Becoming One with the Needle... Again

The process to prepare for the upcoming Frozen Embryo Transfer (FET) has slowly begun. At this point, we're looking at about two months out (give or take), so I recently started birth control pills again (I swear, the irony of that one will be something I never get over!)... and also ordered the different medications I'll need, and those arrives the other day.

Among them is, drum roll please... (and cue music signifying "impending doom"):

The dreaded Progesterone in Oil - also known as PIO shots.

Ahhhhh...

As I look ahead to having to give these injections, all I can think about and all that keeps swimming through my head is the horror stories I've heard...

In all that I've been through up until this point, for some reason, I swear the thought of these shots scares the heck out of me! I'm literally terrified...

What's so bad about them you might ask, well, let's start with the fact that they are intramuscular injections... In laymen's terms, this means a really big needle that must go through the muscle when you inject it. Yikes! Up until now, most of the shots (at least the self-administered ones) have been subcutaneous, meaning a small needle that basically just injects the medicine right below the surface of the skin into the fat, and then your body absorbs it from there. 

I've had a few intramuscular shots before when I've taken my HcG trigger shots, but the intramuscular ones were done in Dr. M's office by one of the nurses, so we've never had to give them ourselves (I say "we" because my husband is amazing and helps me with pretty much all of the shots).

The second frightened aspect is the fact that I will literally be injecting oil into myself. I don't know why, but for some reason this just seems weirdly unnatural... then again, what part of any of this process has been "natural"?

In addition, I've heard numerous stories that the shots are painful, the oil hurts when going in, the oil can be tough going in, there can be irritation or swelling/ lumps that form at the injection site, all kinds of fun stuff, ugh.

Of course, I've never been one to be afraid of needles or put off by a little pain or discomfort, and again, at this point, I'm pretty used to all that... but for some reason, these darn PIO shots are really psyching me out.

I have my consultation appointment set up for first thing tomorrow morning, where I'll go through some different consent forms and information to prepare for the upcoming transfer, and then will have a training session on exactly how to administer these shots - - so we'll see how that goes. I'm sure I'm just getting myself worked up into a tizzy about this for nothing, but for some reason these darn little shots are already taking me for a ride and I haven't even started them yet... What fun.

Ladies who have been down this road before, any thoughts? Advice? Experiences? I know I've seen, heard, and read little tips and tricks here and there before, so any advice is more than welcomed... until then, I will just sit here and continue to stew over the fear of these radical little shots :) 

Drama on ER Day... and My Popsicles

After my egg retrieval (ER) surgery a couple weeks back, I'm all recovered up at this point... and for the most part, everything went well. The surgery itself was quick and went as expected. The hubs and I arrived to Dr. M's office bright and early for our 6:30am appointment. We checked in, and not long after, we were called back to our room to be prepped and wait for the procedure.

After signing some more consents, getting an IV started, and reviewing what to expect with the nurse, we had a slight hiccup of drama right before I was scheduled to head back into the room for the ER.

Because of my over-response to the hormone injections this cycle, and the elevated risk that put me at for Ovarian Hyper-Stimulation Syndrome (OHSS), one of the nurses had told me a few days prior that they were calling in a prescription order of Ganirelix for me, to my mail-order pharmacy. I've used this pharmacy a number of times in the past, and typically every time Dr. M's office calls in an order, the pharmacy then calls me within a day or two to confirm and finalize the order for delivery. So when the nurse mentioned this, I didn't think anything of it, and just figured the pharmacy would call me as they always have.

Long story short, on the day of the ER, as the nurse was reviewing everything with me prior to the surgery, she mentioned that I would be starting the Ganirelix later that day, and would continue on the daily injection for a total of 7 days... "Uhhhh, I don't have the Ganirelix" I said to her.

And she looked at me with what I would describe as a slight look of terror...

"What do you mean you don't have it yet?  We called in the prescription for you?  It's important that you absolutely start on this medication today!" she said.

"Well, the pharmacy never called me and when I spoke to the nurse the other day, she just mentioned it in passing, and never specifically told me when I was supposed to start so I didn't know I needed it today. I was just waiting for the pharmacy to call me about it like they always do."  Miraculously, I was still somehow staying clam at this point.

The nurse said she would go and check to see if they happened to have one dose of it on hand in the office that they could give me for that day, but mentioned that she was doubtful they would... and mean while, I proceeded to get on the phone with the pharmacy to raise hell.

For the entire 15min. prior to being whisked into the procedure room, I spoke with numerous pharmaceutical representatives, and managers, and pharmacists, and customer service reps., literally having to explain my situation over and over again (while continuing to throw in the line that, "I'm sitting here about to go into surgery in a few minutes, and I need this medication today in order to prevent some post-op. complications that I'm at risk for ")... as if that would somehow magically help the medicine fly across the country from their warehouse to my front door.

Basically, it took 5 different people to finally get a straight answer: "The earliest possible time we could get this medication to you would be tomorrow morning, with overnight priority shipping."

"Wellllll, that's not going to work..."

Awesome.

Looks like we'll have to figure out a Plan B and cross our fingers that another local pharmacy has it in stock AND that insurance will cover it, or else we're choking down the $189 for one dose.

At that point... it was time for the ER.

And the Ganirelix drama was not the stress I needed at that moment.

Literally, always something...

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Regardless, the retrieval did go good... and the next thing I knew, I was back in the room reunited with my husband, apparently saying the same things over and over again and not remembering, because of the anesthesia :)

Immediately after the ER they told us how many eggs they were able to retrieve, and the next day we learned how many fertilized... and then a few days later we learned how many made it to the blastocyst stage.

All of it was, and still is, a very surreal experience.

(Ok, ok, at this point I know you're dying to know the meat of this all and what the ER stats were, so I won't make you wait any longer...)

I went in with approximately 30 follicles, and we were able to retrieve 25 eggs... Whoa.

Of those 25, 18 eggs were mature.

One a side note: Once the hubs and I had learned a few days prior that I was over-stimming, we, along with some guidance from our team at Dr. M's office, had decided that we may potentially not attempt to fertilize all of the eggs retrieved (just depended on the number we got), because we wanted to be conservative and limit the number of embryos we had (I know, not your typical IVF approach... and again, a post for another day). So we had gone into the ER with a maximum number of eggs in mind that we would attempt to fertilize.

Now back to our stats...

So we had 18 mature eggs, and of those 18 we had decided to try and fertilize 12 of them, using ICSI (our clinic uses it for all cases... It's basically where they inject the sperm directly into the egg, rather than just placing the egg and sperm together and letting fertilization attempt to occur on it's own).

Therefore, because of our choice, we were also able to freeze 6 of my eggs (obviously, unfertilized)... So this is nice to have as a back up plan down the road, if needed.

Of the 12 that we attempted to fertilize, 10 actually did fertilize.

And of those 10... 6 made it to the blast. stage and were able to be frozen. So at this point, we have 6 little popsicles in the freezer... and we're hoping to be able to transfer sometime in the next couple of months.

Until then, my heart belongs to my 6 popsicle babes... until the day that I can give each one an opportunity to come home...