Baseline ultrasound and the holidays

Yesterday was about a week before my period would begin, so we went in for a baseline ultrasound appointment.  We needed to check if the ovarian cyst I had last month (most likely due to the birth control pills Dr. A put me on to get me ready for October stimulation…which didn’t happen because of the cyst - whatthewhat?!) was gone.  And then if it was gone and we were cleared for starting stimulation this month, they needed to check my lining and get an antral follicle count, etc.

I knew in the back of my head that I mostly wanted to get the green light to finally move forward with stimulation (and thus, with IVF) but I also knew that I kinda DIDN’T want the green light cuz it would likely mean canceling our trip out of state to see Hubby’s family during the Thanksgiving holiday.

Well we got the green light!  Cyst was gone.  Antral follicle count was 4 on the right side and 5 on the left, which got us a “great” from Dr. A.  And my uterine lining looked “fantastic “!  We can start the stimulation injections on Day 2 of my cycle/period, should we make that decision.

Thus started a couple days of complicated decision-making/compromise/studying of the calendar.  How fair is it that the actual definition of marriage (compromising) was tested immediately upon venturing into this world of IVF?  As if we didn’t have enough on our minds – now we needed to discuss the best timing for injections/retrieval while balancing holiday travel and work (whose family do we see?  whose family don’t we see?  or might we need to just split up for the holidays?  whose work schedule gets the most stressed rushing around to time shots and ultrasounds?)  And you can’t just say – “oh hey, I think I want to start my IVF stimulation… next Thursday!”  Nope.  Mother Nature just does what she wants and if it means you eat turkey takeout at home by yourselves with a syringe of Menopur for dessert, that’s what you do.

Here are the stimulation milestones we needed to weigh in order to decide when to start:

• Cycle Day 1: the day your period arrives.  Really this means it's go-time and the schedule can't be altered unless it's pushed out at least a couple weeks.
• Cycle Day 2/Stim Day 1: baseline blood-work to check estradiol (estrogen) levels.  You want the levels to be between 25-75 (the lower end, the better).  Start injections in the evening.  They need to be at the same time every night, a couple of them have to be refrigerated and there is a good 5-15 minutes of prep/mixing involved before the syringe is ready to go.  So this makes traveling during stimulation quite challenging. 
• Stim Day 5: Dr. A would want to see me for my first ultrasound/bloodwork. This would also make traveling a little difficult :-|.  Additional ultrasounds/bloodwork are slated for Stim Days 7 and 10
• Stim Day 10+/-: somewhere around here, depending on how the follicles are maturing, the trigger shot is prescribed.  
• 36 Hours After Trigger Shot: The 1-day outpatient retrieval procedure (under general anesthesia) happens, followed immediately by fertilization.  Both Hubby and I would need to be VERY present.

The box of medications that arrived on our front porch last month was large enough to have held a case of wine (I wish it had?)  One does not travel lightly while on IVF stimulation drugs.  Let’s also not forget that the stimulation can cause more and more bloating and discomfort the further into it one gets.  It’s really not something you can casually do and continue to very easily partake in daily activities.  It’s really meant to be a time to try and rest up and take it easy.  So really the choice was: IVF or travel.  We could not have done both...

Another option I had (instead of missing holiday travel) was to go on birth control pills again to delay stimulation by 2 weeks - but not have to wait a full month for my next natural cycle.  I could wait until my period started, then start the BCPs and remain on them for a minimum of 10 days.  After stopping, stimulation injections can begin 5 days later (as long as the BCPs don't cause another cyst.)  That seemed like a great compromise since it would allow us to enjoy Thanksgiving with our families and still get the stimulation and retrieval in before Christmas got too close.  Oh, but until we realized that would put our retrieval on the same day as a HUGE annual deliverable Hubby has at work.  **GAAAAAAHHHHHH!!!!!!!**

OK, what if we wait until my natural cycle in December?  Oh that puts retrieval day on December 25th...  "All I want for Christmas is tons of healthy blastocysts!"

So this is why Dr. A doesn’t really recommend you invite IVF over for the holidays…