Showing posts with label ER. Show all posts
Showing posts with label ER. Show all posts
July 23, 2011
August 30, 2009
2 ER Visits in 2 Days!!!
Let me start off with saying that (so far) the twins are doing fine and so am I! I am directly going to get to the story… since I am a little tired and (still) a bit startled!
The week following my first heartbeat u/s was progressing well and then the Thursday (before the second heartbeat u/s)… late in the afternoon I started having this weird feeling. Fortunately I was home… I started having blurred vision and a headache… I attributed that to “low” sugar and decided to have a berry milkshake and eat a sandwich! While prepping the food, I realized that my left foot started tingling… that sensation moved on to my left hand (mainly palm), followed by left side of my lips, tongue and gums! That sure did freak me out. All the tingling eventually turned in to numbness and a headache! Ever since getting PG, I have had tingling and numbness once in a while… but one sided and also mouth - never! I called my nurse and she said that I should go the ER if it continues or if I am uncomfortable – and yes, one sided tingling and numbness is not normal (sometimes associated with a stroke). My DH came home early and we decided to go to the ER. I felt generally okay but we did not want to take any chances! At the ER they did a bunch of b/w… everything seemed normal (HCG had gone up). I was offered a CAT scan, but was told that it was totally up to me if I wanted to do it since I was PG. We decided to not do the scan (if things repeated we would probably go for it is what we thought). We also didn’t do the u/s since I was going to the RE the following morning. We came back home after mid-night… this visit was may be an overkill… but I guess it is better to be safe than sorry.
The following morning (Friday, 08/28), we went for our regular u/s and b/w to the RE’s (at 7W1D). The doctor recommended seeing a neurologist if these symptoms show up again. The u/s went well… we saw our two little peanuts, they had grown a lot and had a strong heartbeat (~140’s)! The b/w results reconfirmed what we saw at the ER (HCG levels had climbed up and Progesterone was greater than 40)!
So… everything seemed to be going well. I was kind of convinced that everything was going well with this pregnancy, we had seen the heartbeat the second time, the measurements were good… I even ordered two pregnancy books (Mayo Clinic Guide to a Healthy Pregnancy and When You're Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy …both have great reviews on Amazon.com)! Saturday was very relaxing (off late we have been keeping a low profile in our social life… as in we are trying to stay home and relax as much as possible and not tire myself out even more than I already get by just sitting on my ass)! We got up late, had a good lunch, lazed around and then went to do some groceries. Picked up some “healthy” food for me… came home had dinner and then settled in to watch a movie!
…And then (TMI warning)! I realized that I felt a little wet down there, so I decided to go check on myself. As soon as I sat down (to pee) there was a HUGE gush of blood (at around 1000 pm - the blood was red and not dark brown or pink). I freaked out and called out for my DH! I held my pee and then emptied my bladder in cups so that I could collect any kind of tissues etc that would come out! I immediately called the RE (nurse), she “calmly” mentioned that it is normal during the pregnancy and I could come in the following morning. However, if I use more than a pad in an hour, I should rush to the ER! Well, I used up a pad in 20 minutes. I was still gushing out blood once in a while (I had no control over the flow and even stained our couch)… we decided to head over to the ER again! After our relaxing dinner, I had some darn watermelon and oh my gosh, that filled up my freakin’ bladder so much! I was afraid to go pee at the hospital since I was afraid I would pass something in the loo. Finally after speaking with the doctor they gave me a pan to pee in to. I passed one small thin clot which they collected (I couldn’t quite empty my bladder completely though). I was then rushed to the u/s room! Oh what a relief, there were the 2 heartbeats! I started stabilizing mentally. However, the first u/s was abdominal… and I had to try to empty my bladder more for the vaginal u/s! So I went again with a pan! I passed a 2 inch oval chunky dark red clot… I skipped a heartbeat seeing that… I had just seen 2 beautiful heartbeats 5 minutes ago… what was this! I went back in for the vaginal u/s…. and there were still those 2 beautiful heartbeats! The clot was collected, the u/s technician wasn’t sure if it was going to be analyzed (since it wasn’t technically fetal matter). She mentioned that this is probably Subchorionic Hematoma. And I could bleed again and pass out more clots. The bleeding stopped (was minimal) after I passed the clot. After the u/s they did some b/w… HCG was still rising everything else looked okay. We came back home at around 0330-0400 in the morning and were supposed to leave for my RE’s at around 0630 am… so we took a “nap” and went to the RE’s. The doctor who was doing the monitoring for the weekend is a dick head! I love all the doctors at the clinic except for this a$$! He has zero bed side manners… he came in and started doing his job, I was a little concerned if he even knew why I had come in. I asked and he was like, yes I know! He wouldn’t discuss anything… just showed us the (good) heartbeats and did some measurements. I offered to show him the ER report and he said he didn’t want to see it since they normally don’t say anything. He also went on to say that more than likely this will happen again! Oh how great! Though he ended our meeting by saying that typically after seeing heartbeats the chances of miscarriage reduces drastically!
