CD 10- Day 7 of Stims

Quick update - this morning's ultrasound and bloodwork, again, went well. (I think I'm always in a place of waiting for the other shoe to drop)

I have several measurable follicles bordering between 9 and 14. (I need them to be around 18 -20mm before they can harvest them.)

Estrogen Levels:
Estrogen Level on Suppression Check: 32
Estrogen Level on Day 3 of stims: 80
Estrogen Level on Day 5 of stims: 192
Estrogen Level on Day 7 of stims: 529

I have another appointment on Sunday to come in for an ultrasound and more bloodwork. If all goes well in that appointment, I will take my trigger shot on Monday and my retrieval will be on Wednesday!!! Oh my god!!

This is a picture of what the doctor's look at when they are measuring my follicles.

These are not MY follicles, but these are an example of what I keep seeing when I go to my clinic appointment.


"The eggs develop in fluid filled structures in the ovaries called follicles. Each follicle can be seen and measured by ultrasound and contains one microscopic egg."

CD 9 - Day 6 of Stims - Our Final Decision for an eSET

M and I have been talking about it forever, but we needed to make a final decision on whether or not to transfer only one embryo on transfer date. It's important we figure these things out now rather than on transfer date. We came to the decision and just gave our doctor the below letter. While nervous, I know this is the right decision for us and our family-to-be. While everything could change on transfer date if we don't have a good quality embryo, it is important that our needs and desires are known and agreed upon by all.

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Hello Dr. O,

After much consideration and research, M and I have finally come to a conclusion regarding our embryo transfer, and as promised I am writing to inform you that we would like to go ahead and plan for an elective single embryo transfer (eSET). It is not our desire to have twins.

We understand eSET’s are not practiced widely in the United States so with this, we hope we have the support of you and the rest of the doctors in this option. I would appreciate if you could please mark this down in my charts and ensure the team of doctors as well as the embryologists understand this decision.

In my research I have found that 5-day blasts are best for eSET procedures, so we will be hoping and aiming towards a 5- day transfer if we have the quality in our embryos we're looking for. We understand this may not be possible and will ultimately depend on the quality after fertilization, however we want to set expectations that a 5-day transfer of one embryo/blast will be our goal.

Our goal would also be to freeze any remaining good quality embryos that qualify for freezing. We also understand that this isn't always possible, but want to ensure you know that this is our goal as well.

In addition to this, I'd like to tell you what our plans are if this first cycle fails. We understand that eSETs have a lower rate of pregnancy rate than DET or otherwise. This is a risk we are willing to take to prevent a multiple pregnancy. If indeed this cycle fails, we have chosen to do another fresh cycle, as opposed to an FET. We would like to of course, start this process as quickly as possible and understand there is a small waiting period before trying again. If there was the opportunity to change protocols, such as bypassing the BCP phase, this would be optimal. We can discuss further options if we need to cross this bridge, but for now, the take away here is that we will want to immediately go into a FRESH cycle not an FET (although we still want any good candidates to be frozen from the first cycle for children in the future).

We appreciate everyone's support in the next coming weeks, and hope we can make all of this happen successfully. I'm attaching an incredible study done in the UK on eSET just for your own reading pleasure. :) Attachment Here.

To summarize our wishes and decisions:

1. We want an eSET for this IVF cycle and we want to aim for a 5-day transfer.
2. We want to freeze any likely candidates for children in the future.
3. If the first IVF cycle fails, we want to do another Fresh Cycle and as quickly as possible.

Thanks so much and please let us know if you have any questions,
{our names}

CD 8 - Day 5 of Stims

Day 5 and things are changing. I am starting to bloat a bit (I gotta muffin top, ok?) There is more ovarian activity happening inside of me, I can feel it. It's like a bunch of small prickly insects running around in my uterus area. It feels a little full, nothing unmanageable at this point, just tight.

I also have on and off menstrual type cramps, especially in my back and where my ovaries are. I'm very conscious of everything that is occurring on the stimulation medicine. I'm visualizing the follicles growing and growing and forming our future child. I know it sounds silly, but it calms me to be so in touch with the process going on in my body. I don't like unknowns. I like to know all and be in control. Sometimes to my detriment I think.

The weirdest side affect that cropped up when I started the stims is EYE TWITCHING. What the hell. My right eye keeps twitching on and off about every ten minutes. If I sneeze, it twitches, I laugh, it twitches. It's very irritating and officially made it to the side effects list on the right side of my blog. I googled it and found other IVFers talking about eye-twitching as well, so I'm not too worried about it.

