March 19, 2012

March 17, 2012 (Second Surgery)

I decided to take my chance and trigger again the same day as my surgery.  On March 17, 2012, I wake up at the crack of dawn again and go into a second surgery.

The surgeon retrieved 9 eggs in all, though only 3 had matured.  My doctor (a little too optimistic for my taste) calls me on Monday (she is absent for the whole weekend while I'm going through the ups and downs of my results) and says that there's still a possibility that the eggs could mature after they are thawed.  She also insists that a second round would almost certainly be more successful as she would change the protocol entirely.  Unfortunately, I'm in the 1% of those who did not respond as expected, but I did show great follicle response, which makes her hopeful that with an entirely new protocol, results could be much better.

I really don't know what to do.  Is it wise to save for another few months and try again?  Or do I call it quits and take my chances? 

March 14 - 11, 2012 (Treatment day 8, 9, 10 and Surgery)

Day 9
One dose of Ganirelix
37 IU Menopur

Day 10
One dose of Ganirelix
75 IU of Menopur
Lupron trigger

On day 9 (March 14, 2012) I take 1 dose of Ganirelix and 37 IU of Menopur.  That night, the nurse that calls me tells me to discontinue any other drug.  Unfortunately, she was mistaken, and when I express my confusion to another nurse, she says that I should have taken Ganirelix on the morning in day 10.  I make up for it in the evening, taking a full dose of Ganirelix, 75 IU of Menopur and the trigger injection of Lupron.

The reason why they keep on changing my Menopur, as I understand it, is that while I have tons of follicles, some of them are still quite small and the doctors want to give them a chance to grow, while being careful of how high my estrogen has gotten.  As a doctor later explained to me, I responded quite well and so it was a balance of putting on the brake and pedal at the same time.

The night before surgery, I take my antibiotic.  I get a phone call from my doctor saying that my hormone levels are unusual, which sometimes indicates that there may be no egg growth, but she's not worried for me.

Long story short, I get up at the crack of dawn on Saturday for surgery...  only to be told that the surgeon found just one eggs, and many unmatured follicles.  So she stopped the procedure altogether.  Completely crushed, I go home, suppressing my tears until we're on the road home.

How can this be?

March 13, 2012

March 13, 2012 (treatment day 8)

Estrogen level: 2826
Medications:   In the morning, one prefilled syringe of 75 Ganerelix, in the evening 75 IU of Menopur
Follicle number and size: too many to count, 11-20 mm

My nurse prints me my ultrasound measurements today.  She only measures a few eggs, but it looks like some are still small (11mm) while others are quite large (20 mm) so they want to give me low doses of menopur since my estrogen levels are so high, all the while allowing the smaller eggs to grow larger.

Once again, I was a little bit panicked about getting my second shipment of medication, but it came on time via fedex and my roommate was at home to receive it.

March 12, 2012 (treatment day 7)

Estrogen level: 1961
Medications: 1 prefilled syringue of Ganirelix in the morning, 150 IU Menopur in the evening
Follicle number and size: too many to count, 11- 19 mm

The doctor’s office called me in the evening to ask me to come into the DC office in the morning.  But the receptionist was off on Sunday, so I could only leave a message.  I decide nonetheless to come in early this morning to get my blood work and ultrasound.  I doubt they’ll refuse to test me… 

At this point, I’m able to manage my panic attacks and start taking this whole process more in stride.

The medical office is packed – I’ve never seen that many people there before.  It’s like a factory: they call someone’s name, she get her blood drawn up, gets an ultrasound, and is given a piece of paper to bring to the front desk to be dispensed.  Wow, a real windmill.

My arms are starting to look like track work, and I alternate the draw to the arm that has fewer red welts on it.

Today, the ultrasound is very uncomfortable and I let the nurse know.  She says “that’s kind of normal.  At this stage, your two ovaries which are usually the size of almonds are now the size of grapefruits”.  So the rest of the day, I imagine large, squishy/soft grapefruits on either side of my bellybutton just jiggling as I walk around, lie down, put the laptop on my lap…  And I feel infinitely more uncomfortable with the image and the cramping feeling.

