Saturday, March 1, 2008

IUI #3

OK .. I haven't even been able to blog about this cycle up until now. It's been so stressful - and I have been so frantic - I just couldn't even bring myself to write about what was happening. But now - it's ALMOST over - so I can. I just got the call to trigger tonight at 9:30pm .. and I will have back to back IUI's - the first one on Sunday morning at 9:30am .. the second on Monday morning at 9am.

Basically - today's instructions to trigger come after my 10th dose of follistim (a record for me) - with the 11th hour addition this past Wednesday of ganirelix to suppress one giant egg that REALLY wanted to be liberated from its follicular shell. Yesterday's follie check revealed:
a 23mm (considered out of the picture/not healthy anymore by my RE at this point due to its enormity) a 17, two 14's and an 11.

For those wondering why a 23 is "too big" - it is only because I'm on injectables, during a natural or a clomid only cycle - a 23 would be great. But on injectables, apparently once you get over 22-ish .. it becomes less likely that the egg inside the follicle is still "good".

The bad thing about yesterday was that my E2 dropped ... from 799 on Thursday ... to 681 on Friday morning. I spent all day Friday (and Friday night) scouring the internet to try and figure this out - because RE nurse really had no explanation for me - and what I found is that Ganirelix not only suppresses LH so you don't ovulate on your own - it also suppresses E2. And most RE's will up your stim dose accordingly. My RE actually wanted to decrease my stim dose .. but we did not end up doing that (I'm a cantankerous patient and argue with everything I don't agree with) and actually bumped it up - and as of this morning - my E2 is 1071! So it came right back up. Whew!

Based on yesterday's scan, although I did not have one today (thank God - as this IUI cycle has already been incredibly expensive) ... I'm hoping the 17 has turned into an 18/19 .. and the 14's are around 16. Which means I'm triggering tonight with at least three mature follies - and possibly four. I'm not writing that huge one totally off. There is a chance it's still viable - the chances are just somewhat reduced that it is.

Although last night was my 10th dose which seemed like A LOT to me - I think 7 - 10 nights of stims is average -- so 10 isn't insane - although I am so glad to be DONE. And done with the ganirelix too .. that's kind of a thicker needle - and the liquid is a little irritating once injected. Oh -- and that was another dilemma -- they instructed me to take the ganirelix this morning even though we knew I'd be triggering tonight. I didn't want to because that seemed dumb - why would I take it on trigger day? AND - the package insert says to take it up UNTIL the day of HCG trigger (not up to and INCLUDING day of HCG trigger.) I compromised. And did half an injection at 6am this morning. I told you I'm a bad patient. But I don't care if I start to surge today - I'm triggering tonight anyway and my first IUI is in the morning. So I don't WANT my follies to be suppressed anymore. I need to just let it go and shut up about it though.

We're also setting records with how much this IUI cycle is costing us out of pocket - I estimated $2500 ... it's closer to $4000. Oh my God, even typing that makes me want to faint. It's taking a big, UNEXPECTED bite out of our fertility budget, that's for sure. It's painful to think those dollars might be better directed at IVF. But .. I have to just let that go too. There was no way to know on CD 3 - a week and a half ago Wednesday - that this cycle was going to be so nuts and so expensive. I have never had more than 3 ultrasounds and 3, maybe 4 blood draws in one cycle and this is my FOURTH injectables cycle (third IUI, first injectable cycle was TI.) But it is what it is. I'd like to think I've been put through the wringer on this one - physically, emotionally and financially - because it's going to .... work. We'll see. I feel like we have a shot.

Although I have one more injection tonight - HCG trigger shot ... I'm looking forward to then having a few nights off from injections! But I'll have to start Lovenox early next week - 1dpiui will be Tuesday night. So I guess that's when I'll start.

So that's my story. It's always something. This journey is not for the timid or the faint of heart .. that is for SURE.

Hope all who read this are doing well. I'll keep you posted, of course. And keep me posted on how YOU'RE doing too. :-)


Ariella said...

Wow 4,000 for a IUI cycle. That is what scares me the most, not to mention you have some coverage while I have none. THIS is exactly why IF should be insured.

I am so hopeful that this will work for you. I hope you guys get great numbers post wash.

Meghan said...

Yikes, that is a lot of an IUI cycle. I agree, with everything you'v gone through this cycle, it just has to be the one for you. Good luck with trigger and both your IUI's

Melisha said...

I have a good feeling for you about this cycle! Hang in there, your thoughness keeps me going!


Anonymous said...

I'm very positive for you this cycle as well!

I'm on day 3 of 100mg clomid. I've got to go for a scan a week from Monday. I hoping for some good follicles as well!

Hope it all goes well!


Melisha said...

I loved this story and wanted to pass it along:

Identical in-vitro triplets born in NY

MANHASSET, N.Y. (AP) -- When they get older, Logan, Eli and Collin Penn may blanch at the notion they wore nail polish to their first news conference. But it's the only way their parents know how to tell the boys apart right now. The identical triplets were born Wednesday at North Shore University Hospital on Long Island - an event so rare that an obstetrician estimated it might happen just once in 200 million births.

The triplets' mother, Allison Penn, was impregnated with just one embryo through in-vitro fertilization, said Dr. Victor Klein, a specialist in multiple births and high-risk pregnancies who delivered the boys.

That embryo split in half, and then one half of that split again, he said.

"This is the first one we're aware of in the literature in the country in which they only put back one embryo" and a woman gave birth to triplets, said Klein. "Most people put back two or three embryos, and you just never know."

Identical triplets are born at a rate between one in 60,000 and one in 200 million, depending on the research, Klein said.

Allison Penn, 31, said she and her husband, Tom, 46, had tried to have a baby since they got married about four years ago. Although she once thought of having several children, the disappointments over four years revised her dreams downward.

"When it took us so long to get pregnant, I just assumed we were going to have one, and that would probably be it," she said. "So I thought one would be good."

And when she and her husband were told three youngsters were on the way?

"I looked over at Allison and her mouth was wide open and her eyes were like saucers, and she didn't say a word," Tom Penn said. "Then I realized that it was possible, and then I started to laugh."

He confessed he couldn't get over the irony.

"Everything we had done was to have one baby," he said. "Anybody who says God doesn't have a sense of humor - everything we did was just for having one baby, and now we have three."

To help tell them apart, the boys have a dot of maroon nail polish on their fingers. Logan Thomas, who weighed 4 pounds, 12 ounces, has a mark on his thumb; Eli Kirkwood, a 4-pounder, has polish on his forefinger, and Collin McGuire, at 4 pounds, 11 ounces, has a mark on his middle finger. Logan may have a problem with a non-functioning kidney, but the other children are healthy, doctors said.

Allison, an education specialist for the U.S. Fish and Wildlife Service, said she has not decided whether to return to work.

"That's one of those 'one-day-at-time' issues," she said

ONE OUT OF SIX said...

That story is crazy!! You never know, huh? ;-)