Saturday, December 3, 2011

Decisions, Decisions

This morning I went in for yet another monitoring appointment. I was quite convinced when I went in that I wouldn't be triggering until Monday. My usual nurse wasn't there today (I guess I can't expect her to work everyday) so my anxiety was a bit elevated, however, the only other person I trust to make decisions for me was there in her place so that was a bit reassuring. Again, everything looked great on the ultrasound. We measured 10 follicles in my right ovary and 6 or so in my left. My left is usually the overachiever so I am hoping that there are more come retrieval time. The most exciting news is that my lining is up to 8.34mm! I cannot believe it. I actually said to her "are you sure" and she measured it again and got pretty much the same exact measurement. After we were done with the ultrasound she told me that she would call right away with my labs once they were up so I could email Dr. Braverman so he could decide how to proceed.

About 90 minutes after I left she called me to let me know my results. My P4 went from 0.9 to 1.2, my LH actually went down a tad, and my E2 spiked from 2373 to 4450, and that was only in a 24 hour period. Yikes! I immediately emailed Dr. Braverman who got back to me within the hour. He said that we had no choice but to proceed as my follicles still needed some more growth, so he wants me to "coast" tonight (no more stims, just Lupron) and to trigger with half of my anticipated trigger dose but to also add in 150iu of Follistim at the time. So instead of doing two Ovidrel injections for trigger (15,000 units of HCG) he is having me only do only one. He is hoping this coasting will help my E2 levels plateau a bit as he is quite worried about a more severe form of Ovarian Hyperstimulation Syndrome (OHSS). As it looks right now, my E2 is expected to be around 7000 or more at time of trigger. In preparation for this he is starting me on 0.5mg Dostinex (starting day after ER) to help minimize OHSS. He said that I need to face the possibility that my ET will not occur and that we will need to freeze everything. Since no more E2 levels will be drawn, we are going to have to base all of our decisions on how I feel and how everything looks on ultrasound. He did tell me that he has used Dostinex on many occasions and his patients have done quite well on it will no adverse effects on pregnancy rates. I was happy to hear that. I do have to admit that I am a bit worried about OHSS though.

So here is the final plan:
  • Tonight I stop the Follistim and Menopur and only take the Lupron along with all of my other meds. 
  • Tomorrow I stop the Lupron, baby aspirin, and Lovenox and I take one Ovidrel injection at exactly 8pm along with 150iu of Follistim
  • Tuesday morning I go in for my ER. I start on the Dostinex the day after and restart the Lovenox and baby aspirin the day after that. 
Wish me luck and say a little prayer that we don't need to cancel my ET. It would kill me to have that happen, especially since this cycle has been so perfect up until this point. 

7 comments:

  1. Prayers said and sending lots of luck to you!!

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  2. Hang in there! We are rooting for you!!!!
    MK

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  3. Keeping my fingers crossed for you. I've heard that coasting can be effective at preventing OHSS. I'll keep my fingers crossed for you that everything goes smoothly from here on!

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  4. fingers crossed here too. Hoping the OHSS doesn't even get a look in and that your transfer goes ahead smoothly and successfully.

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  6. Krystyn, I'm saying many prayers for you and this cycle.
    Thank you so much for your sweet words. I've been following your story since I started blogging and you've been such a strong person and example to so many.
    I hope and pray this cycle stays and brings you and your husband much to smile about! :)
    Xoxo
    Good luck tomorrow!
    Maria

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  7. GOOD LUCK my dear, though sounds like you are on your way!

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