday when I start the PIO shots. My retrieval is scheduled for Wednesday morning at 9:00am. So I really would appreciate LOTS of prayer on Wednesday for the retrieval and fertilization (ICSI) to go well.

Smells

I usually wear nail polish on my finger and toenails (toenails only in the months I am wearing sandals). I had read on the information sheet last month that you cannot wear nail polish the day of the ER. I remember back when I had surgeries years ago they said it was in part to be able to check the color under your nails (a way of seeing how you are doing physically). So I figured that was the reason, and I have been going w/o fingernail polish the last week or so. Today I decided to ask about toenails as mine are still painted. I was told that it's fine for them to be painted if they have been painted for awhile, but that I should not paint them OR remove the nail polish from them the morning of the ER. She said the reason is that eggs and embryos are very sensitive to smells. She said no one who is in the room with the eggs or embryos is allowed to wear lotions, perfumes, etc. She even said not to use a smelly kind of shampoo! They then told a story of how a few months ago the hospital put new mulch outside, but the smell wafted inside. She said the doctor contacted the hospital and was very upset that mulch was put outside during a week they were doing IVF (they have on and off weeks for IVF throughout the year). I guess probably no other treatment inside the hospital might be ruined due to mulch outside the hospital! So anyhow I guess I will leave my toenails "as is" and wait to repaint them until after the transfer. I sure don't want something to do ANYTHING that might hurt my eggs or our embryos! I think I'll tell Paul not to even wear deodorant that day just to be safe. The nurse did say - but we want you to bathe that morning. LOL I am guessing embies and eggs don't like BAD smells either, LOL. I was only going to post one photo a day, but I do have an appropriate photo for this post! My nieces expect me to paint their fingernails and toenails when I see them (which I am very happy to do!!!). So I will post a photo from May in which Susie is showing off her painted toenails (and her nails were also painted red).

Stimming day 11 u/s report

Well I had the phleb. use my left arm again as I wasn't sure if my right arm would cooperate again. Well if I need blood drawn again this week I'm offering my right arm as my left arm HURTS. I've had blood drawn 6 times in the last 12 days and 5 of those times from the left arm. I thought since that arm had "off" on Saturday and Sunday that it would be okay, but I was wrong. But maybe I am done having bloodwork for a few days??? I'll find out when the nurse calls me this afternoon.

Well my ultrasound was very painful (as my ovaries are SUPER DUPER tender) and very long as there were LOTS of follies to measure. She measured more than 30 follies. I know she measured 16 on the one ovary; I am not exactly sure how many on the other side, but I know it was more than 12. The ultrasound machine only allows you to record up to 12 follies per ovary so she had to make the machine think she did two separate ultrasounds as she needed more than 12 measurements per ovary. So I'd guesstimate she measured about 32 follies or so. A few of those (maybe 4?) were "small" (meaning only about 10mm). The biggest was 19mm. There were I'd say at least 5 follies between 17-19mm and quite a few in the 14-16mm range. My lining is thick enough (11mm), but I've only had a problem with a thin lining ONE time and that was on Clomid. My lining is always PLENTY thick enough on inj. I was a little nervous about the fact that I had more than 30 follies that were 10mm or greater, but I think the 10mm are too small to really "count." I hope so anyhow. I am still praying for a fresh transfer. My #s today again convince me my retrieval will be Wed AM, but I'll find that out for sure in a few hours.

