Needles, Needles, Even Bigger Needles, and an End To Needles (For Now) in Sight

My mini-tiger has the sense to stay in bed on the mornings that we get up early to go to the clinic. How I wish that I was Lamont.

Last night, I went to Elements of Health Centre for my first fertility acupuncture session there with Stephanie. The centre specializes in infertility and fertility issues. Stephanie had infertility treatments herself at the Victoria Fertility Centre to have her daughter and she put me instantly at ease. She told me that she is open to her patients asking her questions about her fertility treatments. Someone going through fertility treatments usually doesn't get the opportunity to question one of their health care providers about how they felt going through fertility treatments, so this was an unexpected and added bonus.

Victoria Fertility Centre recommends Elements of Health Centre for acupuncture to complement their fertility treatments. Dr. Hudson himself does acupuncture on his patients (if they want it) after an embryo transfer and he believes that acupuncture can aid in the process of IVF. The theory is that acupuncture can help improve blood flow to the uterus thereby increasing the chances of an embryo implanting during the process of IVF. I've had acupuncture in the past and have found it relaxing and stress is a component in infertility, so I thought that it certainly couldn't hurt to have acupuncture done alongside my IVF cycle.

I had to fill in an intake form and then spent an hour with Stephanie, answering questions, getting acupuncture needles put in me from head to feet (forehead, stomach and abdomen, lower legs, feet, and forearms), letting the needles do their magic while I meditated to the soothing music in the darkened and warm room, having the needles taken out, and then booking an appointment for Thursday at 12:15 PM. She thought it would be a good idea to get a second session in before the egg retrieval. Though I seem to be spending every waking moment of every day injecting, driving to appointments, waiting for appointments, getting tests done, and writing about it, I had no objection to this plan, as I want to do everything I can to improve my chances of this cycle of IVF being successful and me not having to repeat this process (there are conflicting studies about acupuncture and IVF and whether or not acupuncture does improve the odds of implantation of the embryo, but it can't hurt, it's relaxing which is beneficial anyways, and I have some sessions of acupuncture available for coverage under our insurance plan).

Yes, there are four needles sticking out of my head. She's trying to help me with the migrainous headaches I'm getting from the hormones.

When I left the very relaxing acupuncture session, I was exhausted, overwrought, and had a series of panic attacks on the way home. This had nothing to do with the acupuncture. She was very good, had a better delivery of needles than other practitioners that I've gone to, and the office is very comfortable. It just that my body and mind are in a war and I feel like my soul is being shredded into thousands of pieces in the process (or in other words, I'm suffering from being on multiple high doses of hormones that are making my mind and body crazy). I feel like I can't survive much more of this (pain, headaches, bloating, nausea, dizziness, gastrointestinal distress, anxiety, panic attacks, insomnia, daily injections, worry, waiting, fear, etc.).

Today is day 14 of my cycle (today is day 12 of me injecting myself, but I've been on hormones since September 1st, so it's been a long time). The examination slot was 7:30-8:30 AM at the Victoria Fertility Centre today. We were up early again, so my husband could get ready for work before and I could inject myself with Cetrotide and take my Dexamethasone. I had not slept well again. The lack of sleep, plus hormonal shit-storm is really grating on me. I feel like a barely caged tiger, ready to leap out and devour someone or something without the least bit of warning (or remorse). Snaaaaarl!

Don't be fooled by the smile. I'm a badly caged tiger.

We were at the Victoria Fertility Centre at 7:40 AM, but we were six names down the list. We took the last two seats in the waiting room. We of course had to wait quite a while because there were so many people ahead of us. More people arrived after us and more chairs needed to be brought into the waiting room. It's amazing how wide-spread infertility seems to be once you start going to these clinics that specialize in it (VFC and Elements). You would never know that these people sitting in the waiting room are suffering from this terrible life-changing pain. They look so normal and healthy. That's the problem with invisible illnesses like addictions, mental illnesses and disorders, and infertility is that people often look "normal" but suffer terribly, often in shame-filled silence. And our society judges them, sometimes with some form of moral judgment in there, instead of having compassion and offering help.. Hardly anyone talks about infertility or if they do, they're often shrouded in anonymity. It's disturbing that so many suffer in silence and that our society makes it a shameful, taboo topic. Well, I've never been good at suffering in silence (my family will attest to that), so whoever wants can read my grumblings on the subject is able.

