Thursday, January 17, 2008

We made it to retrieval! It's tomorrow.

We have to leave around 6:30 to check in at 7:30 for a 9am retrieval. The person doing the anesthesia is named Pat and she's wonderful. She's been drawing my blood all week. She's very kind and good with the needles. She also is aware of the RSD and promises to do what is necessary to reduce any RSD flares.

I'm amazed to have made it this far. If you've read the rest of this blog, you'll know that my doctor didn't know if I could make enough eggs. Well, I did! The last follicle count was 12, but that could have included cysts and it definitely included some that aren't so big. Still, about 8 may be mature by retrieval time. I can't wait for the fertilization report.

A friend of mine, Renae, had her retrieval this morning. She and I knew each other before this cycle, but were acquainted by chance. Now I firmly believe we were meant to meet and we were meant to go through this together. There is just too much chance going on with this friendship. Anyway, I'm so delighted that she got 7 eggs today. I am just as eager to hear her fertilization report as I am about mine. If you pray, please add a special one for Renae.

A virtual friend of mine on a bb asked me to explain our process. Rather than write it twice, I'm copying it and pasting it here, too.

Basically, what I'm doing is called an antagonist protocol. As far as I know, it's a protocol the experts use on women who don't typically produce much eggs. The hope is to get enough good eggs for retrieval and transfer. I started the injections on January 5th. I did two to four shots in my belly each day. In the mornings I did a medication called Follistim, which is injected with a pen, much like many diabetics use. When the medication would run out in the pen, I would have to do a second shot to finish the dosage. In the evenings I injected Menopur with a syringe and needle. It is also done with a diabetic needle, which is really thin and only 1/2" long. They don't hurt that badly, just sting for about 10 minutes or so. I got bruises from the follistim, though, so my belly is a bit colorful.

After a week of stimulation with the FSH medicines (Follicle Stimulating Hormone - the Follistim and Menopur are FSH, which helps a woman to recruit and produce more and better eggs) I started the antagonist (the drug that makes it an antagonist protocol). The antagonist I used was Ganiralex. It's also an injection in the belly. It comes in a pre-filled syringe ready to go. I did that shot at the same time each day to prevent me from ovulating so that my smaller follicles had more time to develop and produce mature eggs.

Last night I gave an additional injection, the hcg trigger shot. Since I was using the ganiralex to inhibit ovulation, I needed the hcg to induce ovulation. Ovulation usually occurs about 36-48 hours after this trigger shot. The egg retrieval procedure is scheduled for 35 hours after the trigger shot - so tomorrow morning at 9am (though I have to be there at 7:30).

Tomorrow they will give me an IV and make me go floppy sleepy. Basically, I will be deeper than sedation but not as deep as general anesthesia. They'll use an ultrasound to guide a needle to the follicles. They'll stick the needle in each follicle and suck out all the fluid and the egg. After they are done with that, they flush out my ovaries to try to get anything they miss. Since they suck all this out with the eggs, I will need to supplement myself with essential hormones in this 2ww.

They'll tell me at some point how many eggs I have and I will be told to rest for the weekend. They'll be doing a procedure called ICSI on my eggs. ICSI is where they cut a tiny slot in each egg and implant a sperm. They will basically be creating the embryos. We need to do this because on top of my own infertility issues (advancing age and severe endometriosis), my husband has low counts, low motility, and low morphology (morphology relates to the shape/quality of the sperm).

They will also do "assisted hatching," which I think it means that they will do what needs to be done to make sure that the eggs are ready for being embryos. I'll get a phone call on Saturday with the fertilization report. Basically, that will also be indicative of the quality of my eggs.

Through this whole process they monitor the embryos and watch the cells multiply as they study the embryo quality. They will grade the embryos each day from 1-4 (I think), with the higher number being the better grade. On day 2 they will decide if they are good enough quality to go for day 5 blastocysts (after day 3 the grading changes so that the best quality is grade 1) or whether they should be put back on day 3. Sometimes if they aren't doing so well they will put them back on day 2 since they sometimes tend to do better in the womb.

The best transfer is a day 5-6 blastocyst - there is more of a chance of pregnancy from those. Anyway, with any luck I'll go back on Wednesday for the transfer. With a little less luck I'll go back on Monday, which is still good.

Starting tomorrow I'll take Medrol, an immune suppressant and anti-inflammatory medication. This will help suppress an auto-immune response and inflammation from all of the medications and procedures. Starting Saturday I'll add baby aspirin to help support a better endometrial lining for implantation, and estradiol tablets along with progesterone (it's in oil and given by intramuscular injection - in my bum by my husband and ouch) to help support the embryo. The estradiol and progesterone are the hormones needed since they suck all of that out of me at the retrieval.

My pregnancy test will be on February 1st.

1 comment:

Babe* said...

Thinking of you!!