So here I am now… hoping to speak with a different nurse tomorrow (my nurse is on vacation until after Labor Day weekend) and somehow reach my RE so that I feel more convinced. I am supposed to be graduating to an OB on Friday (09/04 at 8W1D) and my OB appointment is on 09/15. I really don’t know if I am going to be able to stay sane during the no u/s phase! Reading about Subchorionic Hematoma has not helped… and I can’t wait for tomorrow! All the posibilities that went through my mind since the bleeding started is all together a different story! I am so glad we went to the ER, or else I would have been miserable throughout the night and that dick would have made my life even more miserable today!
If anybody knows anything about Subchorionic Hematoma or has experienced it, please leave me a message. Thanks for all your support!
The week following my first heartbeat u/s was progressing well and then the Thursday (before the second heartbeat u/s)… late in the afternoon I started having this weird feeling. Fortunately I was home… I started having blurred vision and a headache… I attributed that to “low” sugar and decided to have a berry milkshake and eat a sandwich! While prepping the food, I realized that my left foot started tingling… that sensation moved on to my left hand (mainly palm), followed by left side of my lips, tongue and gums! That sure did freak me out. All the tingling eventually turned in to numbness and a headache! Ever since getting PG, I have had tingling and numbness once in a while… but one sided and also mouth - never! I called my nurse and she said that I should go the ER if it continues or if I am uncomfortable – and yes, one sided tingling and numbness is not normal (sometimes associated with a stroke). My DH came home early and we decided to go to the ER. I felt generally okay but we did not want to take any chances! At the ER they did a bunch of b/w… everything seemed normal (HCG had gone up). I was offered a CAT scan, but was told that it was totally up to me if I wanted to do it since I was PG. We decided to not do the scan (if things repeated we would probably go for it is what we thought). We also didn’t do the u/s since I was going to the RE the following morning. We came back home after mid-night… this visit was may be an overkill… but I guess it is better to be safe than sorry.
The following morning (Friday, 08/28), we went for our regular u/s and b/w to the RE’s (at 7W1D). The doctor recommended seeing a neurologist if these symptoms show up again. The u/s went well… we saw our two little peanuts, they had grown a lot and had a strong heartbeat (~140’s)! The b/w results reconfirmed what we saw at the ER (HCG levels had climbed up and Progesterone was greater than 40)!
So… everything seemed to be going well. I was kind of convinced that everything was going well with this pregnancy, we had seen the heartbeat the second time, the measurements were good… I even ordered two pregnancy books (Mayo Clinic Guide to a Healthy Pregnancy and When You're Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy …both have great reviews on Amazon.com)! Saturday was very relaxing (off late we have been keeping a low profile in our social life… as in we are trying to stay home and relax as much as possible and not tire myself out even more than I already get by just sitting on my ass)! We got up late, had a good lunch, lazed around and then went to do some groceries. Picked up some “healthy” food for me… came home had dinner and then settled in to watch a movie!
