Archive for February 3rd, 2009

PIO: It Does So Sucketh

PIO injections? Not nearly as horrible as I expected them to be. They don’t hurt as much as I thought they would. They go in relatively easily. We haven’t hit an artery yet (er, does that happen often?). Basically, we’re all good.

Or, um, I thought so.

I mean, there’s the mood changes. PIO, is systemic, you see, unlike Prometrium or Crinone, etc. So the mood changes. And the exhaustion. And all that good stuff. I can live with that. I’m moody and exhausted anyway (Shut UP!).

(and the estrace? Did I mention estrogen makes me cry at the drop of a hat? yeah…)

Anyway, back to the PIO. It’s going well. It’s all good. Not hurting. Life is good. I even gave myself my own PIO injection last night without any difficulty. Not bad. No real pain. Life is good.

Except now, every single injection site (not that there’s so many now) is all lumpy and owie. And, in the face of this morning’s news, I have decided to be annoyed about this development. Bah. How am I going to deal with 18 days of this (more if I’m pregnant, but who’s counting on that?)

Edit: Yes, I know all about crinone, etc. I was even in a study for crinone once. But, my clinic uses PIO exclusively for IVF patients for at least the first 18 days after retrieval, except when there is an allergy to sesame. And, frankly, it’s not that bothersome to me to do the PIO shots – it’s just that this morning I had a lump in my patootie and I needed something to focus on and whine about other than that damn embryology report. I’m so sick of embryology reports. (though, I am, of course, on pins and needles awaiting tomorrow’s report…I never claimed to be consistent)

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Yes, people, I know it only takes one. I get that. But the cliche isn’t helping me right now. I have a right to wallow for a few hours in my less-than-stellar news, and that’s precisely what I’m going to do now, because today’s news was even less promising than yesterday’s news.

Let’s Review:

Going into Retrieval: We were expecting 4-6 eggs (not stellar news, but at least we were expecting not stellar news)

Retrieval Day: 10 eggs retrieved! (Double what we expected! A great number, all things considered)

Day 1 Fert. Report: Of the 10 eggs retrieved, 9 were mature (1 post mature) and all 9 fertilized and were 2 celled embryos (unbelievably good news! I was stunned and overjoyed by this news!)

Day 2 Embryology Report: 1 didn’t make it at all, 6 2-celled embryos still (1 with no change; not a good sign), 2 6-celled embryos (with 10-15% fragmentation, not good). Not a good enough report to warrant a 5 day transfer. Transfer scheduled for day 3 at 2pm. Disappointing news at best as with Single Embryo Transfers, they always try to go to blast in order to find the cream of the crop when possible.

Day 3 … (Today):

I’m on my way in to work and the weather is crappy, my head is pounding, my tushie is sore from the PIO shots, I’m cranky. You get it, right?

I’m walking out of my parking garage on my way into my office juggling my keys, my briefcase, a couple shopping bags (I bought candy to re-fill the candy jar I keep for people to snack on in my office), and my phone rings. I’m fumbling for it, but I have to pull off my glove (did I mention it’s snowing?) to get it open and turn it on; I almost miss the call. It’s my nurse at Ye Olde Fertility Clinic.

“Hi Perky One*, it’s NurseAwesome*. SuperDoc wants to talk to you.”
“Yeah? All right,” I sighed.
“You okay??”
“Yeah. Yeah, I’m fine.” I said, knowing that this just wasn’t going to bode well.
“Okay, hang on, here he is.”

Why the man couldn’t have just dialed the phone himself is beyond me. Because that introduction is exactly what gave me the anxiety I had, you know. But whatever. I do love him, and I know he has my best interests at heart. And for all I know it was NurseAwesome that wanted to make the call to me so that she could guage how I was doing, since she knows how pissy I’ve been all cycle. (Update: It turns out that SuperDoc did call me directly himself – but he called me at home and left a message at 8:45. Of course, I wasn’t home – I was on my way to work. NurseAmazing knows better, and she knows me well enough to know that I probably wouldn’t have been okay with just hearing a voicemail on my home number … which I may or may not have checked before I went in for my appointment this afternoon, by the way … so she probably said, “Yeah, no, we’re going to call her cell phone now.” That’s why I love her.)

So he said he took a look at the embryos with the embryologist this morning and what I’ve got is a 7-cell, a 6-cell, a 5-cell, and 2 four cells. If I were any other patient, with their normal criteria, he’d be recommending a two-embryo transfer today (day 3), but he does NOT recommend that with my history. With HOMs at home, and with my pregnancy history (e.g. not good) and with my need to ensure I do not get pregnant with twins (unless, you know, they’re monozygotic, in which case, we just had no way of controlling that risk), he is wholly opposed to a 2-embryo transfer. Which is good, because I am also opposed to it. My exact words were “absolutely not.” And he responded, “We are on the exact same page, don’t worry, I’m not recommending it – I would caution against it.”

My embryos look pretty crappy. They do not meet the criteria to go to a 5 day blast, but given the choice between picking a crappy single embryo for transfer today as planned or trying to grow one to blast by Thursday or Friday, he thinks our chances are better if we wait. He believes we are likely to have one at the blast stage if we wait.

So what happens if we don’t have any blasts by Thurs/Fri? We transfer whatever the best we’ve got is. And what if there’s nothing? We scrap the whole thing and start over. After all, we were all set to cancel this cycle last week before we got to retrieval, remember? It’s really no different, except that now we’ve been through a lot more hell than if we’d canceled ahead of time. But at least now we’ve got more information, right? What I don’t know is whether this would count as a full IVF cycle for insurance purposes if we don’t make it to transfer. My guess? Once you get to retrieval, it counts. That being said, my doctor is confident that we’ll have something to transfer either Thursday afternoon or Friday morning, it’s just a question of quality.

And so it goes.

*Note, she did actually use our real names… she doesn’t refer to herself as “NurseAwesome” though she’d be perfectly justified in doing so.

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Oh so we've reached THAT stage have we?

Every morning when I go into the nursery, Abby has managed to unzipper her PJs *just* a little more…  Today they were a completely off.  I live in fear of the day she figures out she can also take off her diaper and smear poo all over the wall.  I believe there is a roll of duct tape in my future.

Respecting John M-Who?

J-man in the car this morning:  "Abba, if Bionicles were alive, they wouldn't respect John McCain."
S is pretty sure J was having auditory hallucinations.

Not funny, but heart-melting:

Ellie says "Mama" now, and means it.  I touch her nose and say "Ellie" and she touches my nose and says "Mama!"  It's so cute.  :)  If I'm in the kitchen and she's in the highchair, she turns to look at me and calls "Mama!"  Hooray!  (this reminds me I still haven't written a post about the speech therapy consult or subsequen therapy plan)


Every day when I walk in the house, Sam looks up, drops what he's doing and runs over "aaahh!!!" he screams and immediately begs to be picked up.  Then he snuggles in tight for a hug.  But don't try to snuggle too long – he's got important things to play with!

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