Oh! (ss)

Ha ha! Nice one, universe.

At the end of a scheduling phone call to the clinic, it occurred to me to mention the incredible bloating and discomfort. “Oh!” said the study coordinator, grabbing a calendar and counting rapidly. “That’s very exciting!”

Not the word I was expecting, I thought. Out loud I asked, “Really? Why?”

“Because it means you’re probably hyperstimulating.”

“Um, isn’t that a bad thing?”

“Well, yes, but since your symptoms didn’t start until almost a week after your embryo transfer, it might very well mean you’re pregnant.”

Apparently, OHSS is caused by HCG, the pregnancy hormone. Some women who get it, get it from the HCG trigger shot they give right before you ovulate. But other women develop it when their own bodies begin producing HCG in pregnancy.

I asked cautiously, “Should I get excited? Because I don’t want to get excited if I’m going to be wrong.”

“I think you can get excited.”

So, don’t tell anyone. But I’m excited.

I am also drinking three liters of Gatorade and water each day in order to prevent myself from popping or going into organ failure or something unpleasant like that.

Ovarian Hyperstimulation Syndrome

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I might pop.

I can only assume that my current state is related to either 1) the IVF, 2) pregnancy, or 3) having somehow unknowingly swallowed a whole pumpkin, stem and all.

Which is to say, I have been gassy and bloated for the last four days or so. Beyond anything I’ve ever experienced. It hurts to take a deep breath, it hurts to walk or sit or move in any way, and it hurts to roll over in my sleep. I have, of course, decided that this means I’m pregnant (though I have not completely ruled out the pumpkin theory). So I called my mother to ask her opinion.

My mother didn’t figure out that she was pregnant with me until she was six months along. Any time I’ve asked her about (possible) pregnancy symptoms, she’s shrugged and said she didn’t have any symptoms other than heartburn. But when I mentioned the Bloat, she got a little excited. As it turns out, gas and bloat similar to what I’m experiencing are what finally got her to go to a doctor. Who misdiagnosed her as having an ulcer, but that’s not the point. The point is, woo hoo! Maybe.

Update: Internet says gas and bloating are caused by increased progesterone levels.  I’m taking 600 mg of progesterone suppositories daily.  So much for the pregnancy symptom theory.

The two week wait blows.

Today is day 6 of 14.  That is all.

Seven Dwarves of IVF

Achey

Bloaty

Crampy

Moody

Hungry

Whiney

Snoozy

I tried to illustrate them, but I wasn’t very successful.

I am a blue-ribbon hen.

Twenty. I produced twenty eggs. I have been told this is good.

Having been told we should be at the clinic by 11:30am for my 12pm retrieval, we arrived at at 11am. And sat. And waited. And read Us Weekly, because although I had brought What’s the Matter With Kansas, my attention span just wasn’t up for it. Eventually they called Mr. Malaprop into the Pr0n Room, and took me into the procedure room. The anesthetic made the ceiling start to spin, and then I was out. When I woke up, everything hurt. A lot. I remember the doctor patting my leg and saying, “we got twenty eggs!”

“Is that good?” I asked weakly.

“That’s great,” he said. “We’ll call you tomorrow to let you know how many fertilized.” He patted my leg again and left.

Mr. Malaprop came in and held my hand while I lay there, whining softly, until a nurse came in. “I can hear you from way out there! You sound like a cat! I’d better give you some Darvoset.” Fortunately, I was awake enough to fend that off (see below entry about how Darvoset = codeine = puking), so I got some tylenol instead.

After a while, they had me sit up, legs dangling over the edge of the table. This was fine until it suddenly wasn’t, and I knew I was about to pass out. I lay back down. The same nurse who had laughed at my feline whining now brought me apple juice, which made things a little better. I sat up again after about fifteen minutes, and then Mr. Malaprop helped me to get dressed and a nurse wheeled me down to our car.

When I got home, I turned on The Princess Bride, and fell asleep sometime around the Pit of Despair. The rest of the day was spent drifting in and out of sleep, in and out of pain. I ate some toast, took my pills, and tried to drink a lot of water, but the pressure of a swollen bladder on my very tender ovaries was moderately excruciating.

Today I am back at work, though still very tender. I am trying not to jiggle around too much.

