Egg Retrieval

This is an overview of the procedure tomorrow for me. I will be under sedation and will be sleepy afterward. The whole procedure will take about 15-20 minutes. Here is a clip that explains the procedure: 

 

Jake's procedure is called  TESE, which stands for Testicular Sperm Extraction. Jake will also be under sedation and a local anesthetic. Below is a picture of how his procedure will be performed. 

Final Sono

At our appointment this morning Dr. Le re-measured the follicles and decided that I should not receive any more stimulation. My follicles were measuring 16-18mm. And are the right size to complete the egg retrieval. So tonight at 10:15pm I will take my final injection of HCG. This medication will mature all the eggs that are developing inside each follicle so that on Wednesday they will be ready for the retrieval. After the injection it will take 36 hours for the eggs to fully mature and float within the follicle. On Wednesday they will remove each egg out of the follicles.

Todays Appointment

Today is day 8 of using Follistem for follicle stimulation. I had my estrogen level rechecked this morning and it came back at 1826 (1000-2000 was the range Dr. Le wanted it at) my follicles were re-measured and looked like they were packed in my ovaries like sardines. They averaged about 10mm-14mm, he wants them to be about 18mm Dr. Le dropped my Follistem dose down to 125 tonight and 100 tomorrow. We have our next appointment Monday morning where Dr. Le will give us all the final dates for the retrieval based on that appointment.

After Dr. Le found out about our situation with the Urologist he made a physician to physician phone call and got everything straightened out! Dr. Chaung will be available to do Jake's sperm retrieval when needed. Other good news, Jake is now home from Kansas City and is able to go to all my appointments with me, as well as give me the two nightly injections! A special thanks to my other "baby daddy"- Jen, for going to all my appointments with me in Jake's absence, you are the best!

Follicles

Today I had my estrogen level re-checked and Dr. Le measured the maturing follicles. He counted 19 follicles measuring anywhere from 8mm x 8mm to 12mm x12mm. He also checked the lining in the uterus and said that everything looked as it should. This afternoon Dr. Le's office called to tell me my estrogen level was 586, up from 118, which is very good. So good, in fact, that he lowered the dose of the Follistem to 150units and the Lupron to 5 units. I have my next appointment on Saturday to make sure my estrogen level continues to increase, and my follicles continue to grow! Jake comes home tomorrow and Dr. Le estimates our sperm and egg retrieval date to be Thursday, June 2nd!




Sono Pictures of Left and Right Ovaries:
The black circles are the maturing follicles

 

Bump in the Road

I just received a phone call from Dr. Le's office. Unfortunately, the urologist that was to perform Jake's sperm retrieval the day of my egg retrieval is unable to do it because of a scheduling conflict. Dr. Le's office gave us a number to call to try to use another doctor, which needs to be done in the next two days. UGH! For one thing the new doctor, Dr. French, needs to do a consult with Jake and unfortunately Jake is still in Kansas City, Missouri until Friday. To top it off,  even IF Jake can come home early Dr. French does not have any availabilities. My possible egg retrieval days are June 1st through June 4th, so hopefully we will be able work out the scheduling before this time! Ahh!

Follistem

Today is day 5 of stimulation meds. On Monday my Estrogen level was 118, (they want it to be 100-200) which means the medication is doing its job. I have another sono and blood work done tomorrow to see if the level has increased. So far so good, I am getting braver and am able to give the medications to myself every night. The effects of the medication are very strange. I feel that my lower abdomen is growing and always fills "full".  It does not hurt, but is a very strange sensation. Its hard to wear a belt or anything across my lower abdomen because it feels sore and restricting. However, the good news is I am halfway done with the stim meds and next week are our retrievals!!

Sono and Estrogen Level

Yesterday I had a follow up sono and lab work to check my estrogen level. They wanted my estrogen to be below 60 which would  suggest the Lupron was adequately suppressing my natural hormones. My level was 8, woo hoo!  This means that we will start the stimulation medication Follistem on Saturday and start tapering off the suppression meds. The Follistem is used for 10 days to stimulate the follicles to mature for the retrieval. During these ten days I will have to go every 2-3 days for sono's to make sure I am not getting too much medication causing over-stimulation, which is one of the possible side effects of the medication. On a side note Jake's office is flying him home for the weekend, I get to pick him up tomorrow, I can hardly wait.

Medications and Updates

All my IVF medications

These are the vast array of all the medications that were mailed to me last Tuesday. A little overwhelming? Tell me about it. They all work in conjunction to help stimulate eggs, minimize inflammation, prevent infection, grow uterine lining for implantation, and support the embryo after implantation.

I have been taking the daily Lupron injections for about of week now and I have to say now I am a pro! I do not get as squeamish and learned a couple of tricks to minimize the pain. I have to say thanks to Jenn, Julie, and Jake for putting up with my fear of injecting myself and have all taken their turns giving me my daily injections.   I have one more day of birth control pills, which is kind of exciting because that means that this will hopefully be the last period in nine months! It will also help calculate the due date, based on my last menstrual period! But again, I am no stranger to road blocks, challenges, and last minute rearranging so we welcome continued prayers and support!

Jake update: Jakes CT scan came back with minimal bacterial growth which is great news! This along with improved lung function is a welcomed distraction. Because of the lack of design jobs in Jake's office, his boss decided to send him and another employee to Kansas City, Missouri for 3 weeks! Perfect timing right? I am keeping my self busy at work, school, and with all my appointments, medications, and sono's.  It might work out better for Jake to be in Missouri as I hear that once I start the stimulation medication my hormones will be crazy. He is planning to be home May 27th a mere couple days before the real fun starts.

Lupron

Tomorrow I start daily Lupron Injections. Lupron is an injectable medication used at least 10 days before the start of ovarian stimulation. Under normal conditions, only one egg is allowed to develop and mature in a cycle. When there are multiple follicles (the beginning stage of an egg) growing at the same time, our body reguates this process by preventing the other follicles from maturing. Lupron stops our body's process by allowing multiple follicles to mature at one time. So for the next several days I will be taking a combination of Birth control pills and Lupron so that all of my follicles will mature for the next stage in IVF treatment: stimulation.

3 Doctors Appointments

Today we left home early this morning to make it to Dallas by 0730 for Jake's CT scan and his PFT (pulmonary function test) appointment and my trial transfer appointment. Jake's PFT showed a 3% improvement from 2 weeks ago!! Woo hoo! We should receive the CT scan results back next week. For our trial transfer appointment  Dr. Le want to make sure my uterus was conducive for the embryo transfer, he measured the depth of my uterus and made sure there were no abnormalities that he would need to consider.  Next we spoke with the IVF case worker to determine my medication plan, sono and lab work appointments. So here is my schedule:

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
1 Birth Control	2 BCP	3 BCP	4 BCP	5 BCP	6 BCP	7 BCP
8 BCP	9 BCP Lupron Inj	10 BCP LI	11 BCP LI	12 BCP LI	13 BCP LI	14 BCP LI
15 BCP LI	16 BCP LI	17 BCP LI	18 LI Sono/labs	19 LI	20 LI	21 LI Follistem Inj
22 LI FI	23 LI FI Sono/labs	24 FI dose pending based on estrogen level	25	26 Sono/labs	27	28 Sono/labs
29	30 Sono/labs	31	1	2 Possible sperm/egg retrieval	3	4
5	6 Possible embryo transfer	7	8	9	10	11