Coming Soon to a Uterus Near You!

No surprises on my beta today. Big ol' negative.

But, I did talk to several different people at the RE clinic and got a lot more information about what comes next.

First, I will continue to take Prometrium through the weekend, to delay my period for a few days and buy us some time until we've got all our ducks in a row to begin my mock cycle.

There's a really good explanation of a typical mock cycle, and a typical donor IVF cycle at ParenthoodOptions.com.

First thing Monday morning, I'll call the RE's office to set up a time for us to go in and do an injection class.

The shots I'll be taking (more on that in a moment) will be intramuscular (in the butt) so we need all new training, since we've only been doing subcutaneous in the belly, so far.

Or, possibly, they might just let us get Shrike's mom to show her how to give them to me, since she's an RN and knows such things.

And, yes, Shrike will be doing them. So far, I've been doing the majority of the injections myself, but Nurse D (who is kind of taking over for Nurse E, now that we're moving to the donor egg program) said that it's really much easier for someone else to administer IM shots since, well, it's easier for her to reach my butt than for me to!

Once I start my period, we'll jump right in, beginning the injections on Day 2. I'll take estrogen injections every 3 days (Days 2, 5, 8, 11).

Then on Day 12, I'll have an ultrasound and bloodwork, to check my uterine lining and hormone levels.

I'll continue the estrogen (days 14, 17, 20, 23) and add daily injections of progesterone.

I hear that the progesterone in oil shot is a tough one; because it's so thick, it really hurts going in. I guess I'll be finding out for myself soon enough.

That continues through Day 23, when I'll have an endometrial biopsy. That involves going in through my cervix (that, I'm used to) and grabbing a tiny bit of endometrium (not so used to that!).

At that point, I think I stop the shots and start my period a few days later.

When my biopsy results come back, that will tell us whether my endometrium responded as we want, in which case we'll use the same protocol for the real cycle. If not, it might be tweaked a bit.

Meantime, Shrike and I will both be doing some other testing things. A prescreener is suppose to contact me next week to give me a checklist about that.

Once my mock cycle is done, we will both start birth control pills (isn't it ironic) to get our cycles sort of synchronized.

They don't need to be exactly synchronized, in fact I'll be about five days ahead of her. According to ParenthoodOptions.com, once my lining is good to go, I can be in a "holding pattern" for several days waiting for her eggs to mature.

I believe we'll both be taking Lupron at that time, too, if not sooner. That will suppress our bodies' natural hormone production, so that we're only doing what the doctor wants us to do, not trying to control our own bodies internally. (Again, see ParenthoodOptions.com for a better explanation.)

We'll schedule the pills for me to have a period about a week before Shrike's, if I'm understanding correctly.

At that point, I'll start the meds, as above (with possible tweaks, depending on the biopsy results) and about 5 days later, Shrike will start FSH injections, for 10 - 13 days, to stimulate lots and lots of follicles to develop.

I'm assuming she'll have a Day 3 ultrasound first, to see how many antral follicles we've got to work with. (36, again?!?)

Then she'll also have monitoring ultrasounds, much like I've been doing, to check on follicle development. Then she'll get an HCG trigger shot (it actually triggers the final development of the eggs, not the release) and the next day, they'll do the egg retrieval.

The eggs will be inseminated and cultured for a few days, and 3 - 5 days later, we'll transfer a couple of the best-looking ones (of course, being Shrike's, they'll all be pretty cute!) to me, I'll be on bedrest for 24 hours, and then we wait. Again.

On the financial end of things, it looks like Shrike's insurance will not cover her meds, which could be around $3000/cycle, so I'm thinking that we'll most likely go with the "all inclusive" shared risk plan, which is several thousand dollars more, but would cover the meds, so that money would still be guaranteed.

If we're successful quickly, we lose money by going with that option, rather than paying for the meds out of pocket, but we have a baby, so it's worth it.

On the other hand, if we do six cycles and aren't successful, it's the difference between getting back almost all of our money (my meds and, of course, sperm are still not covered) or having no baby and several thousand dollars of of debt.

We're also investigating the possibility of doing preimplantation genetic diagnosis (PGD), which would involve taking one cell from each embryo at around day 2 or 3 and checking to make sure that it's chromosomally normal (exactly the right number of each) and, I think, also checking for some specific genetic diseases (none of which Shrike has any risk factors for or family history of).

Our primary reason for wanting to do that is the higher risk of chromosomal abnormalities because of Shrike's age. If we can be sure that we're only transferring chromosomally normal embryos, then our odds of success should be higher and our odds of discovering some sort of a problem later on should be much lower.

We will have to consider the cost, though, as that will be $3500 / cycle, and is not covered under the shared risk program.

That's $1500 to our RE's office for removing the one cell per embryo, and $2000 to the PGD lab for actually doing the testing. The price is the same no matter how many embryos we test.

So, to summarize, we are, of course, bummed about the negative beta, but we were totally expecting it, and had already moved on, emotionally.

I'm anxious to get started with this mock cycle, because the sooner that's done, the sooner we'll get to the real one.

The mock cycle will take about four weeks, then about four more on the pill, getting synced, then we start the actual IVF cycle.

It should be about three more weeks, I guess, til we're ready to do the retrieval / transfer, which puts the earliest possible conception date around late February or early March.

So, maybe a newborn for next Christmas?