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. :-)