Saturday, August 8, 2009

I need your help!


This morning's u/s didn't really put us at trigger mode...which I'm sort of unclear on because yesterday there were a bunch of 19s and 18s and one over 20, and of course a bazillion other ones as well. I coasted last night on GonalF because of the high estrogen.

Today, the tech (a different one than yesterday) measured a gazillion on the R: over 25 I think total, while many were 20-something by smaller (like 24X15 or whatever) when she printed out the little report it said only one was over 20, all the way at 27! and everything else was under 20, and it didn't seem like they moved much. So the nurse and tech said "Oh you won't trigger tonight." I asked if any got smaller and the nurse looked at me like I was crazy and said "they don't get smaller."

Then the nurse said that the doctor on call would review and give me my evening doses...but that of course is NOT Dr. M. When I spoke to Dr. M on Thursday she said she would personally review my numbers and chart today to make the decision on triggering (mainly on trigger dose I thought) so I tried to tell that to the nurse and she looked annoyed. I refuse to have my case handed over to a different doctor at this phase of the game.

I know maturity is an issue. But quality is an issue too. Dr. M said that stimming for 14 days (which today would be 14 days) is really the max before you start to see reduced pregnancy rates (which I assume means reduced quality, duh) but yet here I am, not a clear-cut indication for a trigger. I'm sure my estrogen fell a bit with no GonalF last night so that might give them the wiggle room to stim one more day (or coast??) but honestly I just don't know if I can get another day off of work.

Correction: I'm sure I could get it, but they won't be happy. And yes I know that at the end of this, our last hurrah, one more day off of work shouldn't make the difference. But it's more than that....

So now I sit and anxiously wait (what else is new??) for the estrogen numbers and a call from someone...already anticipating I'll have to page my doctor. If we trigger too early we risk immature eggs. If we go longer we risk crappy egg quality.

What to do?? What to do??

EDIT: So Dr. Minjarez called. She wants me to go one more day, but she was totally understanding about my work situation. So after we hashed things out, compared this cycle to IVFs #1 and #2 which had low maturity rates and likely triggered too early...I told her to hold on and let me call work. She wasn't concerned about one more day of practically no stims on technically today would be the 14th day.

I called my practice administrator who's been an angel through this. She said "Are you kidding? Chance the cycle because of work???"

Then I gulped and dialed our head endocrinologist, my big boss. I hated to bother him on the weekend but I told him what was happening and he said: "You go for it Ashley. This is big."

I nearly cried. OK I did tear up, but that's because my freaking estrogen went to 6300 despite coasting. Although as Dr. M pointed out, I really didn't coast because I'm still getting the microdose.

So, we're going one more day. We already changed our flights...again. We're about to Priceline for another day at a time. I cannot stay beyond Tuesday, that much is decided. We will trigger tomorrow regardless.

I just want to go home, but with some good eggs staying behind in the lab!


  1. I know you like numbers so I dug out my last cycle information and here is mine:

    LHS: 2.17, 1.71, 1.52, 1.16
    RHS: 2.18, 2.09, 1.7, 1.61, 1.55, 1.46, 1.23

    Not a lot over 20mm and a lot of small ones too in mine. Don't they say that anything over 18mm is considered mature?

    I have had maturity issues in the past too (7 retrieved, 3 mature; 10 retrieved, 2 mature) so I was skeptical when I went into retrieval at CCRM as well. However, of the 11 measured, they got all 11 and 10 were mature (8 on retrieval, 2 more overnight). You've also added the microdose of HCG to try to encourage maturity so that is probably helping them too even though they're not over 20mm.

    I think Taylor stimmed for a long time too and she had no problem with fert and maturity rates with her 30+ eggs if I recall correctly.

    Do not hesitate to page Dr. M if you want to discuss the trigger but I strongly suspect that she's on top of your case and even though she may not be on duty this weekend, she is sure to be checking in on your progress. The nurses don't necessarily know your particular case if it's not your regular nurse so don't pay any attention to them.

    Finally, if you trigger tonight, retrieval won't be until Monday so that's another 2 days of growing and your E2 may continue to rise a little even without the meds as we have seen in the past.

    This is a critical time and I can appreciate how stressful it is for you but you're doing everything you can, leaving no stone unturned and having very thorough, in depth discussions with Dr. M. I hope you both come to an agreement and a decision you feel comfortable with.

    I'm with you in Denver in spirit, I really am. My heart is with you and if I could give you a big hug, I would.

  2. wow- I'm glad you got to talk to your OWN doctor! It's too bad the nurses didn't know what was going on, but in the end things worked out like they SHOULD have.
    It made me a bit teary eyed to read about your bosses responses- I know you have a busy, hectic schedule and demanding job, but it makes it so much better to know you're doing the daily work for people who know what truly matters to their co-workers and colleagues.
    Here's to one more day of growing and developing for those follies! :)

  3. Ack! You poor thing - I wish it was less stressful for you. During my IVFs I always had a little bunch of really big ones and a little bunch of little ones - I never stimmed evenly. It sounds okay though - if you dominant follicle is the only one that may be post-mature and the rest sound like they will be right where they need to be.

    Also, the support you got from work sounds amazing!

    I am keeping it all crossed for you - I hope you have a smooth hotel transition.

  4. i'm glad to hear that your job is being supportive because it is soooo true that it is the least important thing in the scheme of it all...even though it does help to pay the bills! best wishes!!!

  5. Kudos to the job for understanding. This IS a big freaking deal. And kudos for Dr. M for being on top of it and listening to you. We are thinking about you guys.

  6. Awesome news on your job responding as they did, I know that took so much pressure off the situation.

    So holy schmoly, over 25 eggs on one ovary and stiming 14 days??? I bet you're getting quite achy. Sounds like things were changed up in many areas and I'm hoping that's what makes this cycle the winner cycle. Can't wait to hear your next update. Hugs

  7. Wow! I am so impressed with your job being so flexible and supportive. How amazing!

    And, wow! You have a lot of eggs cooking in there:)