More Monitoring, More Results

We've progressed to pre-transfer monitoring, round 2. At this point, we are 16 days into the medication cycle and exactly a week after the last monitoring appointment. We will have one more monitoring appointment in 3 days, and then we'll transfer in a week and a half (June 12).

As with each monitoring appointment, they drew a vial of blood and did another ultrasound this morning. The things that have changed since our appointment last week are that I finished shedding old lining, the RE cut my Lupron dose down to 5 units per day instead of 10, and added oral estradiol at 1 mg twice a day. After the first three days of that change, he upped my estradiol to 2 mg twice a day. The effect that we hoped to see at this appointment was increased estradiol levels in my blood, my endometrium starting to thicken up (goal thickness at transfer is > 8 mm) while the ovaries should still be quiet (no follicles over 10 mm) and progesterone levels should still be low.

Results
Endometrial thickness: 9.3 mm
Right ovary: 6-7 follicles < 10 mm; 0 follicles > 10 mm
Left ovary: 8-9 follicles < 10 mm; 0 follicles > 10 mm
Additional findings: Small pocket of fluid in the uterine cavity
Estradiol: 228 pg/ml
Progesterone: 0.5

Things look great. My lining is already past our goal and we have no rogue follicles trying to impede our progress, so we're in great shape. We're going to keep plugging along toward our next monitoring appointment on Friday. The RE didn't say anything about the small pocket of fluid, but I'm hoping that it'll be gone by the time we do the next ultrasound.

Sneak Peek

Today was our first pre-transfer monitoring appointment. This is an aspect of IVF that I really enjoy and look forward to in each cycle. When couples are trying to conceive naturally, there are a lot of days that pass with no news or no indication of what's going on down in the land of babies. The two week wait is notoriously excruciating because of the lack of information. In the IVF process, however, doctors are getting all up in our business on a pretty regular basis, so I'm very up to speed on how things are progressing during each cycle. I like knowing things. In spite of the magic wand they have to use, this state of knowing things makes me happy.

The routine is pretty much the same at each pre-transfer monitoring appointment. They draw a vial of blood to be tested for the pertinent hormones of the week, then I head to the ultrasound room for a quick look at my inner girl bits. First stop on the magic school bus ride is the uterus where they measure the endometrial thickness (lining) and look for any pockets of fluid. Next they head on over to one of the ovaries, count the number of immature follicles (less than 10 mm), document and measure any developing follicles (greater than 10 mm), and check for any cysts. They repeat that procedure on the other ovary and we're done. I put some pants on and head back to work to await the results.

At this first appointment of the cycle, the goal is a thin lining (around 3-5 mm), two quiet ovaries (no follicles over 10 mm) and low estradiol and progesterone levels.

Results
Endometrial thickness: 5.9 mm
Right ovary: 6-7 follicles < 10 mm; 0 follicles > 10 mm
Left ovary: 8-9 follicles < 10 mm; 0 follicles > 10 mm
Additional findings: None
Estradiol: 34 pg/ml
Progesterone: 0.6

And We're Off, Like a Herd of Turtles

It's that time again: Another month has passed, and the blog needs an update. If you've read any of the older entries, you'll notice a pattern of posting where there's a longer pause between updates during these contract and preparation periods, and more of a flutter of blog activity as we get into some of the more exciting surrogacy events. There are two main reasons for this. First, the contract and preparation periods are tediously long and rather boring. Second, as you may know by now from this blog, I am not a patient person, so I don't take the long, slow waiting as well as one might hope. More frequent updates from me during this period may come out as "Still no *@^$*# contract yet," and no one wants to read my constant Debbie Downer frustrations without some good news to help wash it down. With that said, brace yourself for a flurry of blog excitement on the horizon.