…And then (TMI warning)! I realized that I felt a little wet down there, so I decided to go check on myself. As soon as I sat down (to pee) there was a HUGE gush of blood (at around 1000 pm - the blood was red and not dark brown or pink). I freaked out and called out for my DH! I held my pee and then emptied my bladder in cups so that I could collect any kind of tissues etc that would come out! I immediately called the RE (nurse), she “calmly” mentioned that it is normal during the pregnancy and I could come in the following morning. However, if I use more than a pad in an hour, I should rush to the ER! Well, I used up a pad in 20 minutes. I was still gushing out blood once in a while (I had no control over the flow and even stained our couch)… we decided to head over to the ER again! After our relaxing dinner, I had some darn watermelon and oh my gosh, that filled up my freakin’ bladder so much! I was afraid to go pee at the hospital since I was afraid I would pass something in the loo. Finally after speaking with the doctor they gave me a pan to pee in to. I passed one small thin clot which they collected (I couldn’t quite empty my bladder completely though). I was then rushed to the u/s room! Oh what a relief, there were the 2 heartbeats! I started stabilizing mentally. However, the first u/s was abdominal… and I had to try to empty my bladder more for the vaginal u/s! So I went again with a pan! I passed a 2 inch oval chunky dark red clot… I skipped a heartbeat seeing that… I had just seen 2 beautiful heartbeats 5 minutes ago… what was this! I went back in for the vaginal u/s…. and there were still those 2 beautiful heartbeats! The clot was collected, the u/s technician wasn’t sure if it was going to be analyzed (since it wasn’t technically fetal matter). She mentioned that this is probably Subchorionic Hematoma. And I could bleed again and pass out more clots. The bleeding stopped (was minimal) after I passed the clot. After the u/s they did some b/w… HCG was still rising everything else looked okay. We came back home at around 0330-0400 in the morning and were supposed to leave for my RE’s at around 0630 am… so we took a “nap” and went to the RE’s. The doctor who was doing the monitoring for the weekend is a dick head! I love all the doctors at the clinic except for this a$$! He has zero bed side manners… he came in and started doing his job, I was a little concerned if he even knew why I had come in. I asked and he was like, yes I know! He wouldn’t discuss anything… just showed us the (good) heartbeats and did some measurements. I offered to show him the ER report and he said he didn’t want to see it since they normally don’t say anything. He also went on to say that more than likely this will happen again! Oh how great! Though he ended our meeting by saying that typically after seeing heartbeats the chances of miscarriage reduces drastically!
So here I am now… hoping to speak with a different nurse tomorrow (my nurse is on vacation until after Labor Day weekend) and somehow reach my RE so that I feel more convinced. I am supposed to be graduating to an OB on Friday (09/04 at 8W1D) and my OB appointment is on 09/15. I really don’t know if I am going to be able to stay sane during the no u/s phase! Reading about Subchorionic Hematoma has not helped… and I can’t wait for tomorrow! All the posibilities that went through my mind since the bleeding started is all together a different story! I am so glad we went to the ER, or else I would have been miserable throughout the night and that dick would have made my life even more miserable today!
If anybody knows anything about Subchorionic Hematoma or has experienced it, please leave me a message. Thanks for all your support!
---
Update: I have been bedresting the whole day today and intend on doing that for a few more days! I spoke to a nurse today and my RE is supposed to call tomorrow. I am just hoping to get a few questions answered when I speak to him. All your comments and information have been a great help - Thank you so much! I also came across this forum on Pregnancy-info.net about Subchorionic Bleeding... and that has been pretty reassuring too!
July 25, 2009
The ER Story (and the after effects)
It all started off with me getting up to gulp down tons of water at around 1145 the night before. I am normally a water guzzler, and living without water for 12+ hours sounded awful to me. Fortunately the extra hydration I was working on from 2 days prior helped me not get dehydrated. Honestly, I cheated a little bit… at around 0230 am and 0630 am I had two sips! It wasn’t like I was going to retain that 1-2 ounce of water for the next 6+ hours for the anesthesia to act up. Anyways, I did feel guilty later on… but fortunately my water consumption didn’t cause a problem!
