4dp3dt = four days past three day transfer, otherwise known as 7 DPO.
I'm not going crazy yet, but I can feel the crazy right around the corner. Time is slowly moving forward and I'm thankful for a very busy week at work (including travel from Wednesday to Friday) and a final assignment for University due next Sunday. My few symptoms, sore boobs and light cramping, can be attributed to the 600mg of progesterone and 4mg of estrogen I'm on each day, but that doesn't keep me from analyzing every little twinge and pushing on my boobs every once in a while to make sure they still hurt (they probably hurt because I keep pushing on them).
We got some amazing news yesterday! Left with little to no hope for frozen embryos after the transfer last Wednesday, we got a call from Chris the embryologist early yesterday afternoon to let us know that they had successfully frozen two day six hatching blasts yesterday morning! Last we heard, we had a few embryos that were a day or so behind that they were going to leave in culture to 'see what happens'. We didn't have a lot of hope, but figured there was no harm in letting them sit, right? Well, two of them caught up, and we have two more 'average' blasts on ice for when we need them.
Not only does this let me breathe a bit easier, but it will really help me to relax for the rest of this cycle, because we have a couple of totsicles in the fridge for a second go if we need it. Hopefully we use them for sibling(s), but it is a relief to know that we have a plan B.
Sunday, March 11, 2012
Thursday, March 8, 2012
IVF #1 - Embryo Transfer
One day post transfer and I'm already starting to obsess. Logically I know nothing has implanted yet, but every twinge and cramp draws my attention immediately to my abdomen and my thoughts to those two little embabies in there. How am I going to get through the next two weeks?
The transfer was right on schedule yesterday afternoon. Derek arrived shortly before the appointment and we were ushered into the same room the egg retrieval was performed in. I had a full to bursting bladder for the ultrasound guidance - too full, even, and they asked me to empty about half. Once I was up in the stirrups, the embryologist came into the room to talk to us about our embryos. We had two 'average' day three embryos, one a six cell and one an eight cell, which are exactly where they should be for how old they were. There are a few slow four and five cell embryos still in culture that they'll continued to monitor until day five (tomorrow) to see if we have any that catch up for freezing, but it didn't sound hopeful.
Dr. Scott and the nurse started to work on inserting the external catheter, which was painless - a nice change from the usual pain I experience because of my bent cervix. Apparently the pressure of my full bladder straightened it out. I was seriously shocked when she said she was in, my hand in Derek's ready to squeeze the living hell out of it! I think Derek was somewhat relieved that it went so well.
On the same monitor where I watched them harvest my eggs only a few days prior, they brought up a magnified image of our two little embryos. We watched on the monitor as he sucked them in to the needle, verify they were in there, and then come into the room with the catheter and hand it to the doctor. We were also able to watch on the ultrasound as she injected them - we could see exactly where they were injected. Of course, you can't see the embryos themselves, but there is an air bubble in the catheter between the two embabies that shows up as a white dot on the screen. In less then ten minutes, it was done.
She pulled all of her tools out and covered me up. I lay still for about 10 minutes while Derek and I reflected on the fact that we had two of our own inside me at that very moment. I was moved to a recliner and told to relax for 30 minutes before getting dressed to leave. We sat beside a couple who had gone in before us and wished each other luck as they left.
I spent last night lazing on the couch under direct orders from my husband, who cleaned, cooked and wouldn't let me get up unless it was just to go to the bathroom. We are both in a very positive place and feel like this is going to work for us. We're trying not to talk too much about what will happen if it doesn't, and I sincerely hope we never have to.
One of the best parts of the whole thing was when they handed us a picture of our embryos, which is now hanging up on our fridge with the other family pictures. Here's to hoping that this will be the first page in our baby book:
The transfer was right on schedule yesterday afternoon. Derek arrived shortly before the appointment and we were ushered into the same room the egg retrieval was performed in. I had a full to bursting bladder for the ultrasound guidance - too full, even, and they asked me to empty about half. Once I was up in the stirrups, the embryologist came into the room to talk to us about our embryos. We had two 'average' day three embryos, one a six cell and one an eight cell, which are exactly where they should be for how old they were. There are a few slow four and five cell embryos still in culture that they'll continued to monitor until day five (tomorrow) to see if we have any that catch up for freezing, but it didn't sound hopeful.
