Grow follies, Grow!

Five days after starting the Menopur injections, I returned to Kaiser for my second ultrasound.  It had been less than a week since my first ultrasound, though frequent visits are necessary to carefully monitor the growth of follicles and egg development.  Because the drugs may overstimulate my ovaries, I could be at risk of producing too many eggs.  We all know what that means, I could be at risk of becoming the next Octomom.  Yikes!

I was excited to discover what was going on in my insides.  Back in the ultrasound room, tucked away at the end of a long hallway in Kaiser's Reproductive Endocrinology Department, I sat restless awaiting my doctor.  Instead of my doctor however, I was seen by a nurse practitioner.  Hmm, ok.  Familiar with the routine, I laid back, propped my feet into the metal stirrups and relaxed my knees apart.  As the NP inserted the probe we followed its journey throughout my uterus, around my ovaries, and saw....absolutely nothing.  Boo.  Even after gliding back and forth from the right ovary to the left, maneuvering the probe this way and that, pressing firmly on my abdomen to get a better view, we still saw - nothing.  Dislike. 

Sweetly, the RN comments, "Well, it appears your uterus is very quiet and your ovaries are being patient and taking their time."  Ugh.  Really?  That's all fine and dandy, but seriously after 10 days of injecting myself with hormones designed to purposefully stimulate follicle growth, there really, truly isn't anything?  Say what!?  I just don't get.  The NP asks me to get dressed and meet her in her office.  I pull on my clothes, pick up my pouty lower lip and trudge down the hallway.

In her office, the NP tells me that she is going to continue my regiment of Lupron and two vials of Menopur for the next three days and she will see me again on Tuesday.  By then, she explains, we should see some action.  (For goodness sake, I hope so!)  On my way out, I hit up the 4th floor pharmacy, fork over my credit card for another batch of Menopur and kiss another $240 bucks good bye (not too mention the $127 I paid for the sonogram to view ABSOLUTELY NOTHING!).

Back at the ranch, I take a hit of Menopur each night, and slowly I begin to feel the awakenings of follicle development within the depths of my body.  I've become very attune to my body's reproductive system since I started this journey.  I can read every tinge, twitch, cramp and gurgle in my belly well.  I was sure that when I went in for the next ultrasound that there would be a party going on in my ovaries - and I was positive the action was happening on the left side!

And boy was I right on!  Tuesday afternoon, same place, same sonogram machine, same NP.  On my back, propping my head up to see the monitor, the NP points out two fuzzy black dots inside the left ovary - follicles!  Woo hoo!  She makes a few clicks with the mouse and measures them - 10 & 12mm.  Not bad, but the optimal length to pop out an egg is 18-20mm.  She moves on to examine the right ovary...she looks, and looks....and looks, and looks.  And nothing.  She seems perplexed, which worries me.  Um, where's the party?  She tries slanting the probe up, down, all around, pressing her palm into my abdomen and still nothing.  Humph.

After the exam, I meet the NP in her office.  She is pleased with the progress, explaining that at my age we would hope to see at least 2-4 follicles.  Now that my body is developing these very precious egg factories, the NP instructs me to give up all aerobic activity (eek!) and she would like me to continue with the same dosage of Menopur for another three days.  We all know what that means!  Cha ching!  $$$$$  Back to the pharmacy I go.  Handing over my Mileage Plus United credit card, I think of all the miles I'm racking up and where baby and I will go someday.  I leave Kaiser that afternoon happy for my two follies and a bit worried about the vacant lot on my right side.

For the next three days I am antsy, crawling up the wall and pouting like a little kid.  I've been so active this summer, going to the gym, dancing, and religiously attending Bikram yoga classes that I was going stir crazy not able to exercise.  I did what I could - took long walks, only danced slow hulas and switched over to Hatha yoga (minus the inverted poses).  As I watched the girls sway their hips, looked on as my yoga peers held their bridges, and dilly dallied with wimpy barbells, I reminded myself that it was all necessary to protect the little follies on the inside.

The day before my appointment, I decided to request a visit with my doctor instead of the nurse practitioner.  I'm sure she knew her stuff and was performing the ultrasounds to the best of her ability, though I just felt like I needed to see my guy.  Perhaps the last two visits with the NP - the first visit a big fail with absolutely no development and the second visit, the mystery of the right ovary - discouraged me from wanting to see her again.  Call it bad juju, I guess.  I was informed that the nurse practitioners regularly perform the ultrasounds, though my doctor happened to be on call that day, so they would accommodate me.  Yippee! 

Earlier this afternoon, I went into Kaiser feeling positive, uplifted and sure that I was going to get a good report card.  Sure enough there was a follicle on my right side!  It was just a baby one, at 9.5mm, nevertheless there was something there, which made me again wonder whether the NP was being very diligent in her practice.  Though this little guy won't be of much help this cycle, it was comforting to know that my right ovary had some life to it and rid me of any discouraging thoughts.   

On to the left ovary.  The two follicles that the NP had discovered at the last appointment had grown considerably; 17 and 19mm!  These were very promising and Dr. Huang was pleased with the progress.  After completing the exam, I was surprised when he informed me that by the end of the day the follicles would grow another 2mm and I would be ready to go!  I just needed to pick the day I wanted to be inseminated - Sunday or Monday!  Wow, just like that!?  I get to pick?  What a change from the guessing game I once had to play with the ovulation testing kits!      

Since neither day was better than the other (chance wise) I went with Sunday, the lesser of my busy days.  The doc asked me to meet him in his office after getting dressed.  As soon as he exited the room, I hopped off the reclined chair and did the happy dance.  I was thrilled with the progress, ecstatic that this meant the end of injections and giddy with excitement to try to get pregnant again!  It's been awhile since the last cycle - May - and I've been looking forward to this day all summer long! 

In his office, Dr. Huang explained the procedures for the final injection - a dose of one final hormone that will trigger ovulation - to be taken at precisely 10pm that evening.  I was told to cease all intake of Lupron and Menopur, but to continue the Estrodiol pills.  He sent me down to the pharmacy to pick up the last of my hormones and two boxes of suppositories to take for two weeks following the IUI (those sound like good fun).  He gave me the "ok" to proceed with my regular physical activities, including dancing!  Hooray!  I left his office with a spring in my step, and a smile on my face that not even the $200 expense at the pharmacy could take away!

So now, it is Friday evening, and it is done.  I bailed on a date to stay home and give myself the final injection, the trigger shot, just over an hour ago.  I am hoping and praying that this injection will indeed be the final shot. I can't bear to think of repeating the hormone treatment. Over the next day, my little egg (or perhaps two eggs; one from each follicle) should be making its way into my fallopian tube where it will hang out and await fertilization by the sperm, soon to be introduced to my body this coming Sunday.  I pray that this is my time.  #8, my lucky number...we'll have to wait and see.  Pray for me!