Hmmm, confusing. Single egg IVF?

The confusing part comes at the end, the vitals stats are pretty expected at this point (single, greedy follie).

The gory details:

• E2 level: 401
  
• Nubile Rightie: 18mm, 7mm.
  
• Ol' Leftie: Abdominal gas blocking, sigh...
  

Reaction?

• Good rise in E2. The highest I can recall in my testing days, yay for small things! Still points to no more than 2 follies, though there's no sign of that potential 2nd follie. It probably points more to this disgusting, crusty estrogen patch that is rotting on my stomach after 8 days of wearing it (I'm to remove at trigger or when it falls off of its own, after my body effectively curdles itself away from it)
  
• Greedy bully still gobbling all the FSH.
  
• I've been eating well, trying to drink lots of fluids. But the combo of "abdominal gas" and an anitsocial ovary gives us nary a glimpse.
  

Next check: Monday a.m., continue stimming (gonal-f 450 + menopur 150) + ganirelix through then.

Recap: OK, here's the surprising development, and of course it has to happen on a Saturday so I get the Nurse Weekend who knows nothing about me and, though the nurse stuck with weekend duty rotates every week, always seems to be borderline drunk. At least that's the best explanation I can come up with for the constant errors and lack of knowledge. These are nurses who are completely competent during the week but whose brain cells are off-duty over the weekend. The best anecdote I can give for this is when I had a beta only 8 days after my April IUI, due to spotting. So, it was 10 days after trigger, when HCG could still be in my system from the trigger shot. So the nurse calls me and offers condolences that I do have a positive beta but it's only 11, so she thinks I'm going to miscarry. Um, no, you dumb fuck. It's the trigger shot (which I explained to her and she said she'd never heard of causing this kind of false positive), but thanks for the pro-bono kick in the gut.

Anyway, she gives me all my numbers, which of course include errors. She tells me that I've got 2 follies on my left at 18mm and 16mm and that they couldn't see rightie, but assume there's nothing. I clearly knew that she had gotten left and right confused (annoying) but I really had to question the 18/16mm because I know we didn't see two good follies on u/s. She looked at her paperwork and apologized and said, "Yes, you're right it's the right ovary and it's an 18mm and a SIX-point-nine mm". Gee, thanks. For an IF woman having a totally crap response to IVF, there is a HUGE difference between having one or two good follies. Grrr...

But to make a long story even longer, on to the confusing part. So then she says "The doctor wants to know if you want to do it with just one." Huh? What the hell is she talking about? Do what? Do the IUI to which I'm assuming we're converting? So I stammer "Well...yea....I want to at least do an IUI." And Nurse Weekend says "No, he wants to know if you want to go through with IVF with just one." Now where the hell did THIS come from?? Dr. B had clearly told me that 2 or less follies and we'd convert to IUI, and 3 would the minimum for IVF. Though I really, really like Dr. B, I've often wished I went to a clinic where the doctor actually called you for important events like miscarriages or a complete change in everything he had laid out for your cycle. I want to know why he's willing to do IVF with just one. Did my regular Nurse D pass on that I'm going to be charged with a full IVF by my insurance even if it's converted, so why not? Or does he think this totally crappy response is the best I'm likely to ever get?? (Weep)

I was on the spot because whether I triggered or continued stimming tonight was on the line, so I took the plunge and agreed to do the IVF. So I'll likely be one of those crazy, desperate women going into ER with a single follie. My brain is having a hard time wrapping itself around the wisdom of this right now. Is it such a long shot that IUI would probably have the same chance? I'm not worried about the surgery, I used to be terrifed of it, but after having 4 surgeries in the past 12 months, I now regard it as a nice nap. I figure since I'm being billed for it -- and by this I don't mean $25k but rather wonderfully mandatory-coverage-state co-pays. But it counts as one of the limited cycles they'll cover -- I want to have the best chance for this follie even if it's miniscule. Plus, at least we'll know get the cool science part of IVF and know for sure whether the eggie fertilizes and all that. Finally, I'll know earlier if the cycle is a bust (if the egg doesn't fertilize or doesn't make it to Day 3), which will allow me to get back to my meth and prostitution hobbies all the earlier.

Follie check #3

Welcome back to the slowest and most boring stim cycle ever! In today's news: almost nothing (as usual)!

The gory details:

• E2 level: 254
  
• Nubile Rightie: 17mm, 8mm (teeny) follie. 2-4 tiny ones, too small to measure.
  
• Ol' Leftie: She was seen! 2-4 tiny ones, too small to measure.

Reaction?

• Nice that E2 has doubled since Monday, but all signs still point to a single follie (the 17mm one) in play.
• Hoping hoping hoping that the ganirelix holds the 17mm at bay and the 8mm can catch up.
  
• Well, I see that the wench has decided to come into the sunlight. Interesting there is even anything to see on her surface area since I had pretty much chalked her up to an empty husk ravaged by time, tequila and her boyfriend endo.

Next check: Saturday a.m., continue stimming (gonal-f 450 + menopur 150) and toying with my hormones (ganirelix) through then.

Recap: Nurse D said the phrase sure to make my head explode "cautiously optimistic". Anyone who has ever had a doomed pregnancy with slow rising betas is sure to know that trite nugget. I laughed bitterly (when did I turn into an 18th century spinster?) when she said that and said "I'm glad you're optimstic, because I'm not". I KNOW this is bad, I KNOW I'm supposed to be all shiny and happy so that my ovaries feel the love. But that hasn't worked for me yet, so I'm trying the alternate tack, while still choking down my wheatgrass and watermelon.