Dr. Scott and the nurse started to work on inserting the external catheter, which was painless - a nice change from the usual pain I experience because of my bent cervix. Apparently the pressure of my full bladder straightened it out. I was seriously shocked when she said she was in, my hand in Derek's ready to squeeze the living hell out of it! I think Derek was somewhat relieved that it went so well.
On the same monitor where I watched them harvest my eggs only a few days prior, they brought up a magnified image of our two little embryos. We watched on the monitor as he sucked them in to the needle, verify they were in there, and then come into the room with the catheter and hand it to the doctor. We were also able to watch on the ultrasound as she injected them - we could see exactly where they were injected. Of course, you can't see the embryos themselves, but there is an air bubble in the catheter between the two embabies that shows up as a white dot on the screen. In less then ten minutes, it was done.
She pulled all of her tools out and covered me up. I lay still for about 10 minutes while Derek and I reflected on the fact that we had two of our own inside me at that very moment. I was moved to a recliner and told to relax for 30 minutes before getting dressed to leave. We sat beside a couple who had gone in before us and wished each other luck as they left.
I spent last night lazing on the couch under direct orders from my husband, who cleaned, cooked and wouldn't let me get up unless it was just to go to the bathroom. We are both in a very positive place and feel like this is going to work for us. We're trying not to talk too much about what will happen if it doesn't, and I sincerely hope we never have to.
One of the best parts of the whole thing was when they handed us a picture of our embryos, which is now hanging up on our fridge with the other family pictures. Here's to hoping that this will be the first page in our baby book:
 |
| Six cell on the left, eight cell on the right. |
Wednesday, March 7, 2012
IVF #1 - Fertilization Reports and Transfer Day
After a hugely successful retrieval, we were pumped to get a call from the embryologist on Monday morning telling us that 14 of the 17 eggs had fertilized naturally over night. This was much, much better then we expected, and I got to shock Derek in to silence when I called him to say he's a father of 14!
Unfortunately, we got some bad news on Tuesday (yesterday). Apparently most of the embryos had fragmented over night, and we only had between two and four that were of decent quality. Because of this, they recommended a three day transfer, which happens in about two and a half hours.
The website Advanced Fertility (a clinic in Chicago) has a pretty good explanation of what they look for in an embryo, including proper and timely division, and degree of fragmentation. You can read about it here. Fragmentation is when little bits of the cells break off from the main cells. There isn't a definitive explanation as to why this happens, it just does. Some theorize that it's due to poor egg quality, or possibly sperm issues, or even the type of protocol that's used for the IVF. That said, some fragmentation is ok, and even expected (up to 10% is normal). When we go in this afternoon, I expect them to tell me how fragmented the embryos were as well as at what stage they started to fragment.
Because of the fragmentation issues, they clinic recommended assisted hatching. After an egg is fertilized with the sperm, it develops a tough zona pellucida, in part to prevent other sperms from getting in a ruining the embryo (that does happen sometimes, and you can end up with too many chromosomes, or other issues). Assisted hatching uses a laser or needle to pierce the zona pellucida and allow the embryo to hatch. A summary of how and why it's done can be found here. Because our embryos have undergone assisted hatching, I started taking a steroid yesterday, and will continue for another five days, to prevent exposure of the embryo to inflammatory cells in my uterus.
What we are hoping for this afternoon is two good quality embryos to transfer over. We would be very happy if we had some to freeze, but that seems unlikely at this point.
So, with fingers and toes crossed, Derek and I head to the clinic for our 3:30 appointment to be PUPO. Pregnant Until Proven Otherwise!
