First Injectables Appointment

Hi Friends,

So today we met with the Nurse Practitioner to go over the schedule for an ovarian hyperstimulation w/ injectables cycle. It was a good appointment, and we now have a timeline of when we'll be starting medications and doing ultrasounds. Of course, when that timeline begins depends on when AF comes (which will probably have to be induced with my best friend provera).

I'm guessing AF will come sometime between Oct 23 & Nov 1st.

Here's the scoop:
Day 1 = first day of AF
Day 2 or 3 = go in for u/s and b/w; start daily injections in the evening
Day 7 = u/s and b/w
Day 8-12 = Continue daily injections; Depending on how my follicles respond, I return for an u/s & b/w every day or every other day to closely monitor follicular growth.
When I have 1-3 follicles >18mm, I get an HCG shot to induce ovulation. 36 hours later, I'll return to clinic for the IUI (after, of course, Todd goes to clinic to do his business).
Then we cross our fingers and hope it works! :)

A couple of things that may happen:
1. My follicles don't respond to the low dose of medication that they're starting me on.
If this happens, they'll increase my dose of meds to try and get my follicles growing more.
2. My follicles over-respond to the low dose of meds.
If this happens, they'll decrease my dose of meds. If there's WAY too many follicles, the cycle may have to be canceled (too high of a risk to have "high order multiples" i.e. triplets & higher) or we may have the option of converting to an IVF cycle. Since I have PCOS, I have many (>30) follicles in each ovary. The trick is to stimulate some of then to grow, but not all of them.
3. Ovarian Hyperstimulation Syndrome (OHSS). Can be mild or severe, but more often occurs during IVF cycles. Can result in blood clots, kidney damage, ovarian twisting and chest/abdominal fluid collection.

I hope that I don't have any of the 3 above problems during my cycle! Or if I do, that it is (fairly) easily resolved. Please send some positive thoughts that my cycle goes well, without complications!

The other fun part of the appointment (if you can really call any of this fun!) was practicing mixing the medication & injecting it. As a nurse, I feel very comfortable doing those things, but since we've decided that he'll be giving me the shots, he needed to have a chance to learn. He did a really good job drawing up the medication, mixing it, changing the needles, and injecting it. He had such a fun grin on his face when he was practicing it--I think he's going to take some real pleasure in doing the shots! haha :) Maybe nursing will be a second career for him...

Anyhow, for now we're just passing the days, waiting for cd42 to start provera, to induce AF. We'll be getting our meds ordered from London (cheaper than here in the States) and getting our home pharmacy stocked full of needles, syringes & a sharps container. It's just crazy, but you do what you've gotta do.

I'm trying not to get in my head too much, taking time for yoga, and trying other relaxation techniques so that I can stay calm leading up to and during this next cycle.

Thanks for checking in with us. I appreciate that you come here to see how we're doing. You may not always know what to say, or if you should say anything, but we always appreciate a simple "We're thinking of you."

Thank you for your support and understanding.

Much love,
Julie