And the doctor just called! Because I am lazy, I will just copy another chat session with my friend C.

me: I laid twenty (20) eggs! I just talked to the doctor, and fifteen of the fertilized, but of those, three were abnormal (2 sperm got in), so we’re left with twelve.
Which is, apparently, a whole lot
and because there are so many, he’s going to wait to transfer them until they’re at the blastocyst stage, on Saturday
Because we’ll probably lose some between embryo and blastocyst
Then he’s going to transfer two.
YAY!!!!!!!!!!!1
I am closer to pregnant than I ever have been
c: that’s an insane number of eggs
me: I was pretty pleased
c: [who donated eggs when we were in college] I’m apparently super fertile and I think the most I ever came up with was like, 13
me: I was extra-motivated
c: 😉
me: go me! go me!
c: are the other ones frozen?
me: They will be. I think he’s going to grow them all out to blastocysts – the ones that make it – insert two, and freeze the rest.
c: what happens when two sperm get into one egg?
me: I’m not sure what happens, but I imagine it’s an XYY problem
according to the intarwebs – “Successful fertilization requires not only that a sperm and egg fuse, but that not more than one sperm fuses with the egg. Fertilization by more than one sperm – polyspermy – almost inevitably leads to early embryonic death.”
c: polyspermy is a good word
I hope the unpolyspermied eeggs are sitting in your freezer next to the spoogesicles.
what’s a blastocyst?
me: according to the intarwebs again

A blastocyst is an embryo that has developed for five to seven days after fertilization. At this point the embryo has two different cell types and a central cavity. It has just started to differentiate. The surface cells, called the trophectoderm, will become the placenta, and the inner cells, called the inner cell mass, will become the fetus. A healthy blastocyst should begin hatching from its outer shell, called the zona pellucida by the end of the sixth day. Within about 24 hours after hatching, it should begin to implant into the lining of the mother’s uterus.

Also! Bonus!

Transferring blastocysts following IVF also provides another benefit – reduction of the possibility of multiple pregnancy. Some 2 or 3-day-old embryos do not have the capacity to become high quality blastocysts and a viable pregnancy. However, on day two or three of culture we do not have reliable methods to determine which embryos will be viable long-term. By culturing embryos to the blastocyst stage we have more opportunity to choose the most competent ones for transfer. We can then transfer fewer embryos and obtain high pregnancy rates with less risk for high order (triplets or higher) multiple pregnancy.

Where I’m at.

I’ve been stabbing myself in the stomach for nine days now, and in the thigh for five. The Ganirelix, which is the thigh-stabby, ovulation-preventing med, gives me a hive around the injection site for an hour or so. No big deal. The Follistim just makes me bruised – I look like I have been repeatedly bitten in the stomach by a small, angry snake. Either the Citra-Cal, the Folplex, or both are giving me indigestion. One or all of the above drugs are making me incredibly sleepy.

Saturday night, at 1am (Sunday morning for sticklers), I’m supposed to get the HCG shot. I’m hoping I can get a friend to do it, since I don’t feel super-comfortable with stabbing myself where I can’t see. I’d ask my husband to do it, but it would be terribly inconvenient to have him faint after putting the needle in, leaving me with half an ampule of medication dangling from my buttock. Plus he might hit his head when he fell, and be totally useless for babying me after the egg retrieval.

The egg retrieval, which is scheduled for Monday, should be the fun part. I’m looking forward to the Valium, though I’m a little apprehensive about the anesthetic. I don’t think vomiting will be much fun right after having my vagina impaled with a big-ass(pirating) needle. I will return to work on Tuesday, when I will endeavor to update y’all (all you thousands of people who read this thing) on how it went.

Sound and fury signifying nothing

I didn’t get my period.

When I went in for my appointment this morning, I fully expected the study coordinator to shake her head sadly and show me the door. But that didn’t happen. Instead, she did an ultrasound, and decided that my uterine lining was thin enough that they could start the IVF medication regimen today.

The nurse taught me how to use the injectable medication and the high-tech pen with the little clicky dial. Hearing the words “needle” and “stomach” in close proximity had led me to expect something fairly horrific, but in fact these needles are tiny, resembling nothing so much as a mosquito’s proboscis.

From the office, I went to the pharmacy, where I was given an ENORMOUS BAG full of folic acid, pre-natal vitamins, steroids, progesterone supplements (in two different dosages), antibiotics (one set for Mr. Malaprop, one for me), pain medication I can’t take (“I’m allergic to codeine!” “This isn’t codeine.” “No, but it’s closely related to codeine, and it will make me throw up. Trust me, I’ve been through this before.” “Well, take it home anyway, just in case you change your mind.” Sigh.), Valium, and a sharps container. And probably some other stuff too, but I can’t be expected to remember everything.

After all that panic, I’m feeling pretty damn crampy. I don’t know if it’s the drugs I was given this morning, or just my period deciding that now all the fuss is over, it might as well show up for the party.

oh help

so they delayed my period so we’d be safe to go to hawaii. and now it’s not coming back. and i’m not pregnant. and i will be eliminated from this clinical trial if it doesn’t come back today or tomorrow. which means i would not get the free ivf cycle. we can’t afford ivf.

i’m taking blue cohosh, false unicorn root, dong quai, and drinking a tea made of parsley, ginger, and basil. i have also put some sprigs of parsley inside my vagina as a pessary. all of these things are supposed to be emmenagogues – herbs to bring on a delayed period – but nothing’s happening.

i’m so fucking scared and sad.

Edit: Let’s just add to this the news that my best friend’s mother, who has been like a second mother to me since I was nine years old, is going into hospice care for her  metastasized breast cancer.

Fuck.