Unfortunately, we got some bad news on Tuesday (yesterday). Apparently most of the embryos had fragmented over night, and we only had between two and four that were of decent quality. Because of this, they recommended a three day transfer, which happens in about two and a half hours.
The website Advanced Fertility (a clinic in Chicago) has a pretty good explanation of what they look for in an embryo, including proper and timely division, and degree of fragmentation. You can read about it here. Fragmentation is when little bits of the cells break off from the main cells. There isn't a definitive explanation as to why this happens, it just does. Some theorize that it's due to poor egg quality, or possibly sperm issues, or even the type of protocol that's used for the IVF. That said, some fragmentation is ok, and even expected (up to 10% is normal). When we go in this afternoon, I expect them to tell me how fragmented the embryos were as well as at what stage they started to fragment.
Because of the fragmentation issues, they clinic recommended assisted hatching. After an egg is fertilized with the sperm, it develops a tough zona pellucida, in part to prevent other sperms from getting in a ruining the embryo (that does happen sometimes, and you can end up with too many chromosomes, or other issues). Assisted hatching uses a laser or needle to pierce the zona pellucida and allow the embryo to hatch. A summary of how and why it's done can be found here. Because our embryos have undergone assisted hatching, I started taking a steroid yesterday, and will continue for another five days, to prevent exposure of the embryo to inflammatory cells in my uterus.
What we are hoping for this afternoon is two good quality embryos to transfer over. We would be very happy if we had some to freeze, but that seems unlikely at this point.
So, with fingers and toes crossed, Derek and I head to the clinic for our 3:30 appointment to be PUPO. Pregnant Until Proven Otherwise!
Sunday, March 4, 2012
IVF #1 - Egg Retrieval
Today was the big day! I was a bit stressed out because I stupidly spilled some of my HCG trigger shot on Friday night. I was supposed to be injecting 2 mL split between two syringes, but in the end, I had 1 mL in one, and just over 0.7 mL in the other. However, when I talked to the doctor doing my retrieval this morning, he said that the 10,000 units I was supposed to take (a total of 2 mL) was more of a safeguard, and half of the dose works just as well for most women.
We arrived at the clinic at 9:30 am and were ushered in to the back where the nurse sat me in a chair and put a heating pad over the arm that was going to get the IV. She explained the process to both of us and went over the post-ER instructions, including my doses for estrogen and progesterone to be started tomorrow morning. After about 20 minutes, the doctor came by and did my IV (he said I have nice veins - but really, it's just that he was great at inserting it). They walked me in to a darkened room with stars painted on the walls and roof and a TV screen on the far wall. He immediately gave me Fentanyl for the pain and Versed to relax me. I was awake and responsive for the whole procedure.
He inserted an ultrasound probe and I was able to watch what he was doing on the ultrasound screen. He gave me a heads up before he inserted the needle through the vaginal wall and in to my ovary. I felt a lot of pressure and some pain, so the nurse gave me some more pain meds. Afterwards, I felt very little until the very end of the procedure when he had to dig a bit to get at the last two follies on the left. It wasn't any worse then period cramps though, so tolerable.
I could see the needle go in to each follicle on the ultrasound, which looks like a dark, almost circular spot on the screen. I could actually see him sucking the fluid and egg out on the screen - pretty cool to watch! Every few minutes, the embryologist would come in to the room and pick up a bit of the fluid and take it in to the lab on the other side of the wall. I was able to see what he saw in his microscope on the TV screen at the end of the bed. Every few minutes he'd tell us how many eggs we were up to.
"...five eggs..."
"Up to seven now..."
"...eleven!"
I was out of the room and in recovery before he had counted them all, but he came by within about 15 minutes.
17 eggs!
If you recall, at my last ultrasound I have 11 follies on the right and five on the left (with only two looking promising), so we ended up with more follicles and eggs then we thought.
