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Monday, 4th July 2011
Our baseline scan was all set to go. My period eventually showed up, 6 days late! It’s so typical! Every month you pray that she doesn’t arrive, yet she does, on time or even worse, she decides to make an early appearance. When you do want her to show up, she’s late!
Anyway, down regulating had been going well. I didn’t seem to have too many side effects. The first week of starting the injections I was a little more tired than usual, and I had a slightly bloated belly. I’m not sure if the bloating was from the injections or the amount of water I had been drinking.
The day before our baseline scan, I received some of my test results from a previous clinic and some of the results had me slightly concerned. There was mention of a paraovarian cyst accompanied with a note saying ‘Endo’. I hoped this didn’t mean endometriosis. No one at the previous clinic had mentioned this to me, so I was hoping that the nurse could shed some light on this for me at our scan. As well as asking about these two things, I once again prepared a long list of questions to ask:
* What does the lining of my uterus measure? Is that good/bad?
* When can we start stimming?
* As I have a tilted uterus (retroverted), will this make egg collection or embryo transfer more difficult?
* When will my next scan be and how often will I be monitored?
* As well as the internal ultrasound scans, will I have any blood tests?
* Is there anything I can do to help prevent OHSS?
* In addition to the protein shakes, is there anything else I can be doing at this stage to help?
IVF can be stressful, so I was saddened to read that some people’s employers weren’t very supportive when it came to time off. My employer had been brilliant. She allowed me time off for all of my appointments and I never had to work back any time. It’s a shame not everyone’s employer is like her!
During our treatment, I have previously talked about things to help take your mind off IVF. One of the things that I did was take part in Cancer Research UK’s race for life. It was the 5th year that I had taken part and I was doing it in memory of my mum. She passed away 6 years earlier from ovarian cancer. My twin sister and I managed to raise £250. It was a lovely day, the sun was out, smiles were on everyone’s faces and yeah I got a little sun burnt, but I had a great day!
The morning of our baseline scan and we were both understandably nervous, as I imagine most people having fertility treatment would be. Thankfully, our nurse put our minds at ease straight away about the ‘endo’ comment. She explained it was just a reference to the measurement of my lining. She also advised me that I had two small cysts on the outside of each ovary, but she said they were tiny and nothing to worry about. She said she was glad I had mentioned them to her, because otherwise she might have thought they were follicles growing outside my ovaries. The nurse also answered my questions and confirmed that having a tilted uterus wouldn’t make egg collection or transfer more difficult. She also said that I wouldn’t need any blood tests, as they would be doing regular scans.
Moving on and I am pleased to say that our scan went well. So well in fact, that we were told we could start the next set of injections that night! These injections would be to stimulate my ovaries into producing eggs. The nurse explained that due to my age (24 at the time), she would start me on a low dose of 150iui of menopur and again she let us know that she wanted to scan me regularly. We were booked in for scans every other day, July 8th, 11th, 13th and 15th. This is one of the reasons why I am so glad my employer is supportive. IVF takes up a lot of time, so having the flexibility to work around treatment meant there was one less thing to worry about.
Our nurse told us not to worry if the first scan didn’t show up much because they can always up my dose if needed. She explained that it was better to start on a low dose and increase it if I didn’t respond as well as desired, rather than start on a high dose and end up abandoning the cycle due to over stimulation. I would still be taking the same dose of Suprecur. This meant we were now doing two injections a night. Going back to the subject of work, I hoped to book off the day of my egg collection, as well as the whole two week wait. I wanted to be able to relax 100% and didn’t want to be in work if AF showed up (meaning our treatment had failed), as I know I would get upset. I also decided at this point that I would up my protein shakes to 3 a day. One with breakfast, lunch and dinner.
Later that day, I had a few questions I wanted to find out the answers to. Yup, you guessed it! I turned to the ever wonderful fertility forum. Some of the questions I had were:
* Should we be doing the menopur injection (stimming drug) in the same spot as the suprecur injection?
* Should you alternate sides?
* Should the menopur be kept in the fridge?
After seeking the advice of some fellow treatment cyclers, we decided to do the injections either side of my belly button and alternate sides every night. We didn’t keep the menopur in the fridge.
One evening I decided to make a list of all the things I would do to keep myself occupied during the two week wait (2ww/tww).
* Make fairy cakes
* Go for a walk
* Watch a film I had taped 3 months ago but had never got round to watching!
* Go to the crematorium and lay down some flowers on mums grave
* Cook something I have never cooked before
We couldn’t believe how quickly things were moving. It was only three months ago that we had attended the fertility clinic open evening and now we were actually stimming! My husband thought he was a doctor he had carried out that many injections on me and now he was actually looking forward to giving me two injections a night! The first injection stung a little bit, more so than the suprecur injections. Maybe because the needle was slightly longer and thicker.
I remember reading somewhere that heat is good to help follicles grow, so I starting using a hot water bottle on my belly for an hour a night – grow my follies grow!
In hindsight, we should have done our injections later in the evening, preferably just before we went to bed. Anytime we went out, we had to make sure we were home by 9pm to do the injections. I realise we could have just done the injections out wherever we were or just done them a little later in the evening, but I wanted everything to be perfect. I didn’t want to risk doing anything that could hinder our chances.
Two days into stimming and I was sure I could feel little twinges in the right and left sides of my stomach. More so on the right side than the left. I didn’t know if this was a good or bad thing, but decided to take it as a good thing!
