Trigger (warning a bit of TMI)

It's finally here. I had my u/s this morning and was told that it was time to trigger. I knew even before my appointment based on signs so I was already prepared.

Warning: Some TMI and I'm pretty emotional so I'm a bit sporadic in my writing. 

I've learned many things during this roller coaster ride with infertility (I HATE that word!) I never read TCOYF but with everything I have been through I can pretty much tell you exactly where I am in my cycle and what is about to happen.

Short or long cycle I always get middleschmerz which SUCKS. I'll still never forget the first time I experienced it. I thought I had food poisoning from bad Chinese food, then I thought I was constipated and was going to implode, then I thought that all the scare tissue from previous surgeries had grown together and something was going to rupture. I seriously experienced pain for about 4 or 5 days. I went to my GP who checked for appendicitis and then ordered a series of blood work and an ultrasound. I went to my gyno who did more ultra sounds and it all came back pretty much the same. "Nothing wrong, but it looks like you might be ovulating, come back in 2 weeks so we can see how things look." I went back and everything was back to normal and gave us something to work with and compare. Next cycle it happened again, and once again I thought something inside was going to rupture, more u/s and it was officially confirmed. I don't get cramps with but I DO get major pain during ovulation. After a few months it subsided and would last no more than about 24 hours.
I was using CBEFM at the time so that too confirmed that the pain was ovulation. As you can imagine this made it EXTREMELY hard to BD so timing was always an issue. Can't really have sex if it hurts just to stand or walk right?

Then I started reading a book called The Female Brain. I actually need to look for that book again because I never finished it, but I did get far enough into it where it talked about hormones and how our hormones fluctuate during certain ages as well as during our cycle - pre O, post, PMS etc. I then began to pay closer attention to how my natural hormones affected me. I went on BCP at the age of 17, prior to that I hated the fact that I got AF so I never paid attention to anything and from 17-33 I didn't have to either because of BCP. At 33 I was finally learning how things worked. A bit late? Maybe but it's the choice I made.
I began to notice that I get more aggressive and angry before ovulation, slightly emotional days before AF. Totally fine once AF started and the cycle continued. I also began to notice that I would spot before ovulation, and after some research I found that this was normal and a good sign.

Why am I telling you all this? Well yesterday around noon, I started to bleed. At least I thought it was bleeding, it was bright red and I felt it, like when AF starts, as opposed to just spotting which is usually dark brown and I never feel. I called the RE in a panic, the nurse said not to worry since I was coming in today and that there really wasn't anything they could do (WTF I'm not used to hearing that). I called my acu, she couldn't do much either but I was already going in for treatment so she said she would focus on that in addition to everything else. By 5pm it was gone. I then realized that it was my pre-ovulation spotting only this time it was more because of all the hormones and follicles. Stim or not the doctors can only control so much, yesterday was CD13 so it all made sense. If I didn't trigger tonight then I knew it would be Friday at the latest. Another sign was that I suddenly was VERY snippy with the husband and I noticed that more things were setting me off. Prior to yesterday the haterade shots hadn't affected me that much. I know it's because of all the work I've been doing at acu.

Trigger was at 8:30pm PST and my retrieval will be Saturday at 7:45am. Well that is the time my appt. is, the actual procedure will be shortly after. We're in the final stretch. I can't believe 2 weeks have already passed. I still can't get over how much better I'm doing this time around. I feel more positive overall. Finding the forums have helped me so much and this really is my time of year for new beginnings. Last time it was Fall/Winter and I suffer from SAD. Between the SAD and no longer being on my anti-depressants, it was just hellish. I still question why we didn't wait but I think it was because I wanted to be PG and a baby so badly before I turned 35.

Some results:
Monday 4/12/10 E2 = 563
4/15/10 - lining is at 13.27, 8 follies but they only measured the largest. L: 11.05, 9.41. R: 13.34, 12.52

Thursday 4/15/10 E2 = 1432
4/15/10 - lining is at 17.03, 8 follies total; 2 on left (18.9 & 15.28) 6 on right (21.28, 19.77, 18.27, 16.33, 13.72, 12.64)

My acu's (I see 2 simultaneously) keeps reminding me that it's not the numbers that are important but the quality of the eggs/embryos and the environment that the embryos are going into. They have had patients who only had 1 or 2 eggs at ER and ended up PG with healthy babies, and I have seen these babies. I just have to remember and listen and stay positive. I have done all I can and will do all I can during the 2WW.