Now it's more of a waiting game. The clinic hasn't called today, which means they had enough sperm to attempt natural fertilization. The embryologist will call tomorrow morning with our fertilization report. According to the clinic's typical rates, we're looking at around 70% mature, so of those 17, around 12 will be mature. Of those 12, 70% will fertilize properly. We should end up with eight or nine embryos.
By Tuesday morning we should know if we're doing a three day transfer of two embryos, or a five day transfer of one blastocyst. It's really up to the embryologist to decide what will be best for us.
Either way, I'm very, very pleased with the retrieval and can't wait to get that call tomorrow. It's amazing to me that at this very moment, Derek and I have a bunch of our potential babies in a dish at the lab. Crazy.
We arrived at the clinic at 9:30 am and were ushered in to the back where the nurse sat me in a chair and put a heating pad over the arm that was going to get the IV. She explained the process to both of us and went over the post-ER instructions, including my doses for estrogen and progesterone to be started tomorrow morning. After about 20 minutes, the doctor came by and did my IV (he said I have nice veins - but really, it's just that he was great at inserting it). They walked me in to a darkened room with stars painted on the walls and roof and a TV screen on the far wall. He immediately gave me Fentanyl for the pain and Versed to relax me. I was awake and responsive for the whole procedure.
He inserted an ultrasound probe and I was able to watch what he was doing on the ultrasound screen. He gave me a heads up before he inserted the needle through the vaginal wall and in to my ovary. I felt a lot of pressure and some pain, so the nurse gave me some more pain meds. Afterwards, I felt very little until the very end of the procedure when he had to dig a bit to get at the last two follies on the left. It wasn't any worse then period cramps though, so tolerable.
I could see the needle go in to each follicle on the ultrasound, which looks like a dark, almost circular spot on the screen. I could actually see him sucking the fluid and egg out on the screen - pretty cool to watch! Every few minutes, the embryologist would come in to the room and pick up a bit of the fluid and take it in to the lab on the other side of the wall. I was able to see what he saw in his microscope on the TV screen at the end of the bed. Every few minutes he'd tell us how many eggs we were up to.
"...five eggs..."
"Up to seven now..."
"...eleven!"
I was out of the room and in recovery before he had counted them all, but he came by within about 15 minutes.
17 eggs!
If you recall, at my last ultrasound I have 11 follies on the right and five on the left (with only two looking promising), so we ended up with more follicles and eggs then we thought.
Now it's more of a waiting game. The clinic hasn't called today, which means they had enough sperm to attempt natural fertilization. The embryologist will call tomorrow morning with our fertilization report. According to the clinic's typical rates, we're looking at around 70% mature, so of those 17, around 12 will be mature. Of those 12, 70% will fertilize properly. We should end up with eight or nine embryos.
By Tuesday morning we should know if we're doing a three day transfer of two embryos, or a five day transfer of one blastocyst. It's really up to the embryologist to decide what will be best for us.
Either way, I'm very, very pleased with the retrieval and can't wait to get that call tomorrow. It's amazing to me that at this very moment, Derek and I have a bunch of our potential babies in a dish at the lab. Crazy.
Thursday, March 1, 2012
IVF #1 - Final Monitoring Appointment
Last night sucked. Around 8:30, Derek called me from the union meeting he was attending to tell me he had very serious stomach cramps and was throwing up, so was on his way home. He arrived home and went right to the bathroom, where he continued to suffer out of both ends (poor guy). He crawled on to our bedroom floor and laid there in pain while I called Health Link (our nurse hot line) to ask for advice. Of course, the advice was to head to the hospital, as it could be his appendix or gall bladder.
At this point, the pain was so severe that Derek couldn't sit up long enough to ride in the truck to the hospital, so we called an ambulance. The paramedics gave him morphine and gravol and transported him to Foothills. Once there, a barely conscious Derek sat in a wheelchair while we waited to be admitted. Around midnight, we finally got on the wait list to see a doctor, and actually saw him around 1:30 am. After some blood work and diagnostics, the doc said it was a severe stomach flu and not something requiring surgery, thank goodness. I was seriously starting to question our karma as there seems to be issue after issue happening during this IVF that keeps threatening to cancel. Luckily, it appears that Derek's flu will not affect anything, and we're still good to go.