We reached the clinic at around 0826 am, our appointment was for 0900 am. There were two couples in the waiting room. One of the female was freaking out and the other one seemed cool (from what I overheard later on, both were first timers)… I guess I was somewhere in the middle. The more I thought about the whole process the more I panicked, and that has been the case all the way through… so I am trying not to think or over analyze things! I was the third female to be called in at around 0900 am. The guys had to go to Andrology department to do their job before they could join us. By the time I went in to the Recovery Room, one of the female was ready to go in to the OR and the other one was getting her pep talk. It felt like an eternity before my DH showed up and the nurse came to us with all the pep talk and the information. However, I had already overheard all the instructions that the lady besides me had received… so it wasn’t anything new when the nurse came to my section! Things moved pretty fast after that. To hook up to the IV, I had to squeeze a giant sperm… that was fun ;) and the nurse liked joking about it too! The IV didn’t hurt much, however it started trickling after some time… so they had to re-hook it onto me again! The doctors showed up right about then and introduced themselves… followed by me having to go pee, which was a waste, because I had already pee’ed out all the water consumed by now (by going to the loo at least 3-4 times the night before)! Also, pee’ing with the IV on was interesting, I was walked to the OR soon after… everything after that is a blur!
There were at least 5-7 people in there. I was strapped on to various monitors and before I knew I was asleep! As per my DH, I was in the OR for around 20 minutes and was completely awake 15 minutes after coming out! I was dazed when I woke up and had an oxygen mask on my mouth/nose! The nurse took the mask out and asked how high my pain level on a scale of 1 to 10 was. My answer: around 7-8. She said I should be okay with a Tylenol, though I demanded for some stronger medicine. I just realized how much of a wus I was… I have always dreamt of me doing a natural birth (when I get there)… and avoiding Epidural et al… but after this, I am not sure!:P I think, I was more afraid that something was abnormal more than the pain bothering me… a pain killer was of course not the answer to abnormality… but anyways, they injected something in to my IV and I was okay in around 10-15 minutes. After which, they offered me a choice of 3 beverages and 3 snack items… I chose apple juice and graham crackers! I dislike salty stuff and didn’t want to experiment with saltines. They also gave me Tylenol and Tylenol with Codeine… Once I felt stable, I had to go pee and then we were let go. By the time we left (at around 0130 pm), I was almost pain free (I better be right, after all the drugs)! We had a Ruby Tuesday lunch (to go) and after that I slept for around 2-3 hours on our couch while DH worked (from home)! Rest of the day was pretty uneventful, I guess actually the whole ER was not as dramatic as I had imagined!
At home, I realized I couldn’t get up on my own, my abdominal area was very sore; my DH literally had to pick me up. Unfortunately I had to pee a lot and it wasn’t fun getting up every now and then. By the end of the day I was very bloated and uncomfortable… I somehow fell asleep, though had to get up at least 4-5 times in the night to pee. Problem was that I was drinking a lot of water and on top of it my bladder got (partially) full only to pressurize my ovaries and hurt. That has been the case ever since I got home (…up until now). I hate having to pee or do the other job (forget sex, which they say is okay before ET). I have noticed that the bloating is at minimal in the morning and my abdominal area is hard as rock by the end of the day. However, I have managed to stay Tylenol free after coming home… I just feel like I shouldn’t be pounding on pain killers (unless absolutely necessary) since I have tons of medications in my system anyways and under ideal situation I would have liked my body to be as “organic” as possible during the baby making process!
I feel like my ovaries are slowly moving back to their original position (from the center location covering my uterus during the last u/s)… cause whatever pain I have is on the sides and no longer in the center. I started with Medrol and Doxycycline the day of ER and started the PIO yesterday. I am a little sore from PIO, but it really didn’t hurt as much as Follistim and Lupron while taking it. May be the ice made my rear numb! :)
I got the scare of my life today (Saturday – two days post retrieval). We were not supposed to receive any calls today! We were lazing around in the bed and my phone starts ringing… it was my clinic! No, I was not supposed to hear from them. We have 13 of our embies in the incubator… at least some of them have to grow into healthy babies; we should not be getting any news from them today! I picked up the phone… the reason they were calling was: They were not sure if our transfer was going to happen tomorrow (3DT on Sunday), but they just wanted to let us know that they would be starting the ET very early tomorrow morning and we should expect a call from them at around 0730-0800 am and we would have to be at the clinic by around 0900 am if the transfer is scheduled for tomorrow (in the weekdays the ET is supposed to happen in the afternoon)! Oh what a relief!