Slow moving

I have noticed that in the blogs I read I really enjoy the posts more when there are photos. Although they've been taking about 10 ultrasound photos each visit, they haven't given any copies to me so I can't share those with you. I don't know how interesting you would find photos of my follicles to be anyhow, LOL. You know you're walking slowly when a white haired gentleman at church who looks to be at least 70 years old passes you out as you are walking on the sidewalk leaving church. Yep, that's what happened to me today, LOL! I am walking at a snail's pace these days. I am also soooo thankful for my comfy couch at home! I was in sheer pain in Sunday School sitting on a metal folding chair. OUCH! The church pew was better than the chair but again more painful than my couch in my living room. My flute solo went well this morning although I couldn't hold the last note for as many measures as I was supposed to due to it being rather painful to take a deep breath that involved my diaphragm. This too shall pass (unless I get pg which might curtail my flute playing for a little bit). I am hoping that tomorrow morning will be my last belly shot and that the pressure in my ovaries will decrease after the retrieval on Wed. I figure they are going to retrieve about 2 years worth of eggs (considering the average woman ovulates 13 eggs a year). So my ovaries are definitely being overworked at the moment! I think tonight I am going to try sleeping on the recliner as I haven't slept well in bed the last couple of nights.

I am happy to report that my colleague, Michael, readily agreed to fill in for me on Wednesday evening if my ER ends up being Wednesday morning. He already filled in for me once last summer session when Paul and I had the "all day" RE appt. What a great friend he is!

E2 results

My E2 today was 1,612; Dr. Gell thought it "didn't go up much." 600 in one day isn't much?!? She was concerned when it went from 444 to 1,043 in 2 days but not from 1,043 to 1,612 in one day? I figured it would be at least 1,500. I know with inj/iui the highest they like to see it get is around 3,000. They have you cut your HCG dosage in 1/2 when it gets over 3,000, and if it gets over 3,500 they usually cancel. I speak from experience (both with cutting a HCG dosage as well as having a cycle cancelled). So I asked her what their limit was with ivf. She said 5,000. I think I'll be at 5,000 by Tuesday. So I am almost positive that my retrieval will be Wednesday morning. I doubt they'll put it off until Thursday morning, and Tuesday is definitely impossible if I am not triggering on Sunday night. I was hoping to have the ER on Tues or Thurs, but I guess that just means I need to find a substitute for myself for next Wednesday. If I have the ER on Wednesday then I hope I have a 3 day transfer as otherwise I'll also miss next Monday, and I'd really rather not miss 2 nights of class since the class only meets 12 times total!!! But it's out of my control. Given I only teach 2 nights a week it would have been possible to not need to miss any classes, but I guess now my hope is that I just miss ONE day. But if I need to miss 2 days then I will. I have to be on bedrest for 24 hours after the transfer, and I know I'll be too groggy from the narcotics and too sore to teach the night I have the retrieval.

So bottom line is I am staying at the same dosage until Monday morning, and that's when my next b/w and u/s check will be. Dr. Awad comes back Monday so he'll be making the decisions from here on out (Dr. Gell was making the decisions through phone consultations this week). It was good I got a refill as I will at the very least be using one of the Repronex vials that were in the refill Paul picked up for me on his way home from school. I am doubting I'll need any of the Follistim vial, but who knows for sure. I guess it's not impossible they'll have me wait until Tues night to trigger and have the ER on Thursday morning, but I would say I am 90% certain I'll be triggering Monday night and having the ER on Wednesday morning. Aside from my class on Wednesday night (August 1), I have kept my schedule completely free from July 31 to August 5.

The nurse said today that it's a double edged sword. The more eggs you have the higher your E2 goes, and more eggs can be really good. However a really high E2 or really high # of eggs also increases your chance of OHSS which they want to avoid. So here's my prayer request - I do NOT want this cycle to be cancelled. If my E2 gets too high OR I have too many eggs (more than 30), they will freeze any embryos we have 5 days after the retrieval and will do frozen embryo transfer in the future. The success rate with frozen embryos is not as high, that involves more shots, and involves more $$$ than having a fresh transfer next week will. So I really, really want to avoid OHSS and have a fresh transfer next week. If they thought I was really in danger they would have cut down my dose, so Dr. Gell must not be too concerned. She's also more aggressive. I think if Dr. Awad weren't on vacation he would have cut my dosage back some. My guess is that I'll have around 25 follicles on Monday. I feel like I'll be getting close to the 30 limit, but it's okay as long as I don't get to 31 or an E2 over 5,000. My only issue is that in the beginning they said TWELVE was the goal. I figure I'm going to have twice the "goal" which is why I don't understand the dosage decisions. I figured from the start I'd have a lot more than 12 when they started and kept me at 225iu a day. However, I believe God is in control so I am just trying to trust that it is all going as He has planned.