They gave Derek Buscopan, which relieves stomach cramping, and sent us home around 3 am. Derek seemed to feel a bit better and settled in to the couch while I went to bed for about three hours of sleep before I had to get up for my monitoring appointment this morning. Thankfully, while he still feels pretty horrible, he has no stomach cramps today and the vomiting is gone.
I spent what felt like forever at the clinic this morning, but got only good news. Seems that my right ovary is picking up even more, as they found eleven follies today compared to eight just two days ago. The left still has five, three of which look pretty good. We have a leader at 19mm on the right, and a 16mm lead on the left. My lining is at 9.5, so pretty much perfect. My estrogen has continued to climb and is at 6665 (Canadian units) / ~1800 (US units), which I am happy with. The rule of thumb is about 1000 (Canadian) units of estrogen per mature egg (which is what we need - keep in mind we'll get more total eggs, but about 70% of those will be mature and ready to fertilize). At this point, I'm looking at about six or seven mature, but likely another one or two on top of that by retrieval, as my estrogen will continue to climb.
We had expected to trigger tonight, but the doc has me doing one more night of stims with trigger tomorrow night. That puts egg retrieval on Sunday, which works perfectly for us. I had my HCG mixed today and got instructions on how to inject. Just about there - only one more night of injects and we're done, not to mention no more Suprefact nasal spray. To be honest, it will be somewhat strange to not have my life ruled by such a strict schedule, not to mention being able to actually sleep in on the weekend instead of waking at 6 am to do my spray and being unable to fall back asleep.
Almost there!
At this point, the pain was so severe that Derek couldn't sit up long enough to ride in the truck to the hospital, so we called an ambulance. The paramedics gave him morphine and gravol and transported him to Foothills. Once there, a barely conscious Derek sat in a wheelchair while we waited to be admitted. Around midnight, we finally got on the wait list to see a doctor, and actually saw him around 1:30 am. After some blood work and diagnostics, the doc said it was a severe stomach flu and not something requiring surgery, thank goodness. I was seriously starting to question our karma as there seems to be issue after issue happening during this IVF that keeps threatening to cancel. Luckily, it appears that Derek's flu will not affect anything, and we're still good to go.
They gave Derek Buscopan, which relieves stomach cramping, and sent us home around 3 am. Derek seemed to feel a bit better and settled in to the couch while I went to bed for about three hours of sleep before I had to get up for my monitoring appointment this morning. Thankfully, while he still feels pretty horrible, he has no stomach cramps today and the vomiting is gone.
I spent what felt like forever at the clinic this morning, but got only good news. Seems that my right ovary is picking up even more, as they found eleven follies today compared to eight just two days ago. The left still has five, three of which look pretty good. We have a leader at 19mm on the right, and a 16mm lead on the left. My lining is at 9.5, so pretty much perfect. My estrogen has continued to climb and is at 6665 (Canadian units) / ~1800 (US units), which I am happy with. The rule of thumb is about 1000 (Canadian) units of estrogen per mature egg (which is what we need - keep in mind we'll get more total eggs, but about 70% of those will be mature and ready to fertilize). At this point, I'm looking at about six or seven mature, but likely another one or two on top of that by retrieval, as my estrogen will continue to climb.
We had expected to trigger tonight, but the doc has me doing one more night of stims with trigger tomorrow night. That puts egg retrieval on Sunday, which works perfectly for us. I had my HCG mixed today and got instructions on how to inject. Just about there - only one more night of injects and we're done, not to mention no more Suprefact nasal spray. To be honest, it will be somewhat strange to not have my life ruled by such a strict schedule, not to mention being able to actually sleep in on the weekend instead of waking at 6 am to do my spray and being unable to fall back asleep.
Almost there!
