Ready to Roll

Shrike has an appointment at the fertility clinic on Friday morning to start the IVF cycle!

That morning, she'll have several blood tests, an ultrasound to look at her follicles, checks of height/weight/vitals/whatever, and will get two shots.

It's a double-blind study, so no one (except some patient-assigning computer somewhere) will know if she's in the experimental group (getting a long-acting follicle stimulating hormone, which is one shot that's good for seven days) or the control group (getting the usual seven days of daily recombinant FSH shots).

So, the two shots she gets on Friday will either be the study medication and the first of seven placebos, or a placebo and the first of seven rec-FSH shots.

(Regardless, she is going to be getting seven days worth of ovarian stimulation, either all at once or one day at a time.)

On Saturday, she gets to stay home, and I'll give her a shot of recFSH or placebo.

Sunday, she goes in for bloodwork only, and gets another recFSH/placebo. I think that on the appointment days, she'll get her shots while she's there.

Monday is another stay-home day, and I give her another shot.

Tuesday she goes for blood and ultrasound and gets the same shot, plus an additional medication (Ganirelix).

And so on, through stim day 7 (next Thursday).

Starting on stim day 8, she'll continue to go in for monitoring, and will get Follistim and Ganirelix shots until she's ready to trigger, with a shot of Ovidrel (HCG) to make the eggs mature.

They'll have her do that when the largest follicles reach a certain size. (When we were making Peeper, they had us trigger when 3 - 4 follicles were 18 mm. I don't know if it's the same this time or not.)

When I talked to TN (study coordinator) this afternoon, she said that most patients have been triggering right around stim day 8. One was actually day 7 and the latest was, I believe, day 12.

Thirty-six hours after the trigger shot will be egg retrieval. As with Peeper, for that she'll be under IV sedation, and they'll go in vaginally with a needle, and then "off road" into the pelvic cavity where, watching with ultrasound, they'll poke the needle into the follicles and aspirate all the fluid and, hopefully, an egg from each one.

When we did this before, it only took maybe thirty minutes (although they'd estimated fifteen, so I was freaking out!) from the time I kissed her goodbye and they wheeled her into the room, until I was allowed to see her again. By the time someone came out to get me, they'd already counted the eggs and were able to tell us how many we had.

While we're driving home, they'll thaw out Popeye's boys, pick out the best-looking swimmers and inject one directly into each egg. (Intracytoplasmic sperm injection - ICSI)

The study protocol does not allow for preimplantation genetic diagnosis (yeah, we're a little nervous about that) and requires that everyone do a three-day transfer, so the next two days we'll get phone calls telling us how many eggs successfully fertilized and how the embryos are looking and then on the third day, we'll go back for the embryo transfer. (With Peeper, we did PGD and a 5-day transfer.)

The study protocol also requires that exactly two embryos be transferred (assuming there are two healthly-looking ones), which is the same thing we did with Peeper.

The rest of that day and the following day, Shrike will need to be on what I guess is technically "modified bedrest." With Peeper, my rules were that I was supposed to be lying or sitting around, with my feet up. I was allowed to hang out on the couch watching TV and using my laptop (with it on my thighs, not my tummy, since it's hot-hot-hot!) and could get up to get food (and take it back to the couch to eat) and go to the bathroom.

That was pretty easy (although I did spend a lot of time on the phone and sending / receiving emails, making arrangements to - I swear - meet Hilary Clinton the next day) but this time around, we're a little worried about how Peeper's going to handle Shrike not being able to get up and play with her.

We'll definitely warn her about it and I'm thinking that maybe she and I will leave for a while (hopefully it will be on a day when something's going on with MOMS Club).

Today, it occurred to me that maybe we could rent some movies to all watch together, while snuggling on the couch.

I'm thinking Wizard of Oz (since she's rather obsessed now, but hasn't actually seen the whole thing) and possibly Jungle Book (since she loves the "Bare Necessities" clip that Shrike found on YouTube). We also have Finding Nemo, which she's seen a couple of times when she was sick, and something else that Shrike bought lately, but I've forgotten what it was.

As rare as it is for us to even open the entertainment center, let alone actually watch something on the real TV, that ought to keep her distracted for a while.

Shrike can go back to work the following day, and then we wait.

She'll have an official pregnancy test on day 18 post egg retrieval, but I'm sure I'll have her peeing on sticks well before that. With Peeper, we had a very faint positive at 11 dper, a positive digital the next day and a positive blood test the following day.

If we get her knocked up, the study includes ultrasounds at 7 or 8 weeks and 12 weeks, but the doctor will want more than that, hopefully starting at 6 weeks.

So, by my calculations, it looks like the most likely scenario is that we'll be doing retrieval and transfer sometime during the week before Easter, will have an idea of the results via peesticks by the first week of May and will have an official answer by the following week.

So, here we go!