Twas the Night before...

I am 99% sure that tomorrow is trigger day. One more day of shots, one more date with the dildo cam, one more day of b/w and that is it for me. We're done. What a sprint this has been to the finish line. For those of you who are detailed oriented, here are my numbers from today's u/s and b/w:

Left Ovary
This cycle: 19mm, 15.7mm, 14.1mm
Last cycle in Canada: 17mm, 10mm

Right Ovary
This cycle: 22mm, 18.4mm, 15.8mm, 15mm, 13.6mm, 11.7mm
Last cycle in Canada: 21mm, 20mm, 19mm, 17mm, 15mm, 14mm, 14mm, 13mm

E2= 2199
P4=1.3
LH=1.9

It is very interesting to note that in my last cycle in Canada, my doses at this point (day 10 of stims) was a whopping 750 units/day whereas yesterday, they dropped my dose down to 300 units and today raised it back up to 450 units. I don't see much of a difference in the results so again, more proof that what they say about amounts >450 not yielding better results is holding true for me.

My original calendar had down that I was supposed to trigger tonight but I've been told that it will most likely be tomorrow. I have been repeating and repeating myself over and over again to anyone who will listen that I have had a history of immature eggs and because of my insistance, Dr. S (not Dr. Sch) has pulled me over one more day to see if we can improve on the maturity of my eggs retrieved. Under normal circumstances, he would have triggered me tonight. It just goes to show you that you MUST be your own advocate in this whole thing and if you have a clinical history of something, make sure they know it when they are evaluating your case as it may make a difference to the decisions they make about how to approach your file. My nurse also told me that they may also give me a bigger dose of the trigger shot (HCG) in an attempt to help this issue and mature more eggs. Usually, the dosage is 10,000 units but they may give me more. We shall see what happens tomorrow.

Today we also had our meeting with the genetic counsellor and it was a really educational meeting. We are down to down Microarray testing to check for aneuploidy in our embryos since there are no genetic mutations that we have been diagnosed with that we may possibly pass along. In non-IVF speak, checking aneuploidy means that they will confirm that all 23 pairs of chromosomes are present and that there is no more and no less genetic material. Since we have had a history of not producing that many embryos, we really had to make a decision whether or not we were going to try and push our embryos to make it to day 5 when they will do the biopsy for microarray testing. Embryos must make it to day 5 post retrieval in order to have enough cells to biopsy and the attrition rate is about 50% from day 1 post retrieval to day 5 post retrieval. We were really wrestling with this because we have never tried to push our embryos to day 5 given that we have had, at most, just 3 on day 3 post retrieval. The risk is that we can end up with nothing to biopsy on day 5 and then we would have nothing - nothing to transfer and no answers either. However, the genetic counsellor that we spoke with told us that in these rare instances when this happens (i.e. nothing to biopsy and send for testing), as long as the embryos made it to day 4 post retrieval, they can still do a biopsy and send it out for testing, just to get some answers back for us. Just because the embryos don't make it to day 5 post retrieval doesn't automatically mean that it was abnormal. Also, if this happens, they will refund us $4,000 of the fee for Microarray. The head embryologist said that I am still young and that in his experience, he usually sees embryos from people like me making it to the blastocyst stage on day 5. In the event that we have only 1 or two embryos make it to day 5, we have also requested that they biopsy and test any and all other embryos that may have arrested on day 4 or day 5. We're after answers here and it sounds like they can give us those answers. If they all come back abnormal, than that's my answer whether I like it or not. I also said to my DH that I just would rather not go through again all the pain and anguish of transferring in one or two (if that's all we had left) and then miscarrying later. I would rather find out they are all abnormal and transfer none than not find out and then getting pregnant only to miscarry a few weeks later. Once was enough times for me.

So, hopefully trigger tomorrow with retrieval on Monday. Let the games begin!