So here we stand today, hopefully one step closer to our baby. I am grateful that we have reached where we are today. I hope this cycle turns in to a BFP, but if not, hopefully we will learn a thing or two from it for our future cycles. Your support means a lot to me. Handful of people around us know about this journey, and I would have probably gone insane by now if I didn’t have you gals with me! I hope and pray that we all fulfill our baby dreams in the very near future!
We reached the clinic at around 0826 am, our appointment was for 0900 am. There were two couples in the waiting room. One of the female was freaking out and the other one seemed cool (from what I overheard later on, both were first timers)… I guess I was somewhere in the middle. The more I thought about the whole process the more I panicked, and that has been the case all the way through… so I am trying not to think or over analyze things! I was the third female to be called in at around 0900 am. The guys had to go to Andrology department to do their job before they could join us. By the time I went in to the Recovery Room, one of the female was ready to go in to the OR and the other one was getting her pep talk. It felt like an eternity before my DH showed up and the nurse came to us with all the pep talk and the information. However, I had already overheard all the instructions that the lady besides me had received… so it wasn’t anything new when the nurse came to my section! Things moved pretty fast after that. To hook up to the IV, I had to squeeze a giant sperm… that was fun ;) and the nurse liked joking about it too! The IV didn’t hurt much, however it started trickling after some time… so they had to re-hook it onto me again! The doctors showed up right about then and introduced themselves… followed by me having to go pee, which was a waste, because I had already pee’ed out all the water consumed by now (by going to the loo at least 3-4 times the night before)! Also, pee’ing with the IV on was interesting, I was walked to the OR soon after… everything after that is a blur!
There were at least 5-7 people in there. I was strapped on to various monitors and before I knew I was asleep! As per my DH, I was in the OR for around 20 minutes and was completely awake 15 minutes after coming out! I was dazed when I woke up and had an oxygen mask on my mouth/nose! The nurse took the mask out and asked how high my pain level on a scale of 1 to 10 was. My answer: around 7-8. She said I should be okay with a Tylenol, though I demanded for some stronger medicine. I just realized how much of a wus I was… I have always dreamt of me doing a natural birth (when I get there)… and avoiding Epidural et al… but after this, I am not sure!:P I think, I was more afraid that something was abnormal more than the pain bothering me… a pain killer was of course not the answer to abnormality… but anyways, they injected something in to my IV and I was okay in around 10-15 minutes. After which, they offered me a choice of 3 beverages and 3 snack items… I chose apple juice and graham crackers! I dislike salty stuff and didn’t want to experiment with saltines. They also gave me Tylenol and Tylenol with Codeine… Once I felt stable, I had to go pee and then we were let go. By the time we left (at around 0130 pm), I was almost pain free (I better be right, after all the drugs)! We had a Ruby Tuesday lunch (to go) and after that I slept for around 2-3 hours on our couch while DH worked (from home)! Rest of the day was pretty uneventful, I guess actually the whole ER was not as dramatic as I had imagined!
At home, I realized I couldn’t get up on my own, my abdominal area was very sore; my DH literally had to pick me up. Unfortunately I had to pee a lot and it wasn’t fun getting up every now and then. By the end of the day I was very bloated and uncomfortable… I somehow fell asleep, though had to get up at least 4-5 times in the night to pee. Problem was that I was drinking a lot of water and on top of it my bladder got (partially) full only to pressurize my ovaries and hurt. That has been the case ever since I got home (…up until now). I hate having to pee or do the other job (forget sex, which they say is okay before ET). I have noticed that the bloating is at minimal in the morning and my abdominal area is hard as rock by the end of the day. However, I have managed to stay Tylenol free after coming home… I just feel like I shouldn’t be pounding on pain killers (unless absolutely necessary) since I have tons of medications in my system anyways and under ideal situation I would have liked my body to be as “organic” as possible during the baby making process!
