On Our Way

We had the BIG appointment yesterday. It lasted over five hours, four if you take out the hour for lunch.
We accomplished a lot throughout the day:

-Had a psychological assessment and consultation (yes, we passed)
-Met with the business office to sign consent forms and pay for a miracle baby
-Had a mock/trial transfer
-Had sonohystogram performed
-Met with the doctor again to go over my specific treatment and meds
-Met with the nurse to go over our treatment calendar, and tentative retrieval date
-Had a quick review of med mixing and injections with the nurse

Everything turned out well.

Firstly, we are not crazy. Well, not too crazy. Just a little. Me more so than Joel, but we knew that going in to this. The assessment looked at depression, anxiety, and obsession compulsion issues. All of these factors are known to be aggravated by infertility, and can in turn, affect the outcome of an ivf cycle. Our clinic also like to assure that all their couples have thought about any ethical concerns that they may have, and how they will deal with them. We passed with flying colors. We've talked long and hard about all of this stuff, so it was nothing new.

Next, I had to drink 48 ounces of water and wait two hours. Pure agony. I was sneaking into the bathroom to go a little at a time, I was positive my bladder was going to explode if I hadn't. I think that they purposely have the full bladder procedures after the consent signing and payment meeting so that the woman sits in agony and can't focus clearly while signing her life away in the form of a check. Mean, just mean.

The mock transfer required the full bladder. The full bladder pushes the bowels out of the way so that the catheter has a straight shot from the cervix to the top of the uterus. It also allows a much clearer sonogram of the uterus. The reason for a mock or trial transfer is assure that the transfer of the embryos will go smoothly. They can decide which size catheter will work best, and they can measure the size of the uterus. That is important in determining the placement of the embryos when they are transferred. There is a very specific area that they need to place the embryos.

The sonohystogram was next. They injected saline into my uterus and used the ultrasound to watch as it expanded. It was quite a sight! It filled up like a balloon. It looked great, no fibroids or polyps to be seen. They took a look at my ovaries which still look enlarged and polycystic (pco), even after 2 months on birth control.

I dressed and we met with the doctor in his office to go over all of my meds and everything that he had found during the exams. He wants to keep me on birth control for another month or so to try to shrink my ovaries back down and get them as normal looking as possible before we completely shut them down. My diagnosis of Polycystic ovaries is the newest one. I have PCO, not PCOS. Meaning that I ovulate on my own, and that I have absolutely no symptoms of pcos. My doctor told me that being slender is what is keeping me from having the full blown syndrome. How does this affect me, you ask?
According to my doctor, "Most women with pco have a thick zona pellucida"(fancy words for 'outer shell'). Meaning: My eggs are likely not allowing any sperm to fertilize them. I have quite the little war going on in my body. Either embryos are being created each month and they don't seem to want to implant in my uterus, or my eggs are too dang hard and those sperm have no chance. Chances are that both are the issue. Either way, the only way to deal with it is ivf. So we are making the right choice.

Anyway, the doctor wants me to continue on the birth control for a little longer to get my ovaries looking as "normal" as possible. I'll start on my suppression meds after 3 1/2 more weeks of bcps. In addition to the suppression med, Lupron, he wants to start me on something called dexamethasone. I have a higher chance of miscarrying due to the pco. It is a steroid that will help my immune system somehow. It will help me to create higher quality eggs.

I'll be on Bravelle and Menopur for my stim drugs this time, as opposed to the Follistim in cycles past. The Follistim was easy as it was in a pen and I simply had to dial the dose and jab my belly. Now I have to measure and mix in numerous vials. It will still be easy, just not as convenient as before. No one likes to mix and measure meds in a public restroom while out in the evening.

Joel gets to take some meds this time. It's just an antibiotic for a few days, but at least he has to do a little more than usual this time. Nothing compared to what I go through, although I am not complaining.
I'll get put under for the egg retrieval, and it should only take 20 minutes or so. It is a fairly simple procedure, just a few pokes into my ovaries and they suck all the developing eggs out.

The only part of this process that I am not looking forward to is the Progesterone in Oil (PIO) shots that I have to do starting the day of the egg retrieval. They are intramuscular, and need to be done daily for at least two weeks, in the evening. An additional 8 to 13 weeks of them if I get pregnant! I will have to do them myself. These are the butt shots. I may need to start up yoga again to get a little more flexible. The needles are thick, 1 1/2 inches, and the medicine is in oil. I have heard horror stories about this med. The hardest will be the first shot, just like with the sub-cutaneous. Anything after that will be a piece of cake. I am one tough lady. I can handle it.
My meds are arriving today. That should give me a few weeks to get them all straight. My fridge may not be able to hold much food. Who needs to eat anyway?!

As far as dates go-
Everything will be starting on February 17th. That is the first day of my Lupron, and Dexamethasone.
Our tentative egg retrieval date is March 9th. I highly doubt that will be the actual day. It all depends on how my body reacts to the meds.
Our embryo transfer will happen 3 to 5 days after the eggs were retrieved. We are hoping to do a 5day transfer with 2 blastocysts. That gives us the best odds at conceiving - 80-90% for the cycle. Those numbers are amazing considering a fertile couple only has 20-25% per cycle.