Tuesday, February 28, 2012
IVF # 1 - How to Mix and Inject Luveris (and a monitoring appoitnment update)
*Update - the clinic just called with my E2 and we're up to 3879 (1057 in US units). Holy huge jump! I'm very pleased with this!
*Monitoring update at the end!
Today we are going to learn how to mix and inject Luveris, one of my daily injections. Luveris is synthetic lutinizing hormone, aka LH, and is used in conjunction with Gonal-F (which is a follicle stimulating hormone, or FSH) to stimulate oocyte growth. I'm now on day ten of injections, so I've kind of got this one down, but the first couple of times I was really nervous that I was going to miss a step and screw something up.
First thing first, you need to get all your supplies in front of you on the table. You need a box of Luveris, a syringe, needle, Q-cap, and two alcohol wipes.
Now go wash your dirty hands. I dry them off using paper towel just to avoid lint and possibly dirty dish towels. First step is to take out the two vials (one saline and one the powdered Luveris) and pop off the tops.
Using one of the alcohol wipes, wipe down the tops of both vials really well.
Set 'em down and open up the Q-cap and syringe. Make sure you don't touch either end of the Q-cap, especially the pointy end (that goes in to the vial).
The Q-cap screws in to the end of the syringe. Screw it in so it's tight (not too tight), and the pull back on the syringe plunger and fill it with 1 ml of air. You do this so you can displace the volume of fluid in the vial as you're drawing it out. Makes things easier, apparently.
Now that you have air in the vial, you can flip it over and push the Q-cap down in to the bottle of saline. It takes a teeny bit of force, but shouldn't be difficult to snap it in. Push the air in to the vial. Then, holding the plunger down (the air will try to push back out), turn the syringe/vial upside down and slowly draw in the saline.
Once you have it all in there, flip it back over and pull off the vial. Don't worry, it won't spill. Next, take your vial of powdered Luveris and pop it on with the syringe right side up. Slowly push the saline in to the vial. Now, swirl it around. Don't shake it, or you'll create bubbles, which are bad. It'll only take about 30 seconds for everything to dissolve.
Now that it's all mixed, flip it back upside down and slowly draw the mixture back in to the syringe. I usually draw back so I have a bit of air in the top, then push it back up so the liquid is right at the very top of the syringe. Next, screw off the Q-cap and open the needle package. The needle screws in similarly to the Q-cap.
Holding it needle point up, take a look for bubbles and flick the syringe to get them up to the top. It's ok if there are a few small bubbles, it's not like it's going in to a vein. Once you get the bubbles to the top, remove the cap and slowly, slowly push on the plunger until a few drops of liquid come out of the needle. Now you're set to inject!
Now is where the second alcohol wipe comes in. I inject in my stomach, but you can also inject on the outer thigh. I tend to move around a few inches each time too, just to avoid too much bruising. Take your wipe and wipe down about 2 or 3 square inches on your injection spot. Let it air dry for a few seconds and then take a good pinch of fat.
Keeping it in a pinch, insert the needle. It really doesn't hurt, just try not to hesitate too much. The anticipation is the worst part, trust me! Once it's in, slowly inject the liquid. It does seem to sting a bit if I go too fast, so I take about 10 - 15 seconds to inject it all. Once it's all in, hold the needle in for another few seconds to make sure it's all in there. Let go of the pinch, and pull the needle out.
Cap the needle, take it apart, and put it in your sharps container. Easy peasy, right?
Honestly, in the beginning of this all, I was thinking there was NO WAY I could give myself injections. But, I will do anything to have a baby, and it is not bad at all once you get comfortable with it. Good luck!
Monitoring update: my ultrasound this morning went well! I now have eight follicles on the left, with the leaders at 16mm, 13mm and 13mm, and five on the right, with the leaders at 13mm and 11mm. My lining is triple stripe at 8.3mm (this is good). They have me on the same dose of Gonal-F and Luveris for two more nights, and then my final monitoring appointment on Thursday morning. I should be triggering Thursday night if it all looks good, which puts the retrieval on Saturday.