I feel like my ovaries are slowly moving back to their original position (from the center location covering my uterus during the last u/s)… cause whatever pain I have is on the sides and no longer in the center. I started with Medrol and Doxycycline the day of ER and started the PIO yesterday. I am a little sore from PIO, but it really didn’t hurt as much as Follistim and Lupron while taking it. May be the ice made my rear numb! :)
I got the scare of my life today (Saturday – two days post retrieval). We were not supposed to receive any calls today! We were lazing around in the bed and my phone starts ringing… it was my clinic! No, I was not supposed to hear from them. We have 13 of our embies in the incubator… at least some of them have to grow into healthy babies; we should not be getting any news from them today! I picked up the phone… the reason they were calling was: They were not sure if our transfer was going to happen tomorrow (3DT on Sunday), but they just wanted to let us know that they would be starting the ET very early tomorrow morning and we should expect a call from them at around 0730-0800 am and we would have to be at the clinic by around 0900 am if the transfer is scheduled for tomorrow (in the weekdays the ET is supposed to happen in the afternoon)! Oh what a relief!
So here we stand today, hopefully one step closer to our baby. I am grateful that we have reached where we are today. I hope this cycle turns in to a BFP, but if not, hopefully we will learn a thing or two from it for our future cycles. Your support means a lot to me. Handful of people around us know about this journey, and I would have probably gone insane by now if I didn’t have you gals with me! I hope and pray that we all fulfill our baby dreams in the very near future!
July 22, 2009
Final U/S & B/W before IVF # 1 ER
Triggered last night (with Ovidrel) and had another scan this morning. I think the follicles have now maxed out (in number)... the largest one is measuring 21 mm... I guess they will still keep growing in size until the ER. My ovaries are touching each other and were covering the uterus during the u/s.
The nurse called back in the afternoon to update me on the b/w results… my E2 is 6400. Tomorrow’s ER is definitely no longer tentative. It’s happening… it really is. I can’t believe it! I am grateful that we have reached thus far and my ovaries did decide to respond... a little too much! On the back of my mind, I feel guilty to be able to produce so many follicles when some of my fellow IFs have very few. I hope I am not coming out as an arrogant bitch bragging about my follicles. I am fully aware that having 60'ish (big-small combined) follicles doesn’t guarantee me a baby in my hand 9 months from now. I am aware that not all follicles will be mature; and not all eggs will fertilize; and not all embryos will survive (I could even be left with none)! Quality matters over quantity! The chemical pregnancy in May has taught me that it is too early to celebrate till I have a healthy baby (or two) in hand! The biggest concern I have right now is OHSS (with the gazillion follicles that I have) and how it is going to affect this possible PG! I have read that too high (above 4000) of an E2 value hampers implantation. I am not sure if we will even be doing an ET… it will be a last minute call based on how I am doing (we might end up with FET... assuming we have embies to freeze). My nurse mentioned that they will be clearing out tiniest of the tiny follicle… which hopefully will reduce the chances of (severe) OHSS.
Thank you all for the support and tips. I feel optimistic, yet highly cautious! And yes, I am definitely looking forward to a shot free evening (today). I hope 2 weeks from now I will have some happy news to share!
The nurse called back in the afternoon to update me on the b/w results… my E2 is 6400. Tomorrow’s ER is definitely no longer tentative. It’s happening… it really is. I can’t believe it! I am grateful that we have reached thus far and my ovaries did decide to respond... a little too much! On the back of my mind, I feel guilty to be able to produce so many follicles when some of my fellow IFs have very few. I hope I am not coming out as an arrogant bitch bragging about my follicles. I am fully aware that having 60'ish (big-small combined) follicles doesn’t guarantee me a baby in my hand 9 months from now. I am aware that not all follicles will be mature; and not all eggs will fertilize; and not all embryos will survive (I could even be left with none)! Quality matters over quantity! The chemical pregnancy in May has taught me that it is too early to celebrate till I have a healthy baby (or two) in hand! The biggest concern I have right now is OHSS (with the gazillion follicles that I have) and how it is going to affect this possible PG! I have read that too high (above 4000) of an E2 value hampers implantation. I am not sure if we will even be doing an ET… it will be a last minute call based on how I am doing (we might end up with FET... assuming we have embies to freeze). My nurse mentioned that they will be clearing out tiniest of the tiny follicle… which hopefully will reduce the chances of (severe) OHSS.
Thank you all for the support and tips. I feel optimistic, yet highly cautious! And yes, I am definitely looking forward to a shot free evening (today). I hope 2 weeks from now I will have some happy news to share!
