Day 2

Just did my second injection about a half an hour ago.  That's one expensive pen all done!  I have a tiny little dark bruise from the injection yesterday.  Today I can't even see where I did it.  I don't know what I did differently.  Well, the one thing I know I did differently was that I kept my finger on the plunger until the needle was completely removed!  But other than that, I don't know if I did anything differently.

I'm hyper conscious of any small changes in my body which is weird.  I feel every twinge and ping and ache.  I swear I can feel my ovary pinging every now and then.  I don't know if this is just me being particularly hyper sensitive or if it's anything real.  I read through the leaflet that comes with the Gonal-F all about the possible side effects and the likelihood of the various side effects.  I don't usually find reading such things helpful- it just implants suggestions in your head.

I spoke to the clinic this morning- I have an appointment for a scan midday on Wednesday which will be Day 4 which is when the doctor wanted to see me.  So that's good.  In other news I was looking through various egg freezing sites last night and I think the best I can hope for is 5-10 eggs.  Of course there's a big difference between 5 and 10!  I know this is something I shouldn't be thinking too much about.  There isn't anything I can do to change what it's going to be.  But I know I will be really disappointed if it's 5 or less.  Because then even with two cycles I haven't secured very good odds for all this hassle.

However.  I will worry about this when I need to worry about it and there is no point in worrying about it now!!

First Shot

Well, it's 10pm and I have just administered my first shot.  I was more nervous than I thought I would be.  I watched a couple of videos online about how to do it, then I got my stuff together and got it done.  First things first, I got to open the box that it all comes in, so it looked like this:

So here you see then pen, a shitload of needles that I will not need (for me, this pen holds 2 doses), an information sheet telling you all about what the drug is for and what the side effects are, and then a brochure on how to administer your dose.  Another view:

Now it tells you to take everything to a 'clean place'.  So I figured my bed was maybe not the cleanest dust-free environment so I took everything down to my dining table which I wiped clean.  I also washed my hands (as instructed).  Luckily I had some antiseptic wipes in the house.  The doctor neglected to tell me I needed any, and they didn't come in the box.  And of course I had my sharps bin ready.

Now I didn't take pictures during the needle prep or anything as I was just too focused on getting it done.  I had no air bubble in the pen, so I put on a needle, set the correct dose, wiped my side/stomach down, pinched an inch, and injected at a 90 degree angle.  I did feel a bit of a poke and didn't like it but that was really just an instant and then I honestly didn't feel anything.  I depressed the plunger.  It seemed to go very very slowly.... and then you need to hold the pen in for ten seconds.  Then I went to remove the pen- and as I removed it I accidentally took my finger off the plunger like you are NOT supposed to do, so I sort of freaked out that I screwed something up, but then pen showed a '0' which meant I gave myself a full dose, and I didn't see any blood or anything sucked back into it so I think it's okay.  It did well up with a tiny dot of blood, as you can see here:

Which is probably why they also tell you to have some sterile gauze with you, but I didn't have any of that, so I just gave it an extra wipe with the alcohol pad and it seemed fine.  Now it's gone a little bit dark and it's got a bit of a bump to it (fluid underneath?) but it's all fine and done.  So that's shot one.  Tomorrow, and the next night I am in my 'other' home, so I need to pack up all my stuff and take it with me.  10 pm should be fine tomorrow, although Tuesday night it might be slightly trickier.  Wednesday night, which will be day 4, I add the Cetrotide.  As I get more skilled at this, maybe I can take some better pictures.

Now what am I supposed to do with all of those unused needles?  I guess they all just go straight into the sharps bin. I'll ask the clinic tomorrow when I call to make an appointment for my scan.

Period

Well, my period arrived with a vengeance this morning!  Woke me up with cramping.  Unusual.  My period is usually fairly light.  I have no idea if this is from the norethisterone.  I usually never have cramps or anything!  At any rate, I'm pleased because today is officially day 1.  Tomorrow night, first injection!  I'm excited to be moving forward and of course hopeful.  My internet is acting up and I'm running around all weekend doing things.  I need to do an intensive internet search on if I can take any drugs at all while doing the egg freezing drugs.  I'm guessing it's 'no' though, so I'm not taking any, but with cramps and a cold, I really wish I could!  Oh well.  It will all be a minor inconvenience in the grand scheme of things!

