Friday, October 17, 2008

Is It A Litter, Nest, School, Flock. . .

I had my second ultrasound today and Dave did a precautionary sperm freeze--to create a back-up reserve in case fresh sperm (the preferred kind) is not available on egg retrieval day.  Sperm freezing is optional; however, Dr. Skywalker urged us to consider paying for it (about $410).  

He told us about a couple who did not sperm freeze.  Apparently, on the day the wife did egg retrieval the husband needed to submit his sperm.  For whatever reason he couldn't preform the task and immediately left the clinic--and his wife on the operating table with a ton of eggs and no sperm to fertilize them (we don't want that kind of pressure hanging over Dave; therefore, a precautionary sperm freeze is worth the 41,000 pennies).  

This is a picture of my right ovary from today's ultrasound.  Some of the maturing follicles are circled in red .  I've got a good group (litter, nest, flock, etc.) brewing in both ovaries.  

The doctor counted 11 maturing follicles and 10 additional follicles under 10 mm.  If you do the math that's 21 follicles, I had 18 on Monday (not sure if there was some Florida counting or if the Gonal-f medication triggered more follicle production).  Having more than 8 maturing follicles on Day 4 of FSH (follicle stimulating hormones, i.e. Gonal-f) classifies me as a high-responder.  

This is good, but it does put me at higher risk for ovarian hyperstimulation syndrome.  About 33% of IVF patients experience some mild form of this, yet only about 3 - 8 % will experience a severe form (this link to explains it better than I can).  At the moment, there is no need to panic or worry. 

The second picture shows an endometrioma (the gray blob circled in red).  I have two, one in each ovary.  Will this cause a problem for egg retrieval?  Unlikely, the doctor said they do their best to move around the endometrioma while collecting eggs.  If needed they will go through the endometrioma, but it's not preferred--the thick bloody tissue of the endometrioma gets mixed with the egg (which just sounds completely messy and undesirable).

This afternoon I got a call from the clinic.  I will continue taking 300 units of Gonal-f, 10 units of hCG and start the nightly Ganirelix injections.  Ganirelix suppresses the body's natural desire to release luteinizing hormones (FH).  FH surges trigger ovulation (i.e. the releasing of the eggs) it's too early for my eggs to be released. 

I go back to the clinic Sunday morning for another ultrasound and lab work.  Things are moving quickly!!  Wish us luck!!

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