A little chat

me: can I whine for a minut?
minute?
can I spell? No.
C: course
me: So when I first went in for this IVF clinical trial thing, I told them my dates for Hawaii. “Oh, never mind,” they blithely sang, “worst case scenario we’ll give you something to delay your period a little. You won’t have to come back early from Hawaii.”
C: ok
this is not promising
me: When I went in for my screening appointment at the beginning of this cycle, I reiterated my concerns. “I’m going to get my period on the last day of my trip to Hawaii,” I said. “That isn’t a problem?”
“Nope! No worries. Just come in that Monday.”
C: ok
me: So I called them again today to say I ovulated on Saturday (I think), and what happens if I get my period on THURSDAY, and I can’t make it into their office until Monday?
OH!
Chaos!
Must make calls!
C: oh my
me: Eternal hold!
C: yikes
me: “Well, it would be best if you came back a day early. Alternatively, we can put you on this birth control medication to delay your period.”
C: sigh
me: “But we’re not thrilled about it, and we’re totally going to make it seem like you blindsided us and we had no idea this was an issue. Hawaii? what?”
C: suck
me: SUCK
C: so what’s going to happen?
me: Stress makes me cry
I don’t know!
I’ve got the prescription for the birth control
C: that’s horrible
me: but I’ve also called the airline and there are lots of flights the day before
C: good
me: and if I had to, I could leave early
C: yeah
not ideal, but not the end of the world
me: But I don’t know what’s best
so I’ve called the clinic back and left a message saying “please don’t call until you have a few minutes to talk, because I have questions and I don’t want to feel rushed.”
C: does it fuck things up if you take the birth control?
me: I don’t THINK it fucks things up – I think if it did, they wouldn’t offer
but I DON’T KNOW
I don’t know anything
and I feel shitty about it all
/whine
C: I’m sorry
That really sucks
it’s amazing how little foresight these guys have
me: I just feel like yelling, “but I TOLD you about this! I ASKED! You PROMISED!”
Then I realize I’m being 5 years old.
C: well, not really
it’s pretty reasonable for you to feel that way
if you threw yourself on the floor and cried
then you’d be 5 years old
me: But I so want to.
I want to beat my heels on the floor and turn red with screaming.
Then I want someone to give me ice cream to take my mind off of it.
C: all reasonable
actually doing it makes you 5
or B, who does that regularly, actually
sometimes he forgets I’m in the room and then is embarrassed
me: Hey, I had a dream about you last night.
You were a small siamese cat
but you could communicate
C: ooooh
fun
me: And we hung out just as if you weren’t a cat.
C: I wish I were a cat
me: Except I petted you a little more than I normally would.
C: and I was more prone to licking myself and had a bendy spine
me: right
C: funny, last night, I was at B’s and we were talking about how much I want to be a cat
me: that must be why I had the dream
how odd
C: you’re a strange thing
me: I know

*Crisis averted.  Word from the clinic is that they usually put women on these pills before IVF anyway, but for the purposes of the study, they’re not supposed to. But they’re fudging that for me. So it won’t negatively affect the IVF, although it will make me feel bloated and crampy and fairly miserable for maybe a week.
But that week doesn’t start until the end of the vacation, so. Fine.

OMG WTF IVF

Yesterday and today have been a whirlwind of appointments. First, at 3:30pm yesterday, we met with a doctor at a well-known local fertility/reproductive clinic, who walked us through all the steps of the study and asked us questions to see if we were Good Candidates. He also explained the workings of the reproductive system in exhaustive detail, complete with charts and pictures. When he was explaining how the egg “migrates” to the uterus, I confess, I started to giggle a little.

“What’s funny?” he asked, and I knew with ominous certainty that giggling was not a quality of a Good Candidate. I explained apologetically that I had suddenly pictured the egg somewhere in Iowa, with a rucksack on a stick, trying to hop a boxcar for the uterus. He smiled thinly, and went on with the lecture. I stifled any further leaps of the imagination.

In the end, it turned out we were good candidates. Only one problem.

“We’re expecting an e-mail, maybe tomorrow, maybe Monday, telling us we’re not allowed to enroll any more people for this study.” He handed me a lab order sheet. “I need you to get these blood tests done immediately, and meet with the study coordinator tomorrow to sign consent forms.”

We rushed off to my regular OB/GYN to get the blood drawn, slipping into the office shamefacedly just as they were packing up to leave. Maybe out of pity, maybe out of duty, they stayed long enough to poke me with a needle and draw four or five vials.

This morning I woke up at the ass-crack of dawn to go meet with the study coordinator before I had to be at work. I initialed and signed four thousand pages of consent forms, and then gave her a bit of my medical history. And then we were done. And now I am in – at least through the screening process. No e-mail will come from above and snuff my chances at a free IVF cycle. Whether I’ll manage to snuff it myself through inappropriate humor has yet to be determined.

I leave you with this photo, taken in the bathroom at the fertility center.

See? Totally inappropriate.