Waiting...

End of day three off the norethisterone and finally, just a hint of color... I might get my period tomorrow!  I was starting to worry- what would happen if I didn't get it after all this??  Stress and periods do not go well together!  At any rate, I'm hopeful that tomorrow might be day 1.  But I can tell that it's coming.  So day 4 scan will be Thursday or Friday next week- perfect!

In other news, I am coming down with a cold.  My first thought is "How is a cold going to screw with my egg freezing??" my second thought was "Crap!  I can't take any drugs!!".  This is going to be a very unpleasant cold.  I'm usually a clockwork dayquil/nyquil user.  But I'm not taking anything at the moment.  Not even painkillers for the neck pain I get from sitting at the computer.

I'm still anxious that this is not going to go well and I'm not going to get many eggs. But part of me is also excited to get it started.  And another part of me just wants this first round to be over so I can take cold medication and have a drink!

I think it's a common thing for women who decide on egg freezing - once you decide you want to do it, all of the waiting is particularly painful.  I just want to be getting it done!!

Soon soon soon....

First Drugs

So now I'm just waiting for my period...

In the meantime I thought I'd put up what I got from the doctor.  They had it all ready for me in a blue plastic bag.  This is probably about half of the drugs (or a bit less) than I will actually need.  I appreciate that they are only giving me what I need.  I've read some blogs where people were encouraged to buy all the drugs up front and of course they may adjust the dose so then you have left-over very very expensive drugs.  You're looking at over £600 of drugs and equipment here ($900).

To give you some idea of size, that paper on top is A3 (11x17).  I felt like a serious junkie on my way home from the clinic!  I will post more pictures as I go through the process.  I don't know.  It helps me feel calm and collected to document the process.  The first thing I'll be taking is the Gonal-F on the second day of my period.

For the love of... I'm not computer illiterate!  I don't know why it insists on rotating this photo.  I give up.  So anyway, these are two injection pens.  I'll give more details when I open my first box.  Probably the 450 box.  I'm starting on a 225 dose, so the first pen will have 2 doses.  The second 900 pen has 4 doses.  But they may lower the dose after my next scan which should be on day 4 of injections.  On day 4 I also start the Cetrotide which is the one that came with the instruction sheet because I have to mix it.  That is always the same dose, so each box is a single dose with everything you need to mix it up.  Again, more on that as it happens.

But the thing that really made me feel the most like a druggie?  The sharps bin.  Here you can see the place for my needles... and the top of my instruction schedule.  The nurse was very careful to tell me that as it's shown there it's 'closed' but if I push it the whole way, it will lock.  So don't do that.  Of course I need to travel around with this thing and I'm thinking, if it doesn't close, can't things fall out of it???  I'll just have to pack it carefully.

Now on with the waiting for my period... honestly.  It's worse than being a 12 year old girl!

All Systems Go!

I've just returned from my meeting at the clinic.  Had an ultrasound scan of my ovary to see if it's good to go, and it is!  So had a chat with the doctor to answer some of my questions, he prescribed the drugs, I met with the nurse to collect my drugs and learn all about how to inject myself.  Got a blood test for sexually transmitted diseases and so now it's just a matter of waiting for my period to start.  Last norethisterone is tonight!  I start injecting on day 2 of my period, and need to go in for a scan and possible blood work on the 4th day of the drugs.  I'm nervous, but I'm actually really excited.  I felt really positive about it today!

So I'll do another post with all my drugs but I wanted to also record here some of my questions and answers, in part so I won't forget, and also because maybe it might help other people.  So in no particular order:

• How am I supposed to understand AMH numbers against having one ovary?
• The doctor told me this is a two part answer.  He said if I want to know how many eggs I have left, I should stick with the number as it stands.  But if I'm trying to understand how my ovary might respond to medication, then I should consider the number to be doubled.  Of course I will only get half of what one would expect from the doubled number, so again, tempering my expectation.  But this is kind of great news because it bumps up my AMH to a better bracket.  So that was good news.  Actually, he said my one ovary was actually very promising.  So I felt really good about that (I may regret these words later!)