Before I leave the office, I just assume I’ll have another appointment the next day and make an appointment with the front desk automatically. 

March 11, 2012 (treatment day 6)

Estrogen level: 1473
Medications: In the evening, 150 IU Menopur, 1 prefilled syringe of Ganirelix
Follicle number and size: too many to count, 11- 14 mm

So apparently, I have to go into another appointment today as well.  I borrow my mother’s car (gosh, I’m so sorry mom, I didn’t expect this) and drive myself to Rockville. 

Estrogen is 1473, with a good follicle growth and good lining.  There are so many eggs that the nurses don’t bother counting them anymore.  Each follicle grew to 11 – 14 mm.

But I have to tell you: I am feeling super emotional, had a big long-distance blow up with my boyfriend the night before, feel very tired (though that could be due to the worry and early morning wake ups) and am starting to feel some cramping.

I am panicking a bit because I have to start taking Ganirelix but I only have 3 doses at home.  Oh no!  Will I be able to order the other 3 from Freedom Pharmacy on time?  The nurse calls in emergency doses at a special pharmacy that I can pick up after my appointment.  And miracle!  The pharmacist DONATES those three doses to me and saves me $317!!!

That night, exhausted and emotional, I cry on my roommate shoulder.  Thankfully, I’m totally normal and am almost a little over excessively cheerful at work.

March 10, 2012 (treatment day 5)

Estrogen level: 1206
Medications: In the evening, no Gonal F, 75 IU Menopur
Follicle number and size: too many to count, 8 mm

I borrow my mom’s car again (thanks mom and sorry about the last minute) and I drive myself to Rockville for some tests.  Today, the largest egg is about 8 mm.  My estrogen level is 1206.

I read up on the side effects of Intrauterine Fertilization (IVF) and learn of a syndrome that develops if you grow too many eggs.  I’m not sure if that applies to me given that I’m only in for egg freezing (not IVF) but of course, that makes me worry considerably…  Thankfully, I have a lovely friend who has gone through the same process twice before and who manages to talk me through my worries and calm me down.

March 9, 2012 (treatment day 4)

Estrogen level: 780
Medications: In the evening, 75 IU Gonal F, 75 IU Menopur
Follicle number and size: not sure

This is my first follow up since the beginning of the protocol.  Did I even get my injections done right?  I guess we’ll see…

Everything looks good. My estrogen level is 780 and I still have 20 eggs on each ovary… 

But the office calls me on the afternoon of March 9 and apparently they want me to come for tests tomorrow.  What the heck, is there anything wrong?  Usually, they ask people to come in every 2 or 3 days at the beginning.

I’m starting to freak out.  The nurse tells me that usually, they want to see my levels as less than 100 at this point.  The nurse calls me to stop Gonal F from now on, which of course worries me even more.

March 6 – March 8, 2012 (treatment days 1 – 3)

Estrogen level: 38.3
Medications: In the evenings, 150 IU Gonal F, 75 IU Menopur
Follicle number and size: 20 in each ovary, but don’t know the sizes yet

Every evening, I inject myself with 150 IU of Gonal F and 75 IU of Menopur.  It’s actually a lot more daunting to thinking about the injection that it is to actually inject myself.  I can barely feel the pricks on my (well-padded) stomach, and rewatch the videos many time to make sure I’m following the instructions to a Tee.

Treatment Progress: March 3, 2012

Today, I stopped taking the pills and came into the Rockville office today (the DC office is closed on the weekends).  Man, this is such an imposition because I have to borrow a car from my mother as well as her GPS to go to Rockville.  It’s not a very long ride, but I don’t drive often so waking up early and using various beltways and highways makes me nervous.  Ack, this is not convenient at all, but it’ll be worth it in the end (I hope)…

For some reason, the ultrasound shows that there are 200 follicles on each ovary.  Maybe the 8 on the right ovary suddenly grew to 20?  Other than that, all looks well and I should start my protocol tomorrow.

