Here we go again!

New Year, New IVF Cycle.  Round #2 to be exact!

It's Day 6 of our 2nd IVF cycle.  It's probably not too surprising but this time around is so NOT a big deal.  I guess all the anticipation and presence of mind got used up with our first round.  This cycle - even though I'm on double the meds as our first time (I'll get into that) and taking shots twice a day (I'll get into that too) it's just very much not a big deal.  I guess that's good!  Except for the night Hubby was caught up in the office and totally forgot about our injection timing.  At least he still made it in the door about 15 minutes after we typically do the nightly shots.  Yah, definitely NOT taking over his thoughts, is it?

Our protocol is a little different this time.  You may recall (ok if anyone actually recalls that, then I might be a little worried about you) the last time I was on:

• 150 IUs of Follistim
• 2 vials of Menopur (+ Omnitrope every other night + Ganirelix nightly halfway through)

per night - all mixed together in 1 shot.

This time, because I had so few side effects (if barely any at all) and we'd like to try and get more than 6 mature eggs this time (6 is definitely on the lower side), Dr. A is trying me on double what we did in November:

• 300 IUs of Follistim
• 4 vials of Menopur (+ Omnitrope every other night + Ganirelix nightly halfway through)

But since it's kind of a lot of drugs to take all at once, we're doing the Menopur at night and the Follistim in the morning.  It makes each injection a tad simpler to prepare, but also means we have to make time for shots twice a day.

We're very hopeful that we'll get more mature eggs this time though!  It seems to be a better month for me since my antral follicle count was 16 total (4-right, 12-left).  In November it was 9 total (4-right, 5-left).  Dr. A seems pretty confident that we're going to get another chromosomally normal embryo.  I sure hope so...in fact, um... is it too greedy that I really hope we get 2?  Or ideally - 3?!  With our 1 good embryo on ice, and knowing that we definitely want 2 children (and might like an option to have a 3rd), then I'd REALLY REALLY like to have 4 frozen embryos before we attempt a transfer.  With the costs as they are, even with some insurance coverage - I'm afraid we will not be able to afford another round of IVF after this 2nd one.  So my fingers are going to be permanently crossed for the next couple weeks!  But I always remind myself of how lucky we are to have what we have at this point.  We do feel SO fortunate.

Feeling happy.  Feeling fortunate.

We started Stimulation last Tuesday night - 1/7.  It all seemed oddly familiar - yet I'm not totally sure I'll ever get used to the idea of mixing drugs and administering injections in my living room.  But such is this life we're living right now!  Because 1 of my follicles was pretty large even at my baseline ultrasound (~13mm) Dr. A had me take a Ganirelix injection along with our first night of Menopur and Omnitrope.  Last cycle I didn't start the Ganirelix until night 6 since it is used to hold off ovulation and that becomes more of a risk as your follicles get bigger and more mature.  But after that first night this cycle, we didn't see the Ganirelix again until night 5.

The morning shots were obviously new for us and definitely more annoying and inconvenient since we're quite a lot busier in the mornings.  But, what I didn't learn last time, since we never injected the Follistim directly into my belly but always mixed it into a Menopur vial, is that the Follistim pen is RIDICULOUSLY easy to administer.  The needle is even shorter and thinner than the 1/2" injecting needle we use with the other meds.

It again has taken some days to notice any bloating (um, but I did notice a 2 pound weight gain which is SO UNFAIR right after the holidays!!)  But here we are on Day 6 and I can definitely tell there's some bloating going on.  Not a bad feeling, just feeling...fat.  :-|

One difference between this cycle and last is I've noticed feeling a lot drowsier in the first half of Stimulation than I felt last time.  Looking back to November - I definitely started getting very drowsy (needed to take short afternoon naps) starting around Day 5 or 6.  But the first day after we started shots last week I felt like a zombie at work!  Dr. A attributed it to the surge in estrogen in my body - it can cause what she calls a "foggy" feeling but also drowsiness and sometimes headaches.  The drowsiness has gotten somewhat better since Day 2, but it's definitely vaguely noticeable.

Sleepy...

I had my 5-Day Ultrasound yesterday so allow me to share the specs with you like I did last time:

Baseline (taken 3 days before Stimulation):
Right Ovary: 4 (antral follicle count)
Left Ovary: 12 (antral follicle count)
Estrogen (Estradiol) Level: 40.7 pg/ml

Day 5 Stimulation:
Right Ovary: 4 follicles (1 worth tracking:) 9.5mm, rest very small
Left Ovary:  13 follicles (8 worth tracking:) 4mm, 14mm, 12.5mm, 12.5mm, 9mm, 7.5mm, 8.5mm, 8.5mm, 8mm, 4mm, rest very small
Estrogen (Estradiol) Level: 354 pg/ml
Endometrium (uterine lining): 7.7mm trilaminar

I'll again refer back to my original Day 5 Ultrasound for a little explanation for you: the baseline is taken before Stimulation begins.  At that point, they do an antral follicle count to see how many follicles there are.  I had 16 total, but you'll notice that by Day 5 there were more than that first day.  It's not because more follicles develop, but that with everything starting to mature and grow, you can see more than before.  Some are hiding at the baseline.  We're waiting for as many follicles as we can, to grow to larger than 18mm which would indicate a more mature egg.

We also track my estrogen levels since that tells us how well the follicles/eggs are maturing.  At baseline you want estrogen levels to be under 70 pg/ml to know that your ovaries are "resting" but by Day 5 you'd like to see a level of 150 pg/ml or higher.  The higher, the better, since it means that the eggs are maturing.  A mature egg secretes ~100 pg/ml of estrogen so you want to see these numbers climb higher and higher as Stimulation continues.

I have to say that I was hoping to see larger follicles at this point compared to my last cycle, since we doubled up on the meds.  If you compare my Day 5 specs this cycle with Day 5 last cycle, we're actually tracking 1 less follicle right now.  But there are still 4-5 more days to see what changes.  And another comment Dr. A made is that it's not a bad thing that I seem to be responding a little slower since it means she can push me longer.  Kinda like how slow and steady wins the race...

Slow and steady...slow and steady...

Obviously my play-by-plays aren't as thorough through this IVF cycle as they were in our first.  The experience is less novel now.  That's right, we're becoming jaded IVF patients... ;)  So if this is your first visit here and you'd like more info on the day-to-day happenings during an IVF cycle, I'd suggest you start here for an intro or here for the first day of Stimulation.

But if you just want to keep knowing what we're up to...follow along!  And thank you to those leaving comments and well wishes.  I wish any and all of you who are going down a similar path, the exact same good luck and well wishes you've sent our way.

Good Luck to all of you too!