On Saturday, all I'm willing to get my hopes up about is that the lead follie (Graafian, for science nerds) will have allowed the 8mm right follie to catch up and I can have my first IUI with more than one follie next week. If somehow a 3rd sprints to the finish line and I can actually make it to IVF, I'll keel over and NoodleGuy will need to drag me into the OR, caveman-style.

Title: Follie check #2, Subtitle: Devastation

The gory details:

• E2 level: A crappy 137
  
• Nubile Rightie: one 13mm follie, possible one more <12mm
• Ol' Leftie: "hard to visualize". Jerky ovary.
  

Reaction?

• Completely pathetic, especially with these estrogen patches I've been wearing.
  
• Well, the "2 to 4" line from the first follie check is clearly not on the higher end of the scale.
  
• I had a better tech this time, she found the left ovary, but it's just too small and in a spot that is tough to get good pix. Suffice it to say that the E2 levels show that there's not much going on here.

Next check: Thursday a.m., continue stimming (gonal-f 450 + menopur 150) through then. Adding ganirelix into the mix on Tuesday night, as my LH is beginning to elevate and that 13mm follie should be approaching release soon.

Recap: I'm completely crushed. Like, totally and utterly. I really, really, stupidly had gotten my hopes up for at least 4 follies. Is that so much to ask? I routinely read about women years older than me who get 20+ follies. I just want enough at this point (3) so that my RE does not cancel the IVF. However, I have ZERO hope that things will look better on Thursday. I'm expecting to be cancelled and converted to IUI. It's really beginning to sink in now that I may never have my own biological child. This has been one shitty day.

Follie check #1

The gory details:

• E2 level: 96.4
• Nubile Rightie: 2-4 follies<12mm, possibly some smaller ones
  
• Ol' Leftie: couldn't see

Reaction?

• Meh, would've liked to see the E2 higher due to these patches I've been wearing, but I'll wait to panic about this
• PRAYING the 2-4 is more on the FOUR end. Plus, that a few of those "possible" ones pop up
• GRRRR. The u/s tech told me she got a shot of Leftie after I did all sorts of interpretive dance moves on the table to try to force this Greta Garbo of a egg factory into the limelight. But no, that tech did not get a shot of it. LYING LIAR. I'd like to imagine that there are 10 lovely follies growing in seclusion somewhere in there, but in reality I know I'll be lucky to get anything from Leftie.

Next check: Monday a.m., continue stimming (gonal-f 450 + menopur 150) through then.

Recap: E2 disappointing but acceptable for now, Rightie is producing at her expected low levels but dependably, Leftie and the u/s tech are deadbeats. More to come on Monday!

Finally baseline - start the stimming!

Dr. B's nurse finally called me back at 4:45 today, causing me to harass their office twice and ponder the merits of a nervous breakdown. Turns out she was waiting to call because she wanted to talk to the RE about my pathetic antral follicles.

This nurse is new to my case, as the doctor has 2 nurses: one for IUI/Clomid and one for IVF. Since this is my first IVF, I just started working with her. So while I knew I was a deadbeat in the antral follicle realm, she apparently did not. I like her very much, so it was nothing about her specifically, but it was like rubbing salt in the wound when she said that the RE may opt to cancel this cycle and see if the next baseline looked better. I suspected the RE would not be surprised at my scans and poor number of antrals and we would go ahead, but what would a cycle be without a little added trauma due to misunderstandings and turnover of staff?

After waiting another hour for the follow-up phone call, worrying that my already poor prognosis has gotten even worse, she called back and confirmed that my RE was not surprised at what he saw (or, rather, didn't see). So, the plan is still on and off we go!

As I've posted before, the RE will be happy if I can muster 5 good follies. Less than three and we'll convert to IUI. 150IU of Menoupur + 450IU of Gonal-f, ay caramba. If this can't stim me, nothing will. I go in on Friday morning for my next u/s and b/w to check on follie progress. Talk about TGIF!

Now I'm confused

After Friday's news about my estradiol levels dropping and my LH and progesterone elevating, along with sky high BBT temps over the weekend, I went into ultrasound and bloodwork #4 (CD18) pretty much assuming that it was only a formality, as I had clearly ovulated a sub-par follie on Friday.

Well, the moral of this story is that my body is completely unpredictable. Immediately jumping out on Rightie were two nice follies, one at 21mm and one at 16.5mm. Anything 14mm or larger can contain a mature egg but REs like to see 18mm or larger on a medicated cycle. As they grow 1-2mm per day, even the 16.5 should get there tomorrow.

I'm so confused. Clearly it looks like I ovulated on Friday, and I know you can obviously ovulate more than one follie per cycle -- but can it be 3-5 days apart?? My brain hurts. I'll have to wait to hear from the nurse this afternoon on the RE's plan and my bloodwork. I'm not getting my hopes up, but I'm hoping they at least let me do an IUI to pass that final insurance hurdle for IVF. I figure cautious pessimism might work better for me than cautious optimism.

Somewhat promising

CD12, when I usually ovulate so I'm starting to get a little nervous since last cycle the RE made me trigger with only a 14mm follie since my hormones were looking like they'd be ovulating on their own. No real dominant follie showing, but the nurse is optimistic because there are a "few" <12mm follies and my estradiol has jumped from 104 to 227. Looking better than last cycle, but not counting any chick yet.