They retrieved 17 eggs, of which 12 were mature and were ICSI’d. Of those 12, 9 fertilized (it’s normal for some to drop off at each stage). When they checked them on saturday, which was day 3, all 9 were still going strong! 5 are doing great and the other 4 are not far behind.

I go in tomorrow for my transfer. I’ve decided to transfer 2 unless they suddenly tell me my chance of getting pregnant with one is 85% or something (this happened to a friend who used donor eggs that made gorgeous embies.)

I have learned a few things about the shots that I thought I’d pass along:

- the follistim was no problem for me. I could hardly even feel the needle go in. The menopur stings like a bitch though and I found a few things that really helped me. I mixed it up first then let it sit on the counter while I did the follistim. That seemed to allow more time for the menopur to more completely disolve. I also pushed the syringe down slowly and practiced deep breathing while injecting it.

- I have been giving myself the progesterone in oil (PIO) shots each morning (except the first one, which my mom did.) I purchased a small mirrror – the kind used to put on makeup – which stands on it’s own and which I can angle so I can see the right spot to do the injection. The needle hurts going in but the actual shot doesn’t hurt. I use a heating pad before and after doing the shot and also massage the area for a full minute immediately after the shot. This all helps with muscle soreness. On the first day, I only massaged it for 10 seconds or so and I could definitely tell the difference when I massaged it for a whole minute.

- I give myself rewards. There is a new gluten free ice cream sandwich that I ate after my evening shots each night. Yum. By the time I finished the sandwich, The sting from the menopur was gone. The PIO is in the morning and I’m not up for ice cream then but a her.sheys kiss works just as well.

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• A *ton* of teaching jobs were recently posted for next year and I have been applying like crazy.  It is a long process and I have to apply for all of them within a week, so that is where most of my time has gone.
• I have now done four lupron injections.  And, as an update on an earlier post, it is going quite fine.  Fear of needles (at least the teeny, tiny lupron ones) is gone.  Actually, I kind of oddly look forward to the injections each morning – both for the structure they provide (did I mention I love structure?) as well as the sense that I am doing something proactive that will help get me closer to a baby.
• My pup Cassie has a ton of allergies and will need to start allergy shots.  I am a bit sad for her, but mostly relieved that her allergies will require shots – they have been really bad and if the test results said they weren’t bad enough to require shots, I wasn’t sure where we would go next.  My other pup, Zoe, gets allergy shots and after about a year is doing fantastic with them.  She is almost off her allergy meds.
• Only four more BCPs left.  I will not miss them.
• My suppression check is scheduled for next Thursday, the 27th.
• I got offered a job teaching summer school (kindergarten) this year!  Sooo excited.
• Plus, I will be an Area Leader at my favorite queer camp for one of its lovely weeks this summer.  Again, sooo excited.
• Lupron keeps your pituitary from producing hormones and its been nice and relaxing not to have *any* mood swings (though also odd not to have any strong emotions at all.)
• My stepbrother announced his engagement to his (conservative Christian but very sweet) fiance and their wedding *this August.*  This caused a lot of family drama (because of the quick turn-around, need for people to adjust schedules when doing so wasn’t always possible, etc.)  It seems to all be worked out now.
• For my last three BFNs from IUIs (Jan, Feb, and March), I bought myself something as a bit of a consolation prize.  The last one, kin.der eggs (which I fell in love with when living in Germany) finally arrived, imported from Canada, after a much too long wait (due to poor customer service, etc., that eventually caused me to cancel my order and place a new one with a different company.)  But they. are. here.  Only they don’t taste as good as the German ones, so my little sis, who is in Deutschland right this minute, is sending me some good German ones.

Thanks so much for all your kind comments about my post on “deserving” a baby.  They are much appreciated and it is so wonderful to have people out there who understand.  I’m in a bit of a better place right now (helped, no doubt, by the lupron-induced lack of strong emotions.)

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So, yes, the other night I dreamt that I killed my grandma – not intentionally of course – but still it was awful.  I woke up miserable and curled up with my ever-so-loving-and-sweet pups.  I’ve also dreamt, for example, that the house caught on fire – though this was less a nightmare than a stress dream because my big reaction to it was, “oh, God, now I have to get that fixed.”

There have been some pleasant ones, too, of course – and in general I’ve really enjoyed remembering my dreams in a way I hadn’t been able to do since I was a child.

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they arrived on Friday!

Everything but the follistim (which must be refrigerated) takes up a full shelf in my medicine cabinet.  I start the lupron on Sunday.  Also, my insurance covered some of the meds!  That was a *huge* relief.

And happy 100th post to me!  Since I just wrote a huge reflection on blog birthday, I’ll refrain from doing that here.

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Now that my IVF cycle is looming, however, I have developed a sudden, intense aversion to needles.  Even acupuncture needles (although I’ve had regular acupuncture treatments for years without problems.  For the uninitiated, acupuncture needles are *tiny,* about the size of a cat whisker.)  Every time I have blood drawn or an acupuncture needle punctures my skin, I tense up tremendously.  This, as you may imagine, does wonders for the comfort I feel as the needles actually enter my skin.

