For my IVF protocol, I'm using Gonal-F as my FSH- which comes in these really handy dandy pens. This is also a medication that needs to be refrigerated (see photo). Starting today, I have to do this shot twice daily - 12 hours apart. Since the shots are supposed to be 12 hours apart, we bumped up our normal shot time from 7:30am to 7am. I just feel like 7pm will be easier to workaround than 7:30pm in the evenings. :) Of course they say if you are an hour late/early it's okay - but since this is something that we can control - we'd like to try to be as precise as possible.
Today I started on the ovulation stimulation shots. The purpose of the Follicle Stimulation Hormone (FSH) is to make my follicles mature and develop many eggs, instead of just one. Under normal circumstances, your brain signals to your pituitary glad to release the FSH so that the follicles start to mature/develop. Typically one follicle becomes the "dominant follicle" and is the only one that matures the egg completely. For my IVF protocol, I'm using Gonal-F as my FSH- which comes in these really handy dandy pens. This is also a medication that needs to be refrigerated (see photo). Starting today, I have to do this shot twice daily - 12 hours apart. Since the shots are supposed to be 12 hours apart, we bumped up our normal shot time from 7:30am to 7am. I just feel like 7pm will be easier to workaround than 7:30pm in the evenings. :) Of course they say if you are an hour late/early it's okay - but since this is something that we can control - we'd like to try to be as precise as possible. The Gonal-F pens are pretty easy-to-use. The mail-order pharmacy that we used for my medictions, Freedom Fertility Pharmacy, also sends a website link to video instructions for all of the shots. (Feel free to check out the link if you wish.) They also provide lots of instructions and we went over it in our injections class, so it wasn't too tough to figure it out. I have to take different dosages in the morning and at night, so the nurse recommended that we set one pen for the morning dose (75) and set another one for the evening dose (150). Makes sense - so we're going to go with that approach. It's another sub-cutaneous injection, so it just needs to go into the skin (same needle size as the Lupron). My husband gave me the shot this morning and it went well. The Gonal-F shot didn't really feel any different than the Lupron shot. I still have to keep taking the Lupron shot in the morning, but they reduced my dosage down from 10 to 5. I'm getting ready to take my evening shot of Gonal-F in about an hour and so far I haven't felt any side effects from the shot this morning. I'm sure as the days go by and my ovaries start to get lots of follicles growing with lots of eggs, I may start to feel some discomfort. But I'm ready for it - it's only temporary and will hopefully be very worth it in the end. :)
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This morning I had my first of many "bloodwork & ultrasound" appointments. First, I went to LabCorp (which is conveniently located a few suites down from the doctor's office) to have my blood drawn. The lady just took one little tube of blood from my left arm- pretty simple & painless! Then I walked back down to the doctor's office where my husband met up with me. He's planning on attending all of the appointments with me throughout the process. We are lucky that his work schedule is flexible enough for him to be able to do so.
This may be TMI for some - so feel free to skip to the next paragraph if you don't want to hear the nitty-gritty on the "ultrasound" experience. The nurse takes you back to one of the rooms and tells you to undress from the waist down, points at the lovely paper sheet, and says the doctor will be in shortly. (Typically my husband is telling me to hurry up because he's nervous that the doctor is going to arrive before I'm ready.) So you're sitting there on the table, trying to pull your shirt down in the back with the little paper over your lap. Then the doctor comes in and the fun begins! This ultrasound is not like the tummy ultrasound that they do on pregnant women. This would be a vaginal ultrasound - which means they go right up through the you-know-what. ;) It kinda starts off like any gyno exam - he asks you to scoot down to the end of the table and put your feet in the little stirrups. The ultrasound probe (for lack of a better term) is shaped to fit right up there like the male sexual organ. The doctor places it in and as he shifts it around - you can see your internal organs up on the screen (which is pretty cool)! Of course it just looks like black/white blobs to you, but the doctor helps by pointing things out to you. It isn't painful or anything - just a little awkward like any gyno exam. But instead of just staring at the ceiling, being able to see your insides on the screen makes it more interesting and kinda makes you forget about what's going on down there. Anyway, so the purpose of today's ultrasound was to make sure that the birth control pills and Lupron have been doing "their jobs" of keeping my hormone levels down. First, the doctor pointed out both of my ovaries on the screen. He pointed the one ovary out to us and I was like, "Oh, just that?" I was kinda surprised how little it looked. He circled it again on the screen and then made a much bigger circle with the mouse to show how big they will get throughout this process (due to the Follicle Stimulating Hormones). Quite a big difference! Today he was mainly checking the ovaries to make sure there were no cysts on them. The cysts could later be mistaken for eggs in the IVF process - so they want to make sure there aren't any. If they do find any cysts, they would just have you stay on the Lupron for another week and check again. The good news is that there were no cysts - so the ovaries looked good! He also said that my uterine lining was thin - which is also what he wanted to see. Estrogen makes your uterine lining thicken, so the fact that the lining was thin means that my estrogen levels were likely low (which is also what they want at this stage of the game). However, they can't just go based on that - which is why they had the bloodwork done to check my actual estrogen levels. The nurses told us that they want the estrogen levels to be below 80. I got a phone call this afternoon from the doctor's office saying that my estrogen level was well below 80 - it was 17 to be exact. No wonder my voice has gotten so deep and I've grown some chest hair.... just kidding! But I must say, I aced my estrogen test today and probably ruined the curve for the rest of the class. :) So my reward for having no cysts on my ovaries, a thin uterine lining, and super-low estrogen levels..... more shots starting tomorrow! :) We have been cleared to move into the "Ovulation Stimulation" stage of the process tomorrow. The nurse said that things will start to fly by from this point on. I am a little nervous about how the new type of shots will affect me, but I know that I will be able to handle it. We did ask a couple questions in our appointment today. I asked the doctor why I still got my period if the Lupron was supposed to be stopping me from ovulating. He said that the Lupron was just keeping my hormone levels down so it wouldn't prevent my period from happening. We also asked that if we got a positive pregnancy result, how long until we would know how many babies were in me. The nurse said that we wouldn't know that until they did an ultrasound when I am 7 weeks pregnant. She then explained how IVF pregnancies are counted in a slightly confusing way - if you get pregnant, they consider you to have been 2 weeks pregnant on the egg retrieval day. I would've thought they would've used the egg retrieval (the actual conception date) as the starting point for counting weeks of pregnancy - but I guess not. So we would just have to wait 5 weeks from the egg retrieval date to find out if we're getting a Johnston singleton, Johnston twins, or Johnston triplets! When you can't get pregnant with one baby, it's hard to imagine getting pregnant with more than one. But we have to understand that is a very real possibility with IVF. In my crazy head, I do think twins would be wonderful. We would of course take more - but carrying any more than two babies would make me more fearful of losing one or all of them during the pregnancy. The nurse did share a story about a patient that had the Week 7 ultrasound at the doctor's office with their Reproductive Medicine doctor. The doctor found two babies. Then the lady was transferred back to her normal ob-gyn. And during her first ultrasound with the ob-gyn, that doctor found three babies. I guess one was hiding at Week 7! What a surprise for them, I'm sure! In closing, I'd like to welcome Cain William Kortlandt into the world. He was born this morning to my cousin and his wife up in Kalamazoo, Michigan! Very happy for them, the new big brother (Rowan), and our entire extended family! :) |