January 26, 2010
Monitoring and IVF boot camp
Today was my first monitoring appointment, and so far, not a ton of progress – no follicles over 10 mm. I know that I shouldn’t have expected anything different, but I was really hoping for some growing follies, to be able to see the light at the end of the tunnel a bit. These damn stim shots HURT! Not going in, but for 2-3 days afterwards, the injection site feels like someone punched me with a brass knuckle…not that I know what that would feel like, but still! 😉 And the annoying part is that you can’t see a bruise or any mark AT ALL, so before I shoot up each night, I have to poke around and make sure that I’m not hitting the same spot. My first injection site (from Saturday night) finally stopped hurting today! I’ve actually moved my Lupron shots to my upper thighs (which on me are more sensitive) – to preserve belly fat real estate for the stims 😉 – so I should have some good bruising going on there by the end of the week. Really though, I’m grateful that the injections have gone relatively smoothly, and hope that my estrogen level will reflect slow and steady growth. (I’ll update the post when I hear from the RE’s office.)
Since we’re getting into more of the technical aspects of IVF, I thought I’d give a quick tutorial on some of the terms I reference regularly, for my real life friends who try their darndest to understand what the heck I’m talking about (J and B, this is for you)!
- Follies, or follicles, are located in the ovaries and are where eggs are housed as they grow. PCOS causes multiple follicles to develop, which in turn forces the ovary to grow to accomodate them. Here is a picture of an ovary with PCOS (mine looks very similar) – see those black dots? Each one is a follicle. The goal is for some of these follicles to start growing…retrieval is scheduled once there are several follicles over the 18 mm mark.
- Lupron is a suppression medication that is often prescribed (especially for people with PCOS), to supress the growth of those millions (well 60 in my case) of follicles, and focus the stim meds on growing a few good quality, mature eggs.
- Stims, or stimulation drugs (in my case, Gonal-F plus Repronex) are what are used to grow the follicles and create mature eggs.
- OHSS, or ovarian hyperstimulation, is typically only found in women who do fertility treatments, and it’s essentially just the formal term for big, swollen ovaries. It’s usually relatively harmless, just uncomfortable, but in some cases can lead to twisting or rupturing of the ovary. So for people with PCOS, this is a major concern (since the abundance of follicles makes this occurence more likely) and is tracked pretty closely.
- ER, or egg retrieval, is when the follicles are aspirated (poked with a big needle with a vacuum on the end of it…vaginally – sounds fun right? :-P) and removed from the body, then mixed with the sperm and set aside to fertilize. Don’t worry, they put you out for the ER. 😉
- Occasionally, sperm is injected directly into the egg (called ISCI) in cases of poor fertilization rates or embryo quality. We’ll likely be doing ISCI this time around.
- Finally, the ET, or embryo transfer, is when the fertilized (and hopefully developing) embryos are transfered back into the uterus, via a catheter essentially. Besides the gallons of water you have to drink before the procedure (essentially using the bladder to re-position the uterus), the ET is easy and you can actually watch the procedure on ultrasound.
Okay, so that was definitely TMI, but I hope that things make a bit more sense now. Shout out if you have a question about something I’ve mentioned previously and I’ll try to explain! And thanks for caring enough to try and understand. 🙂
Update – just heard from the RE’s office…my estradiol level is 650, too high really for this early in the cycle. So tonight I’m to take my Repronex only, and tomorrow morning have to go back in for bloodwork and ultrasound. While I appreciate that they’re being cautious, I really hope this doesn’t turn into a daily monitoring. My veins and my beauty sleep are going to suffer! 😉