It is like my body knows the IVF drugs are coming and already has an aversion to them and, by extension, the needles that bring them.

I am really at a loss for how to get past this because I’ve never dealt with anything like it before.  Thoughts?  Anyone else experience something similar?

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Oh, birth control pills, never in my life did I think I would take you … yet I’ve now been on you for a week.  Even before I came out as a lesbian, I was not exactly promiscuous – I had one boyfriend, in eighth grade, and that was it.  So I never dreamed, even then, that I would take birth control pills.  Yet here I am.  Life is funny sometimes.

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1 v. 2: I’m leaning towards transferring 2 and have been leaning this way for several days.  The tipping point was talking with a (queer) couple who had done IVF and transferred 2 and ended up pregnant with 1.  They pointed out that after everything they’d been through (TTC for 3 years, multiple problems trying adoption, etc.), they would have been devastated if they got a BFN on the IVF.  I know I would feel the same way.  (Side note: this was at a Maybe Baby potluck, where I was the *only* one who wasn’t pregnant/the partner of a pregnant person.  *Not* a fun experience for someone dealing with infertility/IVF – though it got sooo much better when I realized that couple had done IVF.  I had a long, lovely conversation with them, interrupted at points by comments from others like (groan) “I feel so lucky!” and “I was worried when I didn’t get pregnant the first couple of times!”)  Plus, I do like twins.  I used to have a not-so-secret desire to have twins.  So if I end up with twins, that will be wonderful, too.

clinic v. hospital egg retrieval: I’m going to go with the clinic.  My mom talked with my uncle, who’s a pediatrician, and he saw no problem with doing it in the clinic.  Plus, this way the eggs won’t have to travel far in their little human-body-temperature microscope to reach the lab.  Also, my mom, who lives across the country, has agreed to come out here for my egg retrieval.  My mom and I don’t have the best relationship, but somehow having her here takes away much of my fear about the procedure.  Didn’t think that mommy-can-fix-everything-and-make-me-feel-better magic would last into my 30s, but here it is.

shared-risk plans: I’m still deciding on this.  An Offering of Love made an excellent point that the cost of one IVF plus one FET is still less than the cost of either of the shared-risk plans.  I hadn’t realized this…. so right now I’m leaning towards just paying for the single IVF, and skipping the shared-risk plans.  But that may change.

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The actual IVF process lasts two cycles: first a suppression cycle, followed by the actual IVF cycle.

Birth Control Pills & Lupron (Suppression Cycle)

For the first cycle, I will be taking birth control pills.  This starts on day 2 of the cycle and lasts at least two and up to four weeks.  I will only be taking the active pills.  The birth control pills will help to suppress my system.  The IVF coordinator explained that in a normal cycle, you have several follicles initially, but one becomes dominant and that one develops.  You don’t want this to happen when you’re doing IVF because you want multiple follicles to develop.  Often your body decides which will be the dominant follicle in the first day or two of your cycle, hence the need to start the BCPs on cd 2.

Also, on day 2, before I start the BCPs, I have to have my ovarian reserve checked, since it hasn’t been checked in a year.  This tells you your estradiol and FSH levels and must be done on cd 2-4.  Ideal estradiol levels are below 80 and ideal FSH levels are below 10.  The ovarian reserve gives some indication of how many eggs you will produce or something – I’m not exactly clear on what it shows, honestly, but only that they want to know it.  The doc told me, but now I can’t remember.

Sometime between two and four weeks after starting the BCPs, I will start Lupron injections.  Lupron inhibits the pituitary, preventing it from releasing the hormones that would normally cause follicles to develop on your ovaries.  Soon after this I will stop taking the BCPs, but continue with the Lupron.  Once I stop the BCPs, I will likely have a period.

Soon after stopping the BCPs and getting my period, I will go back to the clinic for a suppression check.  This is also payment due day.  The suppression check involves a blood draw (to test my estrogen levels) as well as an ultrasound to make sure that my system is indeed suppressed and my body will not produce only one or two dominant follicles (but instead the 10-15 – or more – that are ideal for IVF.)

IVF Cycle – 1st Half

The next day, I start my IVF drugs (and continue the Lupron, at a lowered dose.)  I don’t know yet what those IVF drugs will be.  My IVF coordinator says she can get me vouchers and free samples as much as possible, since I am paying for this out of pocket.  (Like I said before, I really feel that they are taking care of me now that I’m doing IVF – I think especially because I’m doing this on my own.)  It is considered day 1 of the ART cycle (and is usually a Friday because, you know, its more convenient for them.)