July 21, 2009
Thursday it is! ...ER for IVF # 1
Just heard from my nurse – the retrieval is Thursday (and not Friday). My E2 is screaming high and they do not want it to blow the roof off… it is 4680 (ICLW’ers: please read my previous posts for my follicle scan/count story)! I will be triggering tonight (with just 1 syringe of Ovidrel – I guess normally it is 2) and have to go in again (tomorrow morning) for b/w and u/s.
The dates so far for IVF # 1 are as follows...
- Egg Retrieval (ER): Thursday, July 23, 2009
- Egg Transfer (ET): Sunday, July 26, 2009 or Tuesday, July 28, 2009
- Beta: Thursday, August 6, 2009
- Tentative WTF appointment: Thursday, August 13, 2009… this is something I asked for! No, I don’t want to have that meeting, but just in case things don’t work out in our favor, I am not willing to sit on my ass till September mid/end wondering what went wrong. It is very difficult to get an appointment with my RE and on top of it he is supposed to go out on vacation around end of August... hence the tentative appointment!
I have already started loading up on Gatorade and drinking tons of water. As you might have already figured, I am shit scared of OHSS with the big team that I am carrying. I just ran the last batch of errands before my IVF break. I am trying to ease my DH’s woes in case I turn in to a zombie! I hope I look back and laugh at how much I prep’ed being worried that I would be knocked out with OHSS. Any tips about how to deal with it are greatly appreciated.
June 1, 2009
Answers to IVF Questions
We meet with our RE last week for an IVF consult. The RE explained in detail what the IVF procedure would be like. He also answered several questions that I had come up with (see post Q for IVF for background information). Below is a summary of all the questions he answered:
Do we need to do a Clomid Challenge Test and Basal Antral Follicle Count?
No! My day 3 FSH has been < 5 for the last 5 tests (indicating good quality/quantity). I seem to have tons of eggs during every scan and they have had to watch out to make sure that they did not over stimulate me during IUI. So quality and quantity should not be a problem and we do not need to do any more diagnostic as of now.
What are the chances of me having endometriosis? How can we confirm?
Minimal, nothing (cyst/scars) seen in u/s and I do not have any pains and aches.
What are the standard IVF protocol (lupron/long, flare, antagonist) used at the clinic? Which one suits me best and why?
Lupron, since that seems to suit the best for PCOS patients.
How many minimum mature eggs required to continue with IVF (egg retrieval)?
4 minimum
Will we be doing a Mock Transfer?
Mock transfer was already performed prior to IUI and it’s an all clear.
What is the optimum lining of the uterus for implantation? Have I had triple stripe lining?
Optimum lining is 6 mm. I have had at least 8-9 each time. I have had triple stripe lining (also called as Type A) during the pre ovulation u/s.
Should we be doing a PGS/PGD?
PGS/PGD is not recommended unless there is a genetic disorder identified in the family or if there are multiple miscarriages. RE will not recommend this now. When all chromosomes are screened there is 97% reliability in the screening results.
Do I qualify for the clinic’s Embryo Quality Study?
I do not, since I have PCOS.
What are the success rates for IVF and FET?
IVF success rate in my case is approximately 60% and FET success rates is approximately 50%.
For IVF - ICSI or Assisted Hatching? GIFT/ZIFT an option?
GIFT and ZIFT are rarely used since the success rates are very low. ICSI is the way to go. Assisted Hatching is performed when a day 3 transfer is done, this helps in implantation.
My progesterone level 4DP-IUI has been around 6 units? Is it something to be worried about?
Progesterone level of 5 is required for implantation (which is also supposed to be the level indicating that ovulation has occurred). With IF treatment the RE’s like to see a 9. Since I am taking Prometrium, I should not be concerned about low progesterone and lack of implantation.
Should I be concerned about OHSS during IVF? How is that monitored/controlled? Does OHSS lead to IVF cancellation?
During egg retrieval (ER), all the follicles (mature or not) are emptied, therefore the chances of hyperstimulation post retrieval is very low. There will be some discomfort since the ovaries are large, but severe OHSS is probably not a concern. Regular u/s and b/w will help in monitoring the ovaries.
Day 3 or 5/6 Egg Transfer (ET)?