I went to my last Flamenco class for a while tonight. I won't be able to dance during the 2WW and am not sure if the docs will allow it after I'm PG (staying positive here so I'm just going to say that it IS going to happen). I'll go to Hula on Monday and hope that I can possibly continue that one after PG since it is less intense in terms of movement. I will admit that I am bummed because a friend just told me about a Samba class that just started. I want to try and go tomorrow just to get one more class in but am not sure if I can. No matter what I will continue dance after the baby is born and if I have a little girl, I already dream of taking her to dance classes. If I have a little boy, he can go too but I plan to have him learn more of the music side unless he really wants to dance. I get teary just thinking about it.

This is it, our last chance. Our "baby fund" is pretty much depleted and I don't think that I can mentally deal with staying off meds while not PG, not to mention I never wanted to be this old TTC, another year may set me over the edge. 3 years is long enough. But I'm not going to dwell or focus on that, this IS our year. I WILL get PG and STAY PG this time and we WILL get our baby. This isn't even the hardest part, I know that I have a difficult journey ahead of me once I am PG but I know it will all be okay. I went through the worst 6 years ago so that I could have and carry my own child, it will be worth it. Right?

Okay, time for bed, I think I've rambled and jumped around enough for one night. I'll update more this weekend with all my results from this cycle as well as other randomness I'm sure. Not sure who's reading but thank you to those who do and PLEASE don't be a stranger. I'll answer your comments/questions and would love to read some new blogs. to the ladies from the forums, thank you for helping me get this far! I know I've been MIA and quiet this week but you all have helped me more than you know.

Acupuncture, Ultra Sound, Morning Skin, and general randomness

I didn't update last night because I didn't really feel like I had much to say so here is a recap along with today's results.

On Wednesday I had my 1st acu session for this cycle. I went last Friday but since we hadn't started stims yet I count that as a "pre session." I went in feeling bloated and uncomfortable and irritated and came out wonderful. They worked on my belly for about an hour to relieve the congestion which is what causes the bloating, get things moving (I've been having digestive issues) and just working on getting my body ready and responsive. I kid you not, I went in with my jeans fitting snug and left with them loose. I've been going to acupuncture for so long (10 years for various issues/ailments) that I sometimes forget how not only does it work, but how quickly I see results. She said my tongue looked better but that we really needed to focus on getting my digestion better. I realized that I think it’s because I've become addicted to the peppermint butter mints in our reception area and eating 6-10 a day and while my taste buds LOVE sugar, my body has never responded well to me eating too much. So as of today, no more pillow mints.

Since my acupuncturist is also a fertility specialist (acu. fertility specialist) she is very sensitive and understanding of the whole process and also extremely positive. Yesterday she said something and referred to me as "mommy to be," which made me smile. She also shared with me some great news in terms of other patients in the clinic. In the past 2 weeks they have had 2 women, both over 40, become pregnant. One was naturally, after trying for 12 years and never becoming pregnant she found my acupuncturist's book and decided to seek her out and now drives 2 hours one way for appointments and after a year of weekly appointments (just acu no acupressure or massage) she became pregnant naturally. The other lady was via IVF. Now while I am not over 40 or even 40 its news like that that gives me hope because if she can help someone older than me who has had other issues and for longer then she can definitely help me and I've been far more diligent about making appointments to prepare my body n the last 6 months than my last IFV cycle. I go back again on Friday and this time hubby will go as well.

Last nights haterade session was okay but the menopain really hurt, to the point where hubby suggested asking the RE if we could use a different gauge needle. I literally felt the whole shot going in, meds coming out and needle coming out - it was the worst yet. I'm not sure if I just hadn't iced down enough or if I'm getting more sensitive but I can't take this much longer. I did moxa after the pain subsided and it felt MUCH better. I need to remember to do that nightly now. I should be doing it anyway but this will help remind me.

Yesterday morning and this morning we had some issues with the MD Lupron that I am now referring to as "morning skin." For some reason the needle just doesn't want to go in as easily as it does at night or in the previous mornings. Hubby says that my skin just kinda dips in but that the needle isn't going in without him really having to push it in. Since it only happens in the morning I'm guessing it has something to do with my skin either not being hydrated enough or something so I now call it "morning skin." Hubby thinks I'm nuts but I come up with new terms like that for so many things that he's used to it. Plus it makes him laugh, which in turn makes me laugh and that truly IS the best medicine right? Anything to get me to laugh in the morning in general is a good thing, more or less after a shot before I've even finished my 2nd cup of coffee.

