And I thought I had a lot of meds last time!

When I last left off talking about my upcoming procedures, I had to take birth control pills for 18 days before beginning my next round. This is the first step in the protocol for a long IVF cycle before starting the stimulating medications and egg retrieval. This is the second time I’ve had to do this, and it’s all leading up to getting as many embryos as we can in order to have the best outcome for the real reason why we’re doing all of this, Preimplantation Genetic Diagnosis (PGD). I know it’s supposed to help the process and give us the best possible outcome, but it really feels counterproductive. So do the condoms we have to use to make sure we don’t “accidentally” get pregnant on our own while in the middle of all this. There have been so many moments in the past few months that I have just wanted to say to heck with all this and get pregnant on our own again and maybe, just maybe the next time we’ll catch a good egg and it will all work out, but with my track record, and the fear of another miscarriage weighing on me so heavily, I can’t risk it. So I took the birth control pills (begrudgingly) and this brings me to today.

18 days of birth control pills – check!

I took my last birth control pill last night. I pray it really is my last as I hope this is my last egg retrieval ever! Fingers crossed! Also, on a side note, the birth control pills are really awful! I was on the pill for years, but for some reason the birth control pills I’ve had to take with these IVF cycles have made me feel terrible. I don’t ever remember feeling this way, but I had cramps non stop for those 18 days, I broke out and I was so crabby. My poor husband is a truly an amazing man for tolerating me. And now the real fun begins! Today, I went in for an ultrasound to make sure the birth control pills were doing their job and my ovaries were “calm”. Double check. All looked good, though it seems I still have that stubborn little cyst outside of my ovary. Dr. J said it’s nothing to worry about as it’s not in the ovary, so it won’t interfere with what we’re doing, but I can’t help worrying a bit. He drained it when he was in there doing the last egg retrieval, but now it’s back. Or maybe it’s a new one? Who knows?! At any rate, Dr. J doesn’t seem too concerned. Apparently we form cysts and they go away on their own all the time, we just don’t know about them because we usually don’t have this many ultrasounds. Kind of freaky. At any rate, other than that, the ultrasound looked good and I just got an email from the nurse that my estradiol level was also good. So I’m good to proceed with the next step!

Today (Friday, Nov 15th, 2013) – Tuesday, Nov 19, 2013

Do nothing! This would be my favorite part in this process except, I’m to expect a period in a couple days so that’s never fun.

Tuesday, Nov 19, 2013 and Wednesday, Nov 20, 2013

Two injections per day. 20 Units of Lupron at 7am, and 20 Units of Lupron at 7pm. So far not too bad. Though this is different than last time. Last time, I started the stimulatiing med Follistim right away and took Ganirelix to prevent me from ovulating too soon. This time, we’re trying a different med, Lupron. It basically does the same thing as the Ganirelix, but we’re doing it a little earlier and it seems that it means more injections too. Not fun. However, I’m willing to play along if it means great things to come. Healthy eggs, healthy embryos, and finally a healthy baby will make all of this worth it!

Thursday, Nov 21, 2013 – Sunday, Nov 24, 2013

Now the real fun begins. Five injections per day! Holy S^^t! Seriously? Yep, they’re serious. 20 Units of Lupron at 7am, then 20 Units of Lupron, 300 units of Follistim, one 75ml vial of Menopur, and 30 units of Omitrope at 7pm. This is all a little overwhelming. As mentioned before, the Lupron is to prevent me from ovulating too soon, the Follistim is the Follicle Stimulating Hormone (FSH) to help me have a super ovulation and get lots of follicles, the Menopur, also has FSH and LH (luteinizing hormone). These will help my follicles mature and prepare for ovulation. I took both these stimulating meds last time so I know what to expect. It wasn’t that bad. I mostly just felt really tired during the process. The last medication, Omnitrope, is a Human Growth Hormone (HGH), and I’m a little nervous about taking it.

Why do I need Human Growth Hormones?

It would seem that my 5 fertilized eggs out of the 7 eggs we retrieved last time were considered a low number for my age so I’m considered a poor responder. Dr. Internet’s term, not Dr. J. He’s too nice to actually say that, but he did say I had low numbers for my age. So the thought is, adding HGH to the treatment could help poor responders like me to not necessarily get more eggs, but produce better quality eggs. It might improve the quantity of eggs too though there’s debate in the research as to whether HGH helps produce more eggs. However, there seems to be some evidence that there is an improvement with egg quality, which we believe is my issue and why I keep having losses. So this is an interesting addition to my med protocol and I’m actually wondering why we didn’t do it before, but I guess Dr. J wanted to see how I did with just the stimulating meds last time as the Omnitrope is not without risk. There are several scary side effects, though rare, some of these include allergic reactions such as skin rash, swelling of the face, lips or tongue; back curves to the side (don’t know exactly what that means, but it sounds really scary!); breathing problems; changes in vision; ear pain or infection; headache; lumpy or thinning skin at the site of injection; nausea and vomiting, pain in hip or knee; swelling of hands or feet; and feeling unusually weak or tired. These are definitely scary and though they are very rare, I’m pretty freaked out about it. Another con of the Omnitrope is it’s rather expensive (it added another $1000 to the cost of my meds this time). We don’t know yet that the 5 fertilized eggs we already have aren’t good quality so this may all be unnecessary, but since we’re doing another retrieval to get more for the PGD in hopes of increasing our odds anyway, we figured why not try the HGH if it will help with egg quality. And although I’m pretty worried about that list of side effects, I’m willing to try anything at this point.

Here’s an interesting article I found about HGH and IVF: http://www.advancedfertility.com/blog/growth-hormone-to-boost-ivf-success-rates-in-poor-responders/

Here’s an interesting video that talks about HGH and egg quality (Ignore the weird sci-fi music at the beginning): http://www.youtube.com/watch?v=1Pask7v8Gpo

Monday Nov 25, 2013 – Sunday Dec 1st, 2013

I begin going in for ultrasounds and estradiol checks every other day or every day if necessary, starting on Monday Nov 25, and I will continue with the medications as described above with any changes that Dr. J prescribes once he sees how I’m responding. Last time we increased the Menopur quite a bit, so we’ll see if that happens again.

Monday Dec 2nd, 2013 – Saturday Dec 7th, 2013

Week of retrieval. I’m tentatively booked to have my retrieval on December 2nd. If my follicles are mature enough on Saturday, Nov 30th, I’ll stop the meds and do the trigger shot, Ovidrel, and then I’ll be good to do the retrieval on Dec 2nd. So we’ll see if this all plays out according to plan. Fingers crossed! We really can’t afford to do another round so praying this is it and I get a good amount of eggs and then onto the PGD testing and praying we have some healthy ones!