Just wanted to post this cute note my husband left for me on our whiteboard the other day:
Yup, I'll get right on that!
*Monitoring update at the end!
Today we are going to learn how to mix and inject Luveris, one of my daily injections. Luveris is synthetic lutinizing hormone, aka LH, and is used in conjunction with Gonal-F (which is a follicle stimulating hormone, or FSH) to stimulate oocyte growth. I'm now on day ten of injections, so I've kind of got this one down, but the first couple of times I was really nervous that I was going to miss a step and screw something up.
First thing first, you need to get all your supplies in front of you on the table. You need a box of Luveris, a syringe, needle, Q-cap, and two alcohol wipes.
Now go wash your dirty hands. I dry them off using paper towel just to avoid lint and possibly dirty dish towels. First step is to take out the two vials (one saline and one the powdered Luveris) and pop off the tops.
Set 'em down and open up the Q-cap and syringe. Make sure you don't touch either end of the Q-cap, especially the pointy end (that goes in to the vial).
The Q-cap screws in to the end of the syringe. Screw it in so it's tight (not too tight), and the pull back on the syringe plunger and fill it with 1 ml of air. You do this so you can displace the volume of fluid in the vial as you're drawing it out. Makes things easier, apparently.
Now that you have air in the vial, you can flip it over and push the Q-cap down in to the bottle of saline. It takes a teeny bit of force, but shouldn't be difficult to snap it in. Push the air in to the vial. Then, holding the plunger down (the air will try to push back out), turn the syringe/vial upside down and slowly draw in the saline.
Once you have it all in there, flip it back over and pull off the vial. Don't worry, it won't spill. Next, take your vial of powdered Luveris and pop it on with the syringe right side up. Slowly push the saline in to the vial. Now, swirl it around. Don't shake it, or you'll create bubbles, which are bad. It'll only take about 30 seconds for everything to dissolve.
Now that it's all mixed, flip it back upside down and slowly draw the mixture back in to the syringe. I usually draw back so I have a bit of air in the top, then push it back up so the liquid is right at the very top of the syringe. Next, screw off the Q-cap and open the needle package. The needle screws in similarly to the Q-cap.
Holding it needle point up, take a look for bubbles and flick the syringe to get them up to the top. It's ok if there are a few small bubbles, it's not like it's going in to a vein. Once you get the bubbles to the top, remove the cap and slowly, slowly push on the plunger until a few drops of liquid come out of the needle. Now you're set to inject!
Now is where the second alcohol wipe comes in. I inject in my stomach, but you can also inject on the outer thigh. I tend to move around a few inches each time too, just to avoid too much bruising. Take your wipe and wipe down about 2 or 3 square inches on your injection spot. Let it air dry for a few seconds and then take a good pinch of fat.
Keeping it in a pinch, insert the needle. It really doesn't hurt, just try not to hesitate too much. The anticipation is the worst part, trust me! Once it's in, slowly inject the liquid. It does seem to sting a bit if I go too fast, so I take about 10 - 15 seconds to inject it all. Once it's all in, hold the needle in for another few seconds to make sure it's all in there. Let go of the pinch, and pull the needle out.
Cap the needle, take it apart, and put it in your sharps container. Easy peasy, right?
Honestly, in the beginning of this all, I was thinking there was NO WAY I could give myself injections. But, I will do anything to have a baby, and it is not bad at all once you get comfortable with it. Good luck!
Monitoring update: my ultrasound this morning went well! I now have eight follicles on the left, with the leaders at 16mm, 13mm and 13mm, and five on the right, with the leaders at 13mm and 11mm. My lining is triple stripe at 8.3mm (this is good). They have me on the same dose of Gonal-F and Luveris for two more nights, and then my final monitoring appointment on Thursday morning. I should be triggering Thursday night if it all looks good, which puts the retrieval on Saturday.