I'll post my next update on Monday morning! I greatly appreciate your prayers and comments on the blog that have let me know you are praying for me and cheering me on!!!

U/S report

Well first I have to share an answer to prayer. I was praying this morning that the phlebotomist would be able to get blood from my right arm (which no one has been able to do in many years although various ones have tried). I had to go to the outpatient lab at the hospital as the RE's office doesn't have a phlebotomist in on Saturdays. Going there involves walking up a very big hill, which normally wouldn't bother me but it was very painful today because of my tender ovaries. However that trip was well worth every painful step since she was able to draw blood from my right arm. YAHOOO!!!

The u/s tech said I have 21 follicles between 10-15mm; so they all grew 2-3 mm since yesterday morning (when they were 7-13mm). A lot of the follicles were 13-14 mm today. The nurse said likely I'll come in on Monday morning for another b/w and u/s check and either trigger Monday or Tuesday night (which would mean having the retrieval on Wednesday or Thursday morning). She'll call me later today after they get my b/w results and she talks to Dr. Gell. So I'll post again after I hear from her.

Going in again tomorrow

My E2 was 1,040 so I was correct in my prediction (I predicted it would be around 1,000). So they don't want me to wait until Monday for my next b/w and u/s, but neither the u/s tech or Dr. Gell are available to do the u/s on Sunday. So I'm going in again at 8:00am tomorrow. She said to stay at the same dosage, but they didn't give an indication as to when the stimming might stop. So just to be safe I called in a refill today of the Repronex and Follistim. I only have to pay $20 altogether for those vials, and I figure it's better to be on the safe side.

I did ask the pharmacist to only give me one box of Follistim (the Rx was for 2 boxes), and she said "but you only have to pay $10 for 2 boxes." To which I responded that I don't need 1,200 more IU of Follistim! I mean I actually might already have enough at home, but just to be safe I wanted to get one more vial (600iu). Yes, I know I will pay $10 whether I get 600iu or 1,200iu, but my insurance is paying the rest! I am sure they'd rather pay $591 for one box rather than $1,182 for two! I told her there was no way I needed 1,200iu so please just refill the Rx with only 1 box. I should have done the same with the Repronex now that I think about it. I should have just asked for only 1 box of that also as again the Rx was for 2 boxes. Well at least a box of Repronex is "only" $324 (for 375iu). If I get pg and have left over meds I'll donate them to someone so they aren't wasted.

I hope my vein is up for more b/w tomorrow. It really hurt today. Normally it doesn't hurt at all, but #1 I am not as crazy about this phlebotomist as others I've had there in the past and #2 I've had blood drawn from that vein 4 times in the last 9 days. So tomorrow will mean 5 times in 10 days. We shall see if it cooperates or if they need to use my hand instead. My right arm just can't be used for drawing blood so I always offer the left arm.

In terms of adoption we assembled the profiles last night (took us an hour working on it together), and I mailed them to Cathy today. Well I'll post another update tomorrow after my next appt!