This is the part that scares me the most – I’m freaked out about having to inject myself, and use needles to mix medications, saline solution, powders etc.  I have pre-filled syringes for Ganerelix, saline solution and powder solution to reconstitute in a needle for Menapur, and a weird kind of clicky pen for Gonal F.  What the heck does it all mean? 

I choose to forgo the injection class and instead use the great injection videos online.  I watch some of them several  times and hope that I can do this right.

Also, my medication should have arrived from Freedom Fertility Pharmacy to the Fedex office today but haven’t heard from Fedex yet.  I freak out a little bit, wondering whether I’ll have enough drugs to start my protocol.  I decide to show up to the Eckington Fedex office right after my appointment and hope that my medication package arrived.  And it did!  Woohoo!  I’ll be able to start my protocol on time!

Treatment Progress: February 11 – March 3, 2012

I’m taking my birth control pills.  I really hate the symptoms.  I feel irascible, depressed and bloated.  I’ve tried to take the pill on and off since I was 16, but ended up quitting every time because I just generally felt crummy while I was taking it.

Treatment Progress: February 11, 2012

I experience my first transvaginal ultrasound and blood draw at 7:30 a.m.  Thankfully, the DC medical office is on the same metro line as my work, so I’m able to hop on the metro after the appointment and be at work on time.

I have a normal uterus, with 8 follicles in my right ovary, and 18 follicles in my left ovary.  The 18 follicles are arranged in a curve-like shape around the border of my left ovary – often called “pearl configuration”.  I was first told when I was 16 years old that my hormonal levels probably indicated that I had PCOS.  But this is the first time – 18 years later - that my condition is confirmed by ultrasound.

These are my baseline readings:

Estrogen Level – 38.3 (doctors prefer this to be lower than 50)
Luteinizing Hormone – 14.0
Follicle Stimulating Hormone – 6.12 (should be less than 10)
Prolactin – 10.6 (should be less than 25)
Thyroid – 2.47 (should be less than 4)

The ultrasound shows no abnormality with the uterus and the ovaries.    My nurse tells me to start the birth control pill today.

Brrrr, it's cold in here!

I haven’t blogged in a while.  Mostly, I’ve been trying to concentrate on work (I’m doing a 3-month rotation elsewhere) and I’m in the process of freezing my eggs.  You’ve read it right.  Freezing my eggs.  Feh-Reez-Innng Ma’ Eggies.

Why Would You Ever Want to Do That?
I’ve wanted to have children since I was 16 and was seriously ready to have them since I was 26 (I’m 34 years old now).  In these last 4 years, I’ve been inconsolably sad about not having that opportunity. 

My boyfriend is not ready to have kids right now – to be fair, we’ve dated for about a little bit more than a year, and most of that time he’s been abroad.  I’ve always wanted to adopt kids and I finally have a house of my own, which gives me much more flexibility to adopt. 

But 1) I have a roommate who isn’t too keen on foster kids running around the house, and 2) my job has me travel unexpectedly for 1 – 3 months deployments.  So right now, having kids or adopting is just not going to happen.

I hope that freezing my eggs will buy me time.  “Hope” being the operative words here.

My Profile and Statistics
There’s a lot of good blogs from women out there documenting their adventures in egg freezing.  And they all seem to cling to details of their treatment and ensuing statistics.  I must admit I also find it helpful, so for those of you going through the same process, here’s a rundown.

Age: 34 years

Height, weight: 5’3’’, 130 (though I don’t weigh myself too often – best not to know exactly!)

Medical Conditions: Polycystic Ovarian Syndrome (PCOS), never pregnant before

Maternal History: no problems getting pregnant at all.  As a matter of fact, she had 3 children, and often says that she got pregnant a few days after stopping birth control for all three of us

Cost of treatment: $7,500 with Shady Grove Fertility Center + $2,000 for medications (though medications will probably only end up costing me about $1,200 because a local pharmacy donated some unused medications)