prior to egg retrieval.

After my initial ultrasound post-meds, I had two more ultrasounds prior to my scheduled egg retrieval.  The first one was on January 9th, the second would be January 11th, and the third was January 13th.

On the 11th, I went in completely apprehensive and prepared for more less-than-ideal news.  I hoped all six follicles were still there, and I wanted an explanation as to why my body wasn't responding as expected.

I went through the blood draw and then headed back to the imaging room.  My husband was able to be there with me, thankfully, since it was a Saturday.  I wasn't sure if I could make it through my anxiety without him.  I got undressed and all situated on the table, waiting for my doctor and nurse to come in.  When they did, they asked me how I was doing.  I explained how nervous I was, that I was surprised I had so few follicles, that I only wanted good news.

My doctor and nurse both did what they could to calm my nerves.  They told me how normal my feelings were, that it only takes one good egg for all of this to work.  They reminded me that my age will really work in my favor.  And then it was time to see what was going on.

As they were situating everything and moving the screen so I could see, I asked why I only had six follicles when I originally had 17.  The only answer I could get was that these were the ones that were good, the ones that could respond.  They would be my cohort to work with this cycle.  It didn't and still doesn't make a lot of sense to me.

I still had the six follicles, and they were growing at a good pace.  My lining was right where they wanted it.  Then on my right ovary, they found an additional follicle.  They weren't sure if it was new or if it had been hiding before, but I gained a follicle.  I can't even tell you what a blessing this felt like.  To just have another follicle, a total of seven, felt like the biggest gift I could have hoped for.

After I got dressed, my nurse taught J how to give the intramuscular progesterone shots in my ass.  He practiced with saline and did great.  It didn't hurt, and he seemed very comfortable.  The progesterone was set to start the night of the egg retrieval.

I was able to leave that appointment feeling good, like things might just work out after all.

My next and final ultrasound was Monday, and unfortunately my husband couldn't be there with me.  I was incredibly nervous for this one too, because they were determining whether I was ready for the trigger shot and whether we could move forward with the retrieval on Wednesday.  It was a sort of post-op appointment, in addition to my regular follicle check.

This time I had the same seven follicles, plus two tiny ones.   My doctor wasn't too hopeful that the new ones would produce anything since they looked to be so immature, but it was nice to know that, while slow, my body was responding.

I left there with instructions for my final Lupron injection, my trigger shot, my progesterone injections, and everything I needed to know for my egg retrieval.  I left feeling okay about things and was just anxious to get the show on the road.

That night, I had class out of town.  The trigger had to be administered at exactly 10 p.m., and I knew I would get home at 9:30 as long as everything went right.  On my drive home, which takes about an hour and a half, I got pulled over for having a headlight out.  I noticed it when I got back to my car after class, but what can you do at 8 p.m. in a different town about an expired headlight?  The officer had to go through standard protocol -- license, insurance, registration, etc.  It didn't take long, but long enough to have me panicking that I wouldn't be home and ready for my shot in time.

I did make it, and J gave me the trigger at 10 on the dot.  It wasn't bad at all, and it just felt exciting to know that it was exactly what my follicles needed to get my eggs ready.

To be honest, I never once paid attention to the pain of the injections, or the inconvenience.  I never once complained.  I never once dreaded them, even.  I looked forward to them, because for the first time in such a long time, I had reason to hope -- even if that hope came from daily needles in my thighs.
Now that it's over, I look back at all of it fondly.  Those days when I didn't know the outcome yet.  When it was all ahead of me.  There was possibility, and I was taking action.  We were moving forward.

Now we're stuck again.  Stuck in sadness.

how it all began.

My first step entering into the actual IVF process was to begin daily Lupron injections in order to suppress my system.  This past summer I had been on monthly depo Lupron injections to do the same thing long-term in order to eliminate remaining endometriosis after laparscopic surgery.  I felt fine about beginning the daily shots and actually was just excited to be doing something and moving forward.

We began with .2 ml daily.  My doctor had us use the sides of my thighs as injection sites rather than my abdomen, which I was thankful for.  Something about the idea of needles going into my stomach -- even if they were only subcutaneous -- was a little unsettling.  I didn't find the Lupron injections to be difficult at all.  In fact, I had no problem administering them myself, and they quickly became just a part of daily routine for us.