Exactly a month ago, I closed with "Here's hoping we have a signed contract next week. If so, we'll be right on track for a transfer in the last week of May." And then the gods laughed and laughed. T'was not meant to be for an end of May transfer. We experienced two major hiccups to the plan. First was that Wes and Mandy's attorney *must* get paid by the hour. I can't think of any other explanation for why someone would hold onto this document for days and weeks on end without signaling forward progress. Holy buckets! I have never seen someone work so slowly in my life. Working with her has led to me the conclusion that if I ever find myself in the situation of doing another stork contract and the IPs select her as their attorney, it's an automatic deal breaker for me. I have also decided that I would rather be subjected to an angry hoard of starving fire ants with no route of escape than to wrap myself up in another several month long contract negotiation, especially with that attorney or any others like her. But I digress. There was a secondary hold up as well.

Back in early April when we all visited the RE, Mandy and Wes also had to have blood drawn to meet FDA testing requirements for transferring the embryos to a third party (me!). Normally, IPs will have this done at the time of egg retrieval and/or sperm collection, but Mandy and Wes did not intend to use a surrogate at the time of their embryo creation, so the RE had no reason to run those tests at that time. Now that we're getting ready to start cycling, they need those results on file before we can get started. It was about two weeks after the results for Mandy, me, and Scott had come back that everyone started to question where Wes' results were. After some digging into it, the answer was that the lab lost his blood sample. This is quite problematic, as Wes is working an out-of-country job assignment, so he doesn't have access to lab to get another sample drawn quickly. It took about a week to get another sample drawn and submitted, but alas, the contract still wasn't done, so we waited patiently for the results. About a week ago, as we were all trying our hardest to pry the final draft of the contract out of the attorney's death grip, we got an email from the clinic saying that one of the infectious disease markers on Wes' blood panel came back positive, and that we would need to do some additional steps before proceeding. The positive result was for a relatively inconsequential virus and indicated a very old exposure that Wes had fully recovered from. Still, I had to have an antibody titer done to assess my immunity to it, meet with an infectious disease specialist to talk about the risk of contracting the virus from the embryo (highly improbable) and sign an FDA form stating that I assume that risk in moving forward with the transfer. Amazingly, I was able to whip through all of that in two days AND put some ink on the signature line of the contract last Tuesday. It was like some kind of post-Mother's Day miracle! Still holding the wet pages with a look of shock and awe on my face, the box of medications arrived on Saturday in order for me to start my first Lupron injection today.

We're cooking with gas now! We may still be a month away from transferring, but we have some dates to look forward to in that time span. I'll start Lupron tonight and my first monitoring appointment will be May 26, with two more monitoring appointments on June 2 and June 5. Then I'll fly out to the clinic on the 11th for our frozen single embryo transfer on June 12. This stork is officially no longer on standby; let the oven pre-heat begin!

Round 3 - Ready, Set, Go

It's that time again - needles, syringes and vials by the fistful. I started the third round of meds this past Monday, so today is day 5 of Lupron. The last time it took about a week before the side effects kicked in, so we'll see in a few days if the hot flashes, insomnia and weight gain will return with this cycle. Today I met a brand spanking new side effect that didn't pop up last time; nausea. To be fair, nausea is my catch-all 'something's off in my body' symptom. Some people get headaches, I get nausea. Especially when hormones are involved; even your run-of-the-mill birth control pills will make me nauseous on a daily basis. When we did the first round of meds in July and August, I was actually pretty lucky that the nausea side effect didn't show up until we added the Estrace and then it was pretty intense. I cursed the Estrace a bit for it, but I guess there's a chance that the Lupron was equally to blame. On the bright side, I didn't need to hold onto those extra calories I ate at our office holiday lunch anyway.

So we're about a week into the cycle with exactly 4 weeks to transfer. I'll go in for a baseline monitoring appointment next Wednesday and if everything looks good, we'll start the Estrace on Friday and work on building a nice thick lining for the next monitoring appointment in December. Scott and I are going to sneak a nice little Caribbean getaway in between to get some rest and relaxation in before I get called up for stork duty. We're now 2 weeks away from vacation, and I'm looking forward to a fruity drink in my hand and some sand in my toes. Here's hoping that the tropical sun will help clear my hormonally-induced pukiness.