RE recommends transferring 2 embryos in my case (assuming 2 good embryos are identified). Day 3 transfer will be performed if two really-really good embryos are identified (remaining will keep growing in the lab for a possible FET). It’s quite obvious that uterus is the better incubator (as compared to the lab), so transferring the really-really good embryos in the better incubator early makes sense than leaving them out (in the lab) for the next 2-3 days. If there are several embryos doing well and it’s hard to tell which ones are the really-really good embryos, we will be waiting till day 5/6. This will give a chance for the really-really good embryos to stand out… these two will then be chosen and transferred (remaining will keep growing in the lab for a possible FET).
Is Baby Aspirin recommended?
RE’s clinic prescribed Baby Aspirin to patients for two years (after studies showing increased successful pregnancy rates). However the clinic did not see any increase in pregnancies, where as they noticed increased bleeding and bruising in patients. They no longer recommend Baby Aspirin.
Do we need to do a Clomid Challenge Test and Basal Antral Follicle Count?
No! My day 3 FSH has been < 5 for the last 5 tests (indicating good quality/quantity). I seem to have tons of eggs during every scan and they have had to watch out to make sure that they did not over stimulate me during IUI. So quality and quantity should not be a problem and we do not need to do any more diagnostic as of now.
What are the chances of me having endometriosis? How can we confirm?
Minimal, nothing (cyst/scars) seen in u/s and I do not have any pains and aches.
What are the standard IVF protocol (lupron/long, flare, antagonist) used at the clinic? Which one suits me best and why?
Lupron, since that seems to suit the best for PCOS patients.
How many minimum mature eggs required to continue with IVF (egg retrieval)?
4 minimum
Will we be doing a Mock Transfer?
Mock transfer was already performed prior to IUI and it’s an all clear.
What is the optimum lining of the uterus for implantation? Have I had triple stripe lining?
Optimum lining is 6 mm. I have had at least 8-9 each time. I have had triple stripe lining (also called as Type A) during the pre ovulation u/s.
Should we be doing a PGS/PGD?
PGS/PGD is not recommended unless there is a genetic disorder identified in the family or if there are multiple miscarriages. RE will not recommend this now. When all chromosomes are screened there is 97% reliability in the screening results.
Do I qualify for the clinic’s Embryo Quality Study?
I do not, since I have PCOS.
What are the success rates for IVF and FET?
IVF success rate in my case is approximately 60% and FET success rates is approximately 50%.
For IVF - ICSI or Assisted Hatching? GIFT/ZIFT an option?
GIFT and ZIFT are rarely used since the success rates are very low. ICSI is the way to go. Assisted Hatching is performed when a day 3 transfer is done, this helps in implantation.
My progesterone level 4DP-IUI has been around 6 units? Is it something to be worried about?
Progesterone level of 5 is required for implantation (which is also supposed to be the level indicating that ovulation has occurred). With IF treatment the RE’s like to see a 9. Since I am taking Prometrium, I should not be concerned about low progesterone and lack of implantation.
Should I be concerned about OHSS during IVF? How is that monitored/controlled? Does OHSS lead to IVF cancellation?
During egg retrieval (ER), all the follicles (mature or not) are emptied, therefore the chances of hyperstimulation post retrieval is very low. There will be some discomfort since the ovaries are large, but severe OHSS is probably not a concern. Regular u/s and b/w will help in monitoring the ovaries.
Day 3 or 5/6 Egg Transfer (ET)?
RE recommends transferring 2 embryos in my case (assuming 2 good embryos are identified). Day 3 transfer will be performed if two really-really good embryos are identified (remaining will keep growing in the lab for a possible FET). It’s quite obvious that uterus is the better incubator (as compared to the lab), so transferring the really-really good embryos in the better incubator early makes sense than leaving them out (in the lab) for the next 2-3 days. If there are several embryos doing well and it’s hard to tell which ones are the really-really good embryos, we will be waiting till day 5/6. This will give a chance for the really-really good embryos to stand out… these two will then be chosen and transferred (remaining will keep growing in the lab for a possible FET).
Is Baby Aspirin recommended?
RE’s clinic prescribed Baby Aspirin to patients for two years (after studies showing increased successful pregnancy rates). However the clinic did not see any increase in pregnancies, where as they noticed increased bleeding and bruising in patients. They no longer recommend Baby Aspirin.
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