Yep, frenetic energy coupled with exhaustion. We're in the waiting room again.

Dr. Hudson gave me a pelvic ultrasound. When I commented that the follicles looked bigger on the screen, he said to not rely on how the image looks on the screen too much, because he can zoom in or out, so it's not that reliable. But the measurements that he took that were up on the screen were bigger than previous times, so they are growing. He says that my endometrium looks "beautiful" and "as good as it gets." So, if we manage to get an embryo and it manages to implant, it will hopefully have a nice home. He says that my eggs are looking good and that I've done much better than he expected (I promptly informed him that I always exceed expectations and that I'm modest too). He said that there are several large follicles, but also that there are several immature ones and they have to make a judgment call over whether or not to trigger me now or wait longer for some of the other follicles to mature more. Since my egg reserve is not great, waiting longer and having very mature eggs is risky he says. Therefore, he decided that I would take my "trigger shot" tonight. He said that I must take it within 5 minutes or so of the time set, as the egg retrieval must be done within 35 hours of the shot (the "trigger shot" is not as forgiving as the other shots which can be done in a range of a couple of hours each morning or night).

On the examination table again.

My "beautiful" endometrium.

Follicles in the right ovary.

Follicles in the right ovary.

Measuring follicles in the right ovary.

Measuring follicles in the right ovary.

Follicles in the left ovary.

Measuring follicles in the left ovary.

So, my egg retrieval will be Friday morning. They naturally would have to review my blood work first, shuffle around spots around on their very, very full Friday morning, and then email me an exact time and dose of the "trigger shot" for this evening. Dr. Hudson warned me that I will feel "very hormonal." Um, I already do. Oh, great! The badly caged tiger will transform into a rabid werewolf as the moon wanes. . . . He also said that I would be very bloated. I already am pretty bloated, so this should be "fun." He added that I would be very sore after the retrieval. I am dreading this, however, I've also had some really awful surgeries in my life, so I'm hoping that this is not the worst. All in all, it sounds like it's going to be one freaky Friday.

The nurse took my blood and then told me to go next door to the drug dispensary to pick up my "trigger shot" and the medications that I'll need before and after the egg retrieval (so I don't have to worry about collecting them right after my egg retrieval when I'll have been under anesthetic and on pain killers like Fentanyl and perhaps some Ativan too).

Another blood test.

The blood letting continues. Wonder if I'll miss this almost daily activity if I ever get free of IVF? Well, if I do I can just buy some leeches.

At the drug dispensary, I was told to hold onto my Gonal F pen that still has 50 mL or so left, because I won't need any more of that this cycle (and who knows if I'll be doing another cycle and the stuff is like liquid gold). I was told that the only shot I'll be doing tonight is the "trigger shot" so that was good news. The exact dose is to be determined based on blood work, so I will not be finding out that till this afternoon. Pregnyl comes with a syringe, a vial of liquid, and a vial of powder that require mixing, rather like Menopur (consequently it has two different needle heads, thick for mixing, thinner for injecting).

My "trigger shot" is comprised of human chorionic gonadotropin (hCG). I'm on Pregnyl, which is just one of many brands (and made from the urine of pregnant women- woo wee!). It is used instead of luteinizing hormone for the final maturation of follicles and to induce ovulation. Ovulation will happen 38 to 40 hours after an injection of hCG when there are one or more mature ovarian follicles. In IVF, the shot is given and the egg retrieval (oocyte retrieval) is scheduled to happen 34-36 hours after the injection, just hours before the eggs would burst forth from the ovary (instead of ovulation, a giant needle aspirates the eggs from the ovary through the wall of the vagina- sounds like a fun Friday morning).