•  If I think I'm going to need two cycles, how much time should I prepare to leave between cycles (if any)?
• The doctor said they recommend to take a two or three month break in between cycles.  Now on the way home I realized I still didn't understand this perfectly.  I'm having a February cycle now.  March would be one month off.  Then is April possible?  Or does a two month break mean not to do it in March or April?  May won't be any good for me as I'm traveling to the States to see family for the annual trip home so I guess I'm looking at June.  If I want to do a third cycle, and need to take a break, that means my third cycle will happen when I'm 39.  I'll cross that bridge when I come to it, it depends on a number of other factors.

• Is there a way for them to know if an ovary has twisted?
• I was reading up about how you shouldn't do any impact activities or twisting activities while stimulating.  Because when I lost my other ovary, it had twisted 3x, I'm a little worried about it happening to this one.  Twisting cuts off the blood supply and is pretty much bad.  I mean, why does it twist??  So apparently there is no actual way for them to 'see' if it's twisted and the only way for them to know would be if it was very painful.  He said that as the ovary gets larger, that's what might make it twist.  Now my cyst, that was large- around 15cm.  He said under stimulation, the ovary will grow to between 7-8cm so hopefully not so large to make it twist, but large enough that I need to be careful.  That's fine.  I plan on being very careful.  They said to call of course if I had any pain or worries during the treatment.

• How many eggs should a woman freeze to have a very good chance at one future baby?
• Okay, this one has been bothering me because a lot of the egg freezing stuff I'm reading have women talking about freezing 10 or 11 eggs.  When I met with the doctor the first time he said ideally I would really want around 20.  I saw a different doctor today who will be managing my process and he actually said 20-30!!  But that 20 was probably a good number to have a very good chance at one successful baby.  His rationale was because the clinic results (see chart below for 2011) show a 33% success for clinical pregnancies with women 38-39.  So because I am 38, the eggs I am freezing now will give me about a 1 in 3 chance of a successful pregnancy.  He said that one IVF cycle will use about 7 eggs. So 20 frozen eggs accounts for 3 cycles and the odds show one of those would be likely positive.  It's important to note that for live birth the number drops slightly.

Patients age	<35	35-37	38-39	40-42	43-44	>44
% clinical pregnancies*	44%	37%	33%	13%	6%	-
Clinical pregnancies per cycle commenced	72/165	27/73	20/60	11/84	2/32	0/12

On the Pill and Considering Diet

Just an update.  I've been taking the norethisterone for six days now.  No side effects that I can tell, not that I think there are supposed to be any.  I have my scan and nursing appointment on Tuesday which is just two days away.  I'm so anxious to get to it!

In other news I've been trying to moderate my diet in preparation for the procedure.  This has meant trying to eliminate caffeine and alcohol from my diet.  This has not been easy at all.  I could do alcohol fairly easily, but it gets hard when you can't have a coke instead of a glass of wine.  I've managed fairly well but I've had 2 glasses of wine in the past week because... well, I have no excuse.  I read that and then I think, what the hell, I haven't managed fairly well at all!!  But I've turned down quite a bit of alcohol in the past week, so I feel like I've done well.  Ugh.  This will be it until the procedure is finished.  I fear it's too much money to be wasting and not taking it seriously.  I've looked on forums and seen mixed information on how strict you should be and when you should start.  Some people say to cut all caffeine and alcohol three months before the procedure (which I have completely missed the boat on) and some say only when you're on injections.  Most seem to agree that a small cup of tea or coffee a day is okay, but caffeine isn't really my issue as I don't drink many hot beverages.  It's the alcohol.  I've cut back, and I'm happy to cut it out completely for the next three weeks.  But it is hard.

My mind still wanders to worrying about egg collection and how few there might be.  It's the whole one ovary thing.  I read other blogs and other people's experiences and then I have to remind myself that they have two ovaries.  I want to be hopeful but I am so terrified that I'll only get one or two or three when I really want seven or eight or nine.  I know I just need to do it and see what happens but it is actually incredibly stressful.