From Menopur Through Retrieval

We are working the calendar. I can't believe how this is moving along.  Tomorrow is our transfer already. Yep, let me fill you in on what has happened over the last week.

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I realized that I was in need of about 26 more vials of Menopur and Aetna was causing hoops by not honoring refills and they did not send me what I needed- they sent 40 instead of 60.  Luckily, I was helped by Dr. Doherty's office and my medicine was rushed for $2,500 ding on my insurance and $50 copay for myself.

I also did Ganirelix one evening after going to an ultrasound appointment to find out the size of the follicles. We were looking at six on the right side and seven on the left. They were 11-12 in size and needed to be near 18.  The Ganirelix caused a injection site reaction and was not much more than just annoying.

Ganirelix: Injection Site Reaction

Friday, March 31, 2012: Trigger Shot HCG

This shot is the most time sensitive and the most important. I had to do it at 10pm.

Monday, April 2nd 2012: Retrieval

Nathan and I had Nate's dad bring us to our appointment. Due to Nate's lack of vas deferens he must do a testicular biopsy to extract sperm.  Today was the day to retrieve eggs with me put under and Nate in an outpatient procedure doing a testes biopsy for sperm.  This would be the first time his sperm and my eggs would meet.  They have been probably screaming that they couldn't get out all these years!  Retrieval went well for both of us.

We ended up 11 eggs retrieved.  I would receive a call each day on the quantity, quality and status of the eggs.  Day 1: 10 out of 11 fertilized on their own and were considered grade a by day 2

I have been doing the Progesterone in Oil shots and those are NOT fun. I can handle injecting the needle but its had to twist around like I want to.  The oil is so thick that I have to have Nate now push in the plunger.  It hurts the next day and then for a few days after. Ugh. I just researched that some sit the vial in warm water a little while before injecting so I am going to try that today. Yup. Anything to ease the bruising feeling I get with each PIO shot that I have to repeat through the pregnancy test around April 16th.

So, here we are the night before transfer.  Dr. Doherty is calling us early to discuss how many to transfer. I think it will be two like we discussed when we started this journey back in October.

Here we go!

How To Prepare & Inject Menopur

When I was about to start my shots, my brother searched his cell phone for youtube videos on how to do specific injections.  I happened to watch one while I did my first injection.  It helped a ton.  Today could be my last day of Menopur injections since I have blood work and an ultrasound in the morning so I thought I had better get recording. 

4 to 6

Menopur Injections:

I have been doing Menopur injections since last Thursday.  I went in for blood work and an ultrasound on Sunday morning and my eggs are being produced as needed, however, my  lining isn't thick enough.  We moved from 4 vials of Menopur per day to 6. When I prepare the syringe, I am using 1cc of sodium chloride (dilutent in liquid form) to all powders, six vials worth.

My next appointment for blood work and ultrasound is Wednesday morning.  At that point we will then probably more to the next injection.  Our retrieval is only about a week away.  For the retrieval, Nate will get a nerve block to get his testicular biopsy done while I will be put under and fully sedated.

Shot 1: Score!

I did it! I injected myself for the first time and I didn't die!  Okay so that is a little over dramatic but I did get extremely dizzy, queezy and pale as my brother watched me jab myself in my pinched belly fat.  I couldn't talk but just breathe while I slowly injected the Menopur.  My first fertility injection on this IVF journey, try 1, cycle 1.

It was very useful to be able to google for Menopur and watch a few videos on youtube before and while doing the loading of the syringe and the injection.  I wasn't sure which needle to use for sure.  It ended up being about 27 g and it was very small.  Luckily.

Now, Sunday I have my first test to check the enlarging follicles and see where our progress is before starting a new drug.  I am so excited.  I did the shot at 9:30am and was so proud of myself.  It took a little while to recover from being lightheaded but proud, I am.

Use a Jabbing Motion to Inject Intramuscular?! What?!

I'm figitng. I am nervous and my stomach is upside down.  Only a few short days until the shots start. Lots of shots.  I have never been scared of needles and shots but this many and not done by a medical professional makes me queezy all of a sudden.  I have shots that need to be taken both Intramuscular and also Sub Q.  With the sub q injections, I can use my upper thighs or I can pinch my belly to use that area.  In the upper buttocks/hip area, I am pretty sure the intramuscular and stabbing action needed is what frightens me there. :)  I'll be fine but it makes me nervous.  I am hoping Nate will be good at helping with the injections.  The timing is important though so I am sure there will come times when I need to do them.

We have delayed our IVF from January to now (March 2012) because of my extensive travel schedule.  For work I have had the opportunity to travel to more than 15 cities in the US and Canada in less than eight weeks.  I did get some great experiences in before starting this actual process.  With Nathan's azoospermia, we have no choice other than medical intervention for us to conceive or at least have a chance at it.  As a reminder, Nathan carries the CF (cystic fibrosis) gene and was born without vas deferens which are the vessel for sperm to be carried out of the body.  After having a testicular biopsy, we found sperm and here we are now on a calendar. An actual cycle that we have planned for months.  I feel fluttering of nerves as I blog.  Excitement and possibility just pump me up.

So, over the last five weeks I have taken birth control pills to start regulating my body.  I took the last dose yesterday the 18th of March, 2012.  On this Wednesday morning at 7:30 is my sounding.  This is where the cervix is measured and the shape is noted.  I will then be given the ok to start injections which we believe will be the next day, March 22nd.  The injections will consist of the following medications, however, some of this is cloudy to me and I have a lot of questions on Wednesday so bare with me while I learn this myself :)

With these injections we want to produce several eggs in one cycle.  Menopur which stimulates the development of follicles.  There is also Ganirelix which suppresses hormone production, prevents ovulation and allows improved stimulation of ovarian follicular development.  Chorionic Gonad prepares the oocytes for the final maturation process which takes 36 hours for eggs to be released after injection.  The last of the items I will be using is Clomid- I am not positive as this is one of my questions for Wednesdays appointment and Progesterone which prepares the uterus for attachment of on the lining.



Nathan and I will have retrieval on the same day and I will be sedated but Nate will not be.  He will receive a block again as when they did the initial testicular biopsy.  When the follicles have matured, I will do the HCG injection and 34-36 hrs later I will have my eggs removed from my ovaries with a needle and ultrasound probe guiding it.  The retrievals will be either April 1st or 2nd with us resting the remainder of the day.  At that time there will be an Embryologist that mixes eggs and sperm for fertilization.  2 or 3 days later will be the embryo transfer to my uterus.  At that time I am on bed rest with only bathroom privileges for 24 hours.  This is our now planned infertility journey.  We can just pray and hope that the embryo implants and the pregnancy sustains.

So here I am.  Preparing for this very important journey...