The clinic continues to monitor me every couple of days via ultrasound and estradiol blood tests, starting on day 4 and continuing every other day until about day 9 or 10, when they will become daily.  They become daily once the largest follicles are approaching 18mm (can’t remember how close – maybe 14 or 16mm) – when they reach 18mm, they are mature and ready for egg retrieval.  The ultrasounds are generally between 8:30 and 10 am, which means I will be taking a lot of days off work during those two weeks.

IVF Cycle – 2nd Half

The night that the largest follies reach 18mm, I will give myself an HCG injection.  The next day, there are no medications.  Exactly 35 hours after the HCG, they do egg retrieval.  This will either be in the clinic or at the hospital; I have to figure out what I want to do.

At the egg retrieval (usually day 12), the doc uses a vaginal ultrasound with a needle guide attached to it to remove the follicles.  The needle scoops up the follies and they pass through it into a small container.  When all the follicles are collected, they are immediately passed to the embryologist, who is waiting in the room with a special microscope kept at body temperature (to avoid stressing the eggs/follicles.)  The embryologist removes the eggs from the follicles (some follicles won’t have eggs.)

Once the eggs are removed, they are brought to the embryology lab.  Then, the embryologist either puts the eggs in a solution of some sort and lets them sit there with the spermies (this is traditional IVF) or they perform what’s known as ICSI (Intracytoplasmic Sperm Injection.)  That’s what they’ll be doing for me, since I’m using donor sperm.

In ICSI, they insert one individual sperm directly into each fertilization-ready* egg.  They choose the 100 or so best-quality spermies and put them in another of those solutions and then add something that causes the spermies to slow down.  Then, they choose the ones with the best morphology (the ones that look the best) for ICSI.  They suck each individual li’l swimmer up into a needle and then insert it directly into the egg.  Apparently it is kind of tough to do because of the egg’s shell.

My clinic also does assisted hatching, which I *think* happens on this day, too.  They use a special laser to thin the egg’s shell (called the zona pellucida I believe); this assisted hatching helps the embryo to break out of its shell and grow.  Apparently as women age, their eggs’ shells become harder and thicker, making it more difficult for the embryo to develop.  (I think I’ve understood this part right, but we didn’t talk a lot about it.)

This is considered day 0 for the fertilized eggs and they let them sit in their supportive fluid overnight.

*Interesting fact I learned from the embryologist: eggs initially have two sets of chromosomes! (just like other cells.)  Hello, high school biology, you taught me wrong….  As the egg readies itself for possible fertilization, it moves one set of chromosomes into this little polar pocket (the actual name was something like this, but I forget exactly what it is.)  So the embryologists know the egg is ready to be fertilized when they see that it has this polar pocket on one side!

They check the eggs on day 1 and hope to see eggs with two nuclei inside (one from the egg and one from the sperm.)  Ideally these continue to grow until they have 4-8 cells on day 3.  Sometimes the eggs will be put back at this point.  However, my doc will probably wait until day 5, the blastocyst stage, when there are 100-150 cells.  The stronger embryos tend to make it to this point, making it easier to choose which is the most ideal candidate(s) for transfer.  The clinic also freezes remaining embryos at this stage (they won’t freeze them on day 3.)  At the blastocyst stage, you can also see the cells gathered together in one section, surrounded by what will hopefully become the placenta.

On day 3 or (most likely) day 5, I’ll return to the clinic for the embryo transfer.  My understanding is that this is kind of like an IUI, only with an ultrasound simultaneously – they deposit the embryo in your uterus, using the ultrasound to place it in the most ideal location.  My understanding is that I’ll be awake for this procedure.

As for meds during this time, I start daily progesterone shots two days after egg retrieval and on the night of the embryo transfer, I also start estrogen patches.

Then, 15 days after the egg retrieval, I take a pregnancy test, which will hopefully be positive.  If it is, then I continue progesterone injections (though weekly now instead of daily) through the 10th week of pregnancy.

And that’s it!  I hope its been useful to y’all.

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My clinic has several IVF plan options.

- The first is the standard IVF – one IVF, they will freeze any remaining embryos (you pay for this separately), etc.  With all my procedures, it costs ~$14,000 plus ~$4,000 for meds.  Any frozen embryo transfers (FETs) I did later would be ~$3,500 plus ~$1,000 for meds.

- The second is good for one year and gets you two IVF cycles plus unlimited FETs.  You have to do the FETs before the 2nd IVF cycle.  It costs ~$20,000 + ~$4,000 for meds (per IVF cycle.)

- The third is also good for one year and gets you one IVF plus unlimited FETs.  However, if you’re not pregnant (beyond 1st trimester) by the end of one year, you get back 80% of your money.  It also costs ~$20,000 plus ~$4,000 for meds.

For the 2nd and 3rd options, you need doctor approval, though I think there’s a good chance I’d get it – I’m young, etc.

What do y’all think?  Which one would you do and why?  Thanks for your input.

(I will post more later on the specifics of what I learned – to help me organize them in my head and for those of y’all who are looking at IVF in the future.)

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