The day before our first follicle tracking scan, my husband and I were both feeling very positive. We were looking forward to our scan and it went well! There was a big TV screen mounted on the wall in front of where I lay during the scan. This meant that we could both see what was going on! The nurse said that the lining of my womb was now thickening nicely. She said that my lining was 5.9mm and that they like it to be around 10mm for egg collection. She counted 5-6 follicles on my right side and 6-7 on my left side. The nurse seemed please with this, so my husband and I were very happy! Our next scan was in 3 days time and I was excited to see how things would progress.
I decided that I would start to drink one small glass of pineapple juice every day in the run up to our egg collection. I had read that it can help improve the lining of the uterus. I was, however, advised to buy ‘not from concentrate’ pineapple juice and only to have one small glass a day, as too much pineapple can cause uterine contractions, which aren’t good.
Second Follicle Scan
Our second follicle scan arrived and it was more good news. The nurse said that was my womb lining was good at around 10mm. On my right side I now had 6 follicles, and my left side had increased to 15 follicles. The nurse measured the follicles and said that I had one at 10mm and one at 11mm on the right side. The remaining four were between 8-9mm. On my left side, two follicles were 11mm, seven to eight follicles were around 10mm and the rest again were around 8-9mm. There were a few others as well but the nurse didn’t measure them as they were small.
I realised that when using my hot water bottle, I tended to put it more on my left side. This led me to wonder if this was one of the reasons why I had more follicles on that side than the right side. I guess we’ll never know!
The nurse did say that she didn’t know why there weren’t many more follicles on the right side, but we were making good progress and she didn’t seem concerned as there were quite a few on the left side. Our next scan was in 2 days time, so we hoped that some of the follicles on my right side would grow a bit more and that the ones on my left side would continue to grow at a good pace.
I remember asking the nurse if all went well at our next two scans, when would we be looking at egg collection. She said it would most likely be the following Monday or Tuesday. Yipee, this meant we wouldn’t have too long to wait. Whilst we were at the clinic, the nurse did double check with the consultant about lowering my dose, as she was concerned about over stimulating. The consultant advised to continue on the same dose for now and they would check at my next scan if the dose should be lowered. I decided to increase my protein shakes again so this meant I was now having four protein shakes a day. I also continued drinking 2 litres of water a day.
I started to wonder how many follicles was too many. The nurse told me that they look for between 5-15 follicles in total. I was a little worried as I had 15 on one side and 6 on the other. 21 in total. However, she reassured me that they weren’t concerned, saying that if I had between 30-40 follicles then they would start to worry.
Just to recap, our journey so far:
* Thursday, 14th April 2011 – Fertility clinic open evening
* Wednesday, 25th May 2011 – Our first consultation
* Saturday, 4th June 2011 – Surgical sperm retrieval
* Tuesday, 7th June 2011 – Treatment planning appointment
* Friday, 10th June 2011 – Drugs arrived
* Wednesday, 15th June 2011 – Started down regulating
* Monday, 4th July 2011 – Baseline scan and started ovarian stimulation
* Friday, 8th July 2011 – Follicle scan
* Monday, 11th July 2011 – Follicle scan
* Wednesday, 13th July 2011 – Follicle scan
* Friday, 15th July 2011 – Follicle scan
A few days into stimming and I was starting to feel achy and bloated. I was still having acupuncture, so I made my acupuncturist aware that egg collection would be soon. She advised that it would be beneficial to have acupuncture before and after embryo transfer. I read somewhere that acupuncture can increase the success rate of IVF by up to 65% and that it could help to improve blood circulation to the uterus. I hoped this was true!
Third Follicle Scan
Our third follicle tracking scan showed that we had 7 follicles on my right side, one more than at our last scan. The biggest was 15mm. We still had 15 follicles on my left, which was great, so it looked like I wasn’t going to overstimulate, which also meant that my dose would remain the same. The biggest follicle on my left side was also 15mm and we had a few at 15mm, not just one. The nurse said that they wanted the follicles to be 16mm for egg collection, so we weren’t far off. This meant that following our scan, we would be doing the trigger injection the upcoming Saturday or Sunday and egg collection would definitely be Monday or Tuesday.
Fourth and Final Follicle Scan
Our final scan and I was feeling achy, uncomfortable and bloated. The nurse said that we had 9 follicles on my right side, the biggest was 19mm and the rest were between 12-15mm. On the left side we had 16 follicles. The biggest was 17mm and there were about 4 or 5 at this size. There were three to four 16mm follicles and the rest were between 12-15mm.
I was a bit grossed out when the nurse told me that my left ovary was slightly touching my right one! Eww! That can’t be too good, can it? She said that my left ovary was quite big, which left her in a bit of a dilemma as to when egg collection should be. After checking with the consultant, the nurse confirmed that egg collection would be on Monday at 11am. She told us that she thought some of the follicles were bigger than what she had measured but it was hard to tell as they were squashed together by my ovaries.
Trigger (HCG) Injection
The nurse went on to explain that we would have to do the trigger shot (HCG injection) at 1130pm on Saturday, 16th July 2011. She and the consultant were debating whether or not to use Pregnyl instead of Ovitrelle for the trigger shot, as there was still a chance of me over stimulating and one injection was stronger than the other. The consultant decided that we should stick to Ovitrelle, although she was a little worried about over stimulating but she was sure this was the right decision and she advised me to keep eating lots of protein and continue taking the protein shakes.
So, to sum up…..egg collection was booked for Monday 18th July 2011. I was advised not to wear any perfume, makeup or jewellery! Oh no! My make up free face! That is a scary thought! Anyway, my husband and I had our fingers firmly crossed that all would go well and that we would get enough eggs. Well, we only needed one egg. It only takes one egg to meet one sperm to make a baby! One lucky, little, mature, strong egg!