Ultrasound report

The u/s tech measured 19 follicles (9 on one side and 10 on the other). The biggest was 13mm and the smallest that she measured was 7mm. MOST of the 19 were around 10mm. So I have quite a few growing in there, but they're not big enough yet. I really hope these 19 get bigger and not any more than that, but my guess is I'm going to have over 20. I really hope it stays as close to 20 as possible as I really don't want to get anywhere near 30. I can't remember for sure what this clinic defines as "big enough." I think my first RE clinic wanted to see at least 16mm, and if I remember correctly, I think this clinic uses 18mm as the minimum. I am curious what my E2 was today; I will find out in a few hours. I will post again this afternoon once I get my E2 level and find out what my instructions are as to my dosages and when to go in next. Also, I need to know whether I'll need to refill my prescriptions or not. I have enough Repronex for two more days (will run out after my Sunday morning injection), and I have enough Follistim for three more days (probably run out after my Monday night injection presuming my dosage stayed the same which it might not). I was hoping this was all I'd need. Not because of the cost as if I need to refill both it will only cost $20 total (although the vials are worth hundreds of dollars each) but just because I'd like the stimming portion to be over sooner rather than later if possible.

I am definitely in pain. It's not pleasant to have 19 follicles growing on your ovaries! I feel very bloated. I think my walking/jogging days are over for awhile. Last night was the first night it was too painful to sleep on my sides. I knew that day would come from previous experiences. It's hard for me to fall asleep on my back though as I always sleep on my sides except when my ovaries are feeling like they're ready to pop with 10+ eggs. Well hopefully this pain will not be in vain.

30 more profiles

I talked to Cathy M last night about our profile. She had some minor changes here and there that she suggested. Some were changes to the text and others were suggestions like - lighten such and such photo or make it bigger. So I made some changes last night and the rest this morning. I had a few ideas on my own of changes like I took a photo of Paul with Fergie (the dog we are pet sitting this week), of a deer in our backyard this morning, and of a vase of stargazer lilies in our living room that are from my flowerbeds. The profile is now 12 pages long.

So I ran those off at Staples today (which cost about $200) and then bought some pink ribbon at Walmart that has a string of pearl intertwined. I think it's very pretty. So tonight Paul and I will have what is hopefully our LAST experience of assembly profiles (punching holes, stringing ribbon, signing our names on the last page). After tonight we will have assembled at least 180 profiles over the last 31 months (we have 30 to do tonight). Then I'll get those in the mail to Cathy tomorrow. She said she'll use these 30 up first and then if she runs out she'll switch to the first 10 we sent. I hope one of these 30 is "the one." I can send our profile as a PDF file to anyone who wants me to email it to them.

Altogether we have now spent $10,000 on adoption in 2007 (between Ukraine and domestic newborn adoption) plus over $8K on IVF. It's a bit overwhelming for me the penny pincher! (just ask my dad to tell the story of when he gave me $$ to spend at summer camp, LOL) I know kids are expensive once you have them, but I never dreamed I'd spend over $30K just trying to have or adopt one, but we've already spent that much and will spend a lot more if we actually get matched with a birthmother or do ever travel to Ukraine. 2007 has definitely been the year of spending the most on adoption and fertility treatments. We spent $10K in 2004 on adoption but only about $4K total on adoption in 2005 & 2006. People are always quick to point out the adoption tax credit. Well...you only get that (especially for int'l adoptions) if you actually complete the adoption. So if we don't ever adopt from Ukraine, we'll never get a tax credit for the thousands we spent creating that first dossier that wasn't able to be submitted before it expired. And if we stick with our plan of me becoming a stay-at-home mom after we adopt, we probably won't be able to claim much if any of a tax credit over the 5 years you have to claim it as Paul will make very little as a FT grad student so we won't owe much if anything in taxes to the IRS so again no way of claiming the credit. Bottom line is that if we do adopt or get pg from IVF that child will be worth every tiny penny we spent trying to become parents, and I am thankful that the Lord has provided me with a job that has enabled us to come up with the money for these expenses the last 4 years. Of course we cannot keep spending money at this pace toward our efforts to try to become parents, so I am also glad that there is one free option out there - adopting from the foster care system. It's nice that there is a free option so that even those with very limited incomes are able to adopt even if they couldn't afford int'l or other adoption options.

Well I'll let you know tomorrow how I make out at the doctor. Tomorrow we should start to get an idea of how many eggs they might be able to retrieve from me next week.