Just wanted to post this cute note my husband left for me on our whiteboard the other day:
Yup, I'll get right on that!
Sunday, February 26, 2012
IVF #1 - Day Six Ultrasound and Bloodwork and How to Inject at a Party
Bright and early yesterday morning (I never get to sleep in anymore) I headed to the fertility clinic for my day six ultrasound and blood work. Surprisingly, the clinic was pretty busy, so I had to wait about an hour and a half. One of the other clinic doctors did my ultrasound and he kindly showed me everything on the screen. He started on the left ovary and counted seven follicles. He measured five of them and they were all around 10mm or 11mm. The ideal size for trigger is about 18mm to 20mm, so we are just over half way there. The right ovary was not responding as well and only had four follicles, of which only two of them were around the 10mm mark. Not too bad, but I guess I was hoping for more.
I got the call with my E2 results a couple of hours later: 501. This is still pretty low, so they've significantly bumped up my Gonal-F to 375 UI. Hopefully this gets things going a bit faster! Either way, the nurse thinks we'll be triggering on Wednesday with egg retrieval on Friday. I can't believe how fast this is going!
So last night Derek and I travelled an hour and a half north of the city for his cousin Jon's 1920's dress up Murder Mystery birthday party (We had a ton of fun! Derek is still sleeping off the fun he had!). We arrive just a few minutes before six, which is when I do my injections, sos soon as I was in the door, I beeline it for the bathroom. Normally, it takes me about 10 or 15 minutes to do both injections, what with mixing the Luveris and making sure I'm doing everything properly. Considering there were a bunch of loud people outside the bathroom door, and a knock or two, I was trying to hurry up and get it done. I was nervous I was going to mess something up and tried not to drop plastic caps and needles off the small bathroom counter. I was unable to use ice on the injection sites, but surprisingly it didn't hurt at all - guess I don't really need it! I was so shaky and rushed that I had to take a few deep breaths before each inject to make sure I got it in straight. I think I was in and out in about seven minutes.
I've heard stories of women who've had to do injects in an airplane bathroom or in a vehicle - I don't envy them! Doing it in a strange bathroom was bad enough. Anyway, I got it done, and the side effects are certainly kicking in. I'm bloated and crampy, have a constant headache and am tired all the time. Hopefully my body is just preparing for the next ten months!
Next appointment is Tuesday for another ultrasound and blood work. Fingers crossed for good news!
I got the call with my E2 results a couple of hours later: 501. This is still pretty low, so they've significantly bumped up my Gonal-F to 375 UI. Hopefully this gets things going a bit faster! Either way, the nurse thinks we'll be triggering on Wednesday with egg retrieval on Friday. I can't believe how fast this is going!
So last night Derek and I travelled an hour and a half north of the city for his cousin Jon's 1920's dress up Murder Mystery birthday party (We had a ton of fun! Derek is still sleeping off the fun he had!). We arrive just a few minutes before six, which is when I do my injections, sos soon as I was in the door, I beeline it for the bathroom. Normally, it takes me about 10 or 15 minutes to do both injections, what with mixing the Luveris and making sure I'm doing everything properly. Considering there were a bunch of loud people outside the bathroom door, and a knock or two, I was trying to hurry up and get it done. I was nervous I was going to mess something up and tried not to drop plastic caps and needles off the small bathroom counter. I was unable to use ice on the injection sites, but surprisingly it didn't hurt at all - guess I don't really need it! I was so shaky and rushed that I had to take a few deep breaths before each inject to make sure I got it in straight. I think I was in and out in about seven minutes.
I've heard stories of women who've had to do injects in an airplane bathroom or in a vehicle - I don't envy them! Doing it in a strange bathroom was bad enough. Anyway, I got it done, and the side effects are certainly kicking in. I'm bloated and crampy, have a constant headache and am tired all the time. Hopefully my body is just preparing for the next ten months!
Next appointment is Tuesday for another ultrasound and blood work. Fingers crossed for good news!
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