January 26, 2010

Monitoring and IVF boot camp

Posted in IVF tagged , , , at 11:40 am by lifebytheday

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.Polycystic ovary ultrasound picture
  • 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! 😉

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9 Comments »

  1. Myndi said,

    I had the same issue with not bruising but not wanting to inject in the same location repeatedly because of tenderness. To remember where I injected before, I put a small bandaid (those little round or square ones) where I injected each time. They only stick for a few days because of bathing and what not, but still gives you an idea of where you’ve already “been”. Sorry the shots are causing you so much discomfort. It’ll all be worth it in the end!

  2. K.M. said,

    I feel your pain – hang in there! I am also running out of belly fat real estate (which I guess maybe I should be thankful for?). My biggest problem is the Menopur burning like crazy during and right after the injection. Fun times!

  3. K.M. said,

    PS – I LOVE your IVF boot camp idea! I might even copy and paste some of this for my uninitiated friends and family members. 🙂

  4. jsutera654 said,

    HA! I love this, you totally did this for me (to shut me up with the 20 questions I ask after reading your posts). Thanks dear. 😉 xo

  5. 21reena said,

    Even though I know all this stuff, I love reading about it – it’s like it confirms that I actually do know what I”m talkinig about, lol. That’s a great idea about using the upper thighs to “spread the love”…I’ll have to remember that when I start.

    Sorry your update wasn’t what you wanted – hope your #s settle down and you don’t have to be there every day!

  6. Jen said,

    Hey J!
    Thanks for updating and keeping us posted on the IVF process! Sorry those shots hurt OW! I am pulling for you and have fingers and toes crossed 🙂 C’mon follies mature and estradiol settle down 😉

  7. Kari said,

    Daily monitoring is not fun. At all. I hope you don’t have to submit to daily monitoring. It’s frustrating because not only do you have to wake up everyday early to be poked and prodded but the follie progress seems that much slower. I always wanted to see those big suckers popping out early and I’d get depressed with daily monitoring. Here’s hoping today revealed no daily monitoring. The crib does come in white. That’s the thing I’ve noticed about Canadian companies, they have a whole bunch of finishes. Here’s the link to the brochure that has all the finishes:
    http://www.dutailier.com/view.php?id=2906&f=Furniture

  8. b said,

    hey! i called s last night prior to reading this. the mrs. told me about it when i got home and i couldn’t wait to read it! thank you so much for breaking it down. i feel like i can actually follow along and not bother you with questions that i am sure you get tired of answering.

    i admire both of you for the strength you have kept through this entire process. i hope everything levels out and we’ll be hearing great news in a few weeks!

  9. CA said,

    Hi, I’m starting this process in a couple weeks and I’m getting a little nervous. I’v heard that some people get very nauseous or get emotional. Has that happened to anyone?


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