I feel like a big negative blob. The people at work and my own lovely husband is tired of me complaining, I can feel it. This only polarizes me more, and I try to fight the feelings of fear, confusion, and sadness by myself. I think it's just really hard for other people to understand what one goes through in this process. And maybe I'm just Wendy Whiner, or maybe it's even a little bit of both. Whatever it is, my emotional state is worn, but overall I have an upbeat outlook and am looking forward to completing this cycle in the next week or so.

Today we went in for another stimulation check appointment and they took my blood and did an ultrasound. He found about 4-6 nicely growing follicles on one side, and 5-7 nicely growing follicles on the other.

I called Nurse S (my favorite nurse of all time) and asked to her explain what all of this means. She said they expect to see at least 1 good follicle on this ultrasound, she said I had at least 2 total, and that I'm progressing very nicely.

My thyroid levels also changed to 1.7, that's awesome from 4.5! woot!

We'll see how it pans out, my next appointment is Friday. M has a different doctor appointment so I'll be going by myself to this one.

My estrogen levels came in from today's check and the results are below:

Estrogen Level on Suppression Check: 32
Estrogen Level on Day 3 of stims: 80
Estrogen Level on Day 5 of stims: 192 (sweet!!)

Next Steps:
Take my last Menopur shot tonight, and start taking two doses of Gonal F
Another Stim check on Friday @ 8:30

CD 7 - Day 4 of Stims

Quick update - it appears the stimulation drugs are working, yay!

Estrogen Level on Suppresion Check: 32
Estrogen Level on Day 3 of stims: 80

This is good news (celebrate small wins, right?) as all they were looking for was an increase in estrogen level. My next "stim check" is tomorrow at 7:45 am. We'll also be looking for an additonal increase in Estrogen in that appointment.

According to this awesome site, "Most doctors will consider any increase in Estrogen a positive sign, but others use a formula of either 100 pg/ml after 4 days of stims, or a doubling in E2 from the level taken on cycle day 3."

So, what the hell does that mean you ask?

It means that tomorrow's appointment - we hope to increase that 80 to at least 100 but even 120 + would be great.

By the time I take my HCG trigger shot (scheduled now for the 28th) my estrogen levels should be soaring. For every mature follicle, it will emit an estrogen level of 200-600 per follicle. They hope to have at least 10-15 follicles, so you do the math.

Ok, I'll do it for you. My estrogen level at time of trigger I suspect should be in the 2,000 - 3,000 range if not more. They say that anything over 5,000 worries them for OHSS so all eyes are on my estrogen levels right now.

Tomorrow is an ultrasound, so they'll be able to tell me how many follicles they see sprouting up. One of those little follicles could be one half of my son or daughter, fun to think about eh??

As far as the stims are concerned, I certainly feel ovarian activity (similar to when a woman ovulates) but no swelling yet. I don't feel big or uncomfortable yet, but I still have about 8 days to go. :D

Next Steps
Bloodwork and Ultrasound tomorrow
Keep taking stimulation drugs!
Mentally prepare for the Egg Retrieval currently scheduled for 1-30 (subject to change)

CD 5 - Day 2 of Stims

Day one of the stimulation drugs went ok. The Gonal F Pen wasn't that bad, the needle a bit bigger, and sharper, maybe a little firmer, and the Menopur wasn't bad either. Three shots a day feels a little heavy though. My stomach is bruised in multiple places. Tomorrow will be day 3 on stims and I have a blood work appointment at 7am in the morning. We will see what my estrogen level is at. I think they want me back Thursday morning as well for more blood work and an ultrasound.

Besides one crying fit today, no real side affects from 2 days of stims except for a couple of twinges in my ovarian area. Small twinges, nothing painful.

I've booked some time off of work, so I'll be able to stay home if I need to starting the week of the 28th - I figure I'll go in the days I have clinic appointments and stay home on the days I don't. It's soooooo important that I'm not stressed out these next couple of weeks.

I will say I secretly look forward to doing my own shots now. The anticipation is much less and I'm proud of myself the way I gently slide in the needle without flinching. M prepares the injection, I shoot it now. It makes for a good partnership.

I'm going to have to pack away my Menopur shot on Tuesday and give it to myself in the school bathroom. (yuck!)

I'm on watch now, the clinic is very interested in how I'm progressing so this next week is all about monitoring the growth of my follicles.

Movies of both stimulation shots to come soon!