This morning, after the morning skin, I had my 1st u/s since starting stims. I was hoping for some great bunches of grapes but at the same time wasn't expecting much since I was slow to get started last time around plus the whole short period makes me wonder. Sure enough I was right. I'm not responding super great yet, my lining hasn't even begun to grow and my follies are small. But, the doctor isn't concerned and said that he has no doubt that there will be lots of great, mature follies we just need to bump up the follistim. So starting tonight its 400IU instead of 300 and the rest stays the same. I go back Monday morning for another u/s and blood work. No blood work today since he said it would be negative based on the follie size and lack of lining. If he's not concerned then neither am I. Plus I have acu tomorrow and will start my herbs today which I should have done sooner and I have no doubt that Monday will be great.

Here are the results from today as well as from my baseline since I forgot to get those last time.
4/3/10 baseline
E2 (with having been on Estrace for 5 days): 327.2 pg/ml
Left Ovary: 25.03 (no idea what this means because it is not listed under the mm category, just above everything)
Right Ovary: 13.04

4/8/10 1st u/s since starting stims
Left: 6.26, 3.88
Right: 6.56, 6.33
Lining: 6.28

No idea what it all means. They have switched over to a completely electronic system so the results look totally different from 2008. He did say that there were a lot of follies but that none were at 10, which they like to see but that he had no doubt there would be lots very soon. One thing I do know is that they never beat around the bush; they always tell it like it is so if he isn't concerned then I have no reason to be.

The good thing is that my right side looks good he said and that is the side that didn't really produce any mature follies last time and not many in general. The left was the over achiever. This time it looks like the right has finally started to earn its keep and giving the left some breathing room. Considering the infection in Jan was on the left and that is where the fluid is residing I think this is all good news. Oh and we asked the RE about the Menopur needle and they gave us a bunch of smaller ones to use. YAY! They said that lots of patients complain about the size. Um, hmmm why not just prescribe the script with the smaller needle then? DUH! I'll let you know how that goes tonight.

CD 2 - starting Stims tonight

Baseline u/s went well. The doctor said everything looked great and that we were ready to go. Tonight I will started with a microdose (MD) of Lupron and that's it.  Tomorrow is when I start with all 3 meds. MD Lupron in the morning, MD Lupron in the evening along with the Menopur and Follistim. This means a total of 4 shots a day (I requested the 900IU vial of Follistum to cut down on the number of shots while taking a 300IU dose) but every 3 days or so I will have 5 shots because of the left over in the Follistim vial. Hubby is great about giving me the shots so it helps a lot!
I also have to make sure to ice down first so that the injection site is numb.

Tonight was very emotional, I cried before the shot. Not because I'm afraid of needles but because it means this is all so very real and we are taking this journey again. I just hope this time ends with a beautiful, healthy baby in the end.

I've read a few posts on the boards about Lupron headaches and moodiness. I really hope I don't get either, especially the headaches. Headaches always freak me out and I hate taking any kind of pain meds. I already warned hubby about the potential moodiness. I'm already very emotional from the Estrace and this whole process. My therapist says that I have PTSD from the last cycle which I agree. It was very traumatizing on so many levels. I think not only the obvious; having to seek assistance to conceive as well as it ending in a CM but it also goes back to when I was sick (cancer). That was a hard year and in a way all of that has lead to this. I had the surgery to preserve my fertility so that I could eventually have a child. I also knew that that was no guarantee that I would have a child. I still remember laying in my hospital bed after the ureter reimplantaion, talking to my oncologist and her telling me that it was very possible that even though my reproductive organs were still intact  minus my cervix that I could still struggle to get pregnant. I didn't want to believe her but I always appreciated how straight forward she was about everything. She never sugar coated anything. So even though I've been cancer free for 6 years now and not really had any issues since 2005, it is all still very real for me and going through IVF only adds to it. Thankfully I have my husband who is extremely supportive. I couldn't do this without him right there every step of the way.

Tomorrow is day 2, Easter Sunday, definitely NOT the time to tell my parents yet. Maybe next week, we'll see. I really hope I don't have any side effects from the Lupron or at least not to intense.