We paid $390.00 today for drugs. That brings our total for drugs for our first cycle of IVF up to $6,470.00 (when you add in the clinic's fee of $6,500.00 for our first cycle, the total is now at $12,970.00). It remains to be seen if all of our drug costs will be covered or if some of them will only be partially reimbursed or if they will reject our claim for some reason or another (as a former insurance litigator, I never have faith in insurance companies). Of course the doctors' and clinic fees are not covered whatsoever by our insurance (even though you can go to a massage therapist or naturopath and be covered- go figure). In any event, the whole process is very expensive with or especially without insurance.

The only thing we couldn't buy at the clinic's drug dispensary, was low dose aspirin (that I'll take after the egg retrieval to improve blood flow to my uterus). More about the drugs I'll be taking after egg retrieval in later posts, but besides the "trigger shot," I picked up more Estrace (estriadol) for after the retrieval, Endometrin (progesterone) for after the retrieval, and Doxycycline, an antibiotic to prevent infections that I start tomorrow morning and then continue after the egg retrieval. My Dexamethasone will continue, but the other medications I was on, Gonal F, Menopur, and Cetrotide are done for this cycle.

Today's drug haul. Not exactly as exciting as unboxing a new Hermes purse or something like that . . .

This afternoon, I received an email from a nurse coordinator at the Victoria Fertility Centre with two attached documents. One was mixing instructions for the Pregnyl, how much liquid to draw up into the syringe and put into the vial of powder. That was clear. The other document was instruction pre-egg retrieval. While it told me to take my "trigger shot" tonight at exactly 10:45 PM, it then went on to say my egg retrieval was Monday morning. Since "trigger shots" cause ovulation in about 38-40 hours, this had to be impossible. I emailed back for clarification and waited for a call from the nurse.

The nurse called in the later afternoon and also sent a revised document. My egg retrieval will be at 9:45 AM on Friday, so I must be there at 8:45 AM. My trigger shot is still scheduled for 10:45 PM tonight. We reviewed the instructions for leading up to the egg retrieval (medications, fasting, my current weight and height). Everything is very clear.

So, tonight, my last injection for a while, Pregnyl, will happen at 10:45 PM. Tomorrow, acupuncture to hopefully improve the blood flow to my uterus and relieve some of my hormonal symptoms. Tomorrow night, no food or drink after midnight. Then Friday morning (I can take my thyroid medications and stomach pill, but not the antibiotics, Dexamethasone, or vitamins, as are all hard on an empty stomach), hungry and thirsty I must go to the Victoria Fertility Centre for the egg retrieval scheduled at 9:45AM. I must arrive one hour before the scheduled procedure at 8:45 AM. My husband must be with me, because I'll be under anesthetic for the procedure and can't drive after or be alone for 24 hours. And he must be with me, because during the egg retrieval, he'll be providing a sample of his own, so that they can try to create some embryos for us (half will be created through mixing and half from injecting one sperm directly into one egg-ICSI).

After the egg retrieval, there is the jittery wait to see if there are any usable eggs/sperm, if they can make an embryo out of our specimens, if the embryo(s) survives, if so, an embryo transfer (live unless my blood levels don't allow it, then we'll have to wait for another cycle and do a frozen embryo transfer) will occur, another nail biting wait to see if implantation happens (two weeks), if implantation happens, an agonizing wait to see if I make it through my first trimester this time, and then the rest of the pregnancy waiting to see if the baby survives and is healthy. If we can't make an embryo or it doesn't survive and we have no frozen embryos then we're back to square one and we'll be going onto a second cycle of IVF. I feel overwhelmed just listing the steps. I must remind myself one day at a time, one hour at a time, one minute at a time, one second a time, one post at a time. . . .

Please, make this end already.