These shots began on Christmas evening.  I wasn't so sure about the timing, but it ended up being nice. I was happy to be taking steps forward, and the injections were easy to tote around when we went out or got together with friends or family.  On Dec. 27th, I took my last birth control pill.

On Jan. 2nd, we went in for our first official IVF-related appointment for an ultrasound suppression check.  They took bloodwork, weighed me, and did a trans-vaginal ultrasound to check to make sure I didn't have any growing follicles and that my system was sufficiently suppressed.  It was, and we got the pleasant news that I had 17 sleeping follicles.  Twelve on the right ovary, and five on the left.  My nurse assured us that she fully expected they'd get 12-15 eggs from me.  This was absolutely ideal, in my mind, and we left excited, hopeful, and anticipating more good news as the weeks went on.

On Jan. 5th, we were scheduled to begin Follistim injections in the morning, continue Lupron injections at night -- but drop to .1 ml rather than .2 ml -- and begin Menopur injections at the same time as Lupron.  So we did all of those things.  The Follistim was no big deal -- in fact, even less of a big deal than Lupron.  I could barely feel the needles, and there was no burning or stinging from the medication entering my body.  Now, Menopur... that was a different story!  The first day J gave me the injection, I hadn't iced my thighs or anything.  I was doing so well with everything else that it didn't even cross my mind.  But let me tell you, that injection burned like Hell.  I wasn't expecting it at all, and I immediately started crying.  This startled my husband who let up on the injection, which in turn made it take longer. It felt like a 20-second long wasp sting.

When it was over, I just kept crying and crying.  Not because the pain persisted, but because it was a reminder that this process wasn't going to be easy.  That it wasn't really fair that we had to do any of this.  That I couldn't believe we were here.

From then on, I thoroughly iced my thighs in preparation for the Menopur shots for about 15-20 minutes before the injection.  This helped tremendously.  I still dreaded them, and they still hurt, but they were much more tolerable.

My next appointment was on Jan. 9th.  It was a scheduled blood draw and ultrasound to check my progress after having been on all of the drugs for a few days.  I had texted my nurse two days earlier to ask her if what I was experiencing was normal.  I woke up on the third day of injections feeling bloated and heavy.  I could feel things happening in my abdomen, and it was like nothing I had experienced before.  I was nervous it wasn't normal because I hadn't expected to feel anything so soon.  She said that everything I described sounded normal, but she was surprised that I noticed it so quickly.  This made me think I probably had a lot of follicles going, which I was hoping for.

When I got to the office that morning, she took me back for my blood draw, weighed me as usual, and said that they might back off on some of my drugs if I'm already feeling the effects.  Again, I'm thinking I must have at least a dozen follicles going.

I get changed into a gown for the ultrasound and am feeling good.  I can't wait to see what's happening inside me, and I know my husband was eager to find out as well.  They turned the screen to me, and my doctor counted and measured three follicles on one side.  I assumed this was the left side, where there were only five to begin with.  Then he went to the other side where he counted and measured three more follicles.  Only six total were responding to the medication.  I couldn't believe it, and I felt such disappointment.

I am 27 years old, I have PCOS, and I am otherwise healthy.  That's actually a recipe for OHSS, not very few follicles.  I kept it together while the doctor and nurse were still in the room, but once they left I completely broke down.

Having been in this game for a while and knowing what I know, I know the fewer follicles you have, the fewer eggs they'll retrieve.  The fewer eggs you have, the fewer will fertilize, and then the fewer embryos you'll get.  And over the course of wait for transfer, you'll lose embryos, too.  I couldn't help but be realistic about the information I had.

I cried most of the way home -- an hour and a half drive -- and most of the rest of the afternoon.  That might seem a little extreme, but I knew what it meant.  Once I got my emotions out, I decided to turn it around and get some perspective.  It only takes one good egg and one good sperm to make it all happen.  And that's all we needed, and I knew it was possible that it could happen to us.  It has happened before for others.  Why not us?

The most difficult part of the process to this point was that I now had reason to be less excited and more apprehensive, less blindly optimistic and more anxious.  From this point on, I went to every appointment a little guarded and terrified to receive less than ideal news.