Next up was the ultrasound with Dr. Williams! (Did I mention how nice it is to have him back?) He said that we're paying him to be over-compulsive at this stage and did apologize for having us come in again. Of course we don't mind at all and appreciate his care/concern. He told us that the high estrogen level made him a little nervous - which is why he asked me to come in for another blood test. And he explained that sometimes when you lower the Gonal-F dosage, the follicles get mad and just stop growing. I said, "Oh, because they aren't getting their fix..." And he laughed and agreed. :) He measured the lining of my uterus - he said they want to see it at 6 or more (I think it was somewhere around there) and mine is at 12. Then we went to check the ovaries - the good news is that my follicles continued to grow as expected even with the lower dosage of Gonal-F. He found 5 follicles on each ovary that were all in the 18-20mm range - which is exactly where we want them for the retrieval. :) Dr. Williams did warn me that once they take all of the eggs out that I will probably be pretty sore after the retrieval and not to assume that if I'm in pain that it must be OHSS.
He said based on the ultrasound alone, we would be ready for a Thursday retrieval. But again, he wanted to wait for the blood test results to make his final decision. He said if the levels are okay - then we would go ahead with the Novarel (Hcg) shot tonight and the retrieval on Thursday (36 hours after the Novarel shot). If the levels jumped too high again, then he would have me "coast" - which means stopping the Gonal-F shots and waiting until Wednesday night to do the Novarel. He also said that they could adjust the dosage of the Novarel as needed based on the blood test results.
If I were a betting woman (which I am sometimes in Vegas - roulette is really fun), I would've bet that they were going to call and tell me that my estrogen was high and that we were coasting for another day. But I was mistaken! Penny called this afternoon and said that even though my estrogen did go up (to 5636 to be exact), Dr. Williams still wanted to do the "trigger shot" tonight and do the retrieval on Thursday morning at 10:40am. Hearing that we actually have an egg retrieval date and we're really moving forward was really exciting and kind of scary in a good way. We're really doing this!!
She asked if now was a good time to go through my egg retrieval and embryo transfer plans and I said, "Of course!" Then she said that she was going to give me the instructions for me to fill in my forms, then I would have to repeat them back to her. I work in a cube with not much privacy, so the having-to-repeat-them-back-to-her part was a little concerning. I told her that I needed to go somewhere else and she quickly offered to give me a call back in 5 minutes when I was all situated. I ended up going down to the cafeteria with my purple notebook tucked into my work notebook. She gave me my instructions for the entire process - but here are my instructions for tonight and Wednesday:
- No more shots of Lupron or Gonal-F. We're all done with those! :)
- Take 1mL of the Novarel (HCG) shot tonight (Tuesday, Jan 25th) at 10:40pm EXACTLY. This is the shot that will finalize the maturation of the eggs and get the follicles ready for ovulation. This is timed 36 hours before the procedure - to ensure that the eggs will still be in the follicles when Dr. Williams goes in to get them. Normally they would have you take 2mL, but due to my high estrogen levels they are lowering it to 1mL to help prevent OHSS.
- Tomorrow morning (Wednesday, Jan 26th) by 8am I have to take a home pregnancy test. We want it to be positive, even if it's a faint positive. This doesn't mean that I'm pregnant, it just shows that the Novarel (HCG) shot worked as expected. If it's negative, they will have me come in for a blood test.
- Tomorrow (Wednesday, Jan 26th) I start taking Minocin pills with food to reduce my risk of developing an infection related to the egg retrieval process. I'll take 4 pills throughout the day on Wednesday (9am, 1pm, 5pm, & 9pm), 2 in the evening on Thursday after the retrieval (5pm & 9pm), and then 4 on Friday throughout the day(9am, 1pm, 5pm, & 9pm).
- I can't eat or drink anything after midnight tomorrow evening (Wednesday, Jan 26th).
Even though we're moving forward, there is still concern about OHSS. So in addition to monitoring my weight each day (and letting them know about any overnight 7 pound weight gains) they want me to start taking a scoop of Whey protein each evening. I didn't think to ask her what the protein does to help and tried googling tonight, but haven't found a good answer - just recommendations of increasing protein and drinking more Gatorade. I'll have to ask them in the morning. But I got myself a can of whey protein (vanilla flavored) and will enjoy a scoop of that tonight with my milk. The risk of OHSS hanging over me is a little scary (from what I've read online, it can be pretty painful) - but I'm positive that Dr. Williams is doing everything he can to prevent that from happening. And if I do get it, then we will just work through it. It'll just make me stronger, right? :)
I'm feeling excited and a little nervous now that we actually have our egg retrieval scheduled. We are very thankful that things have gone well so far and hope that things will continue to go that way. It's been a long road - but the IVF journey (thus far) has been pretty smooth. Tonight I went out to dinner with my IVF buddy - so nice to catch up with her face-to-face. She had some funny stories to share about getting to fly to Chicago today and having to give herself Gonal-F shots in the airport bathroom - lucky girl! And she treated me to dinner tonight - which was very sweet of her. Thanks, IVF Buddy!! :)
Less than an hour until my Novarel (HCG) shot tonight - I have the alarm on my phone set for 10:30pm to give us some time to head upstairs and prepare for the shot. This is the first intra-muscular one - so my husband will have to do this one in my lower back/upper bum area. He gave me this shot last winter during our IUI (artificial insemination) procedures - so I know he'll do a great job. My plan is for us to have the shot all ready to go and then right at 10:40pm on the dot (based on our phones) - have him give me the shot. The timing is super-crucial - so thank goodness I married a very punctual man!!
Alrighty, I'm going to go have my 1st scoop of whey protein - yummy!!!