First Blood

I’m not really bothered by needles. Except, it seems, when sticking them into myself.

After the negative on Friday’s pregnancy result (a week ago), the nurse said to expect my period around Monday. It arrived Saturday, like everything – seemingly sped up by all these hormones. So, back to the clinic on Tuesday for bloodwork and ultrasound. I have had wicked cramps. Thank god I can have epsom salt baths right now.

After the ultrasound and trans-vaginal ultrasound. We are officially starting our first round of IVF. We have been on the wait list almost 10 months. Allia and I are back to back on the list, but opted to stagger the dates when we come up as eligible. That’s one perk of being queer. We may not have a sperm or penis, but we sure can sign up twice for government subsidized IVF.

After the tests, Nurse N. sat us down to explain the barrage of medication that I’ll be on.

1) Gonal F. 200 is the dose. While they want to avoid hyperstimulation, they want to maximize egg production. When Allia was on this two years ago she had such awful symptoms on just 75 that we had to take her to the hospital. So far, spoiler, I’ve been on it at that dose for 4 days and have no symptoms except bloating (and being grossed out by sticking sharp objects into my stomach). We were told initially that we would come back on Friday at 7 am to maybe drop the dose, and again on the 23 to check in.

How do you do this pre-loaded injection? You click the numbers to the dose (for me, 200). You pull off the cap, after swabbing the area with an alcohol wipe. Pull up a nice bit of belly. Inject. Watch the box for the 200 to drop to 0. This was pretty straight forward. Except that on the first attempt I froze after the first part, sticking it in and had to ask Al to push the plunger. I just held the needle. Advice was: Keep it in the fridge until you’re ready for your first dose. Inject at same time each night.

2) Luveris. 75 IU was the second drug. The combination is supposed to keep both parts of the hormones in balance that will cause my ovaries to overproduce eggs and follicles to get all excited.  It came with more parts than a Playmobil pirate ship. The alcohol wipes. The big syringe tip with angled tip (DO NOT PUT THAT IN YOUR BODY). Small syringe tip. The syringe itself. Two small vials: one with saline, one with powder. Process: We messed this up the first time, taking off and on various parts of the tips at the wrong times and struggling to suck up all the liquid. I was feeling nervous, literally with the thought – maybe this baby stuff is just a really bad idea – running through my head (none of which I said out loud).  So, first: open all your stuff. Swab the area. Take the big tip and attach it to the syringe. Open your vial caps. Use the big needle to draw out the saline. With that same tip inject the saline into the powder and let it mix. Advice was: Do not shake it. You don’t want air bubbles.

Next: DON’T take that big tip off (we did and then freaked ourselves out trying to swap exposed needles off of the syringe). Use the same big needle to draw the mixed liquid up into the syringe. We are thinking, now that we are way more comfortable with this, that we should make a video. Honestly, seeing someone do it would have been SO much easier than remembering details from the nurse and comparing them to the notes I took on my phone and following written instructions.

With the big needle on the syringe and liquid in there (tip the vial upside down and withdraw the needle as you are pulling the plunger so that you can get to the very bottom) keep a good grip on the plunger so it doesn’t squirt back out. Recap the big needle (ours has a sideways guard that swings up over the tip).

Now swap to the smaller needle, the one that looks like it won’t hurt like a _____ when you put it into your stomach (stomach is recommended as the legs have nerves you can accidentally hit). With the small tip, put the syringe tip up and let the air come out; let a few little drops come out the top of the needle to check. Prep your area, holding it in your thumb and finger. Inject and slowly squirt it out. We were told it might sting or burn. (again: Don’t use the big needle!!) Hold it there for a moment. Slowly pull the needle out and I liked to put an alcohol swap back on the area and press it; this was following the first time when blood started oozing back out of me. This, I’ve heard, isn’t uncommon.

Night 1: 9:30 pm first dual injection of Gonal F is closest to belly button. Then we spilled part of Luveris in extraction from the vial. My belly bled from shot 2 the first time. But now, aside from a few bruises we are doing way better. Note: these are pyjamas, not a rockin’ satin matchy-matchy outfit that I wear outside the house. 

So: for now, two injections. I inject same time each night, alternating sides (first day right side, next left. I was told I might get a third shot by the end of the week, Cetrotide, to hold off release of the eggs. The goal is to stimulate for a week. Harvest end of next week. I’ll do my retrieval in Burlington. Ideally, then they will tell us how eggs were harvested. We are hoping: many. Then we will get daily updates after they are ‘in-vitro’d’ telling us how many are surviving. What we want is the count of viable day 5 embryo.The projected time for harvest is the day of retrieval plus five. Apparently for the procedure I will be sedated. Allia there to be my voice; she will be able to tell, better than a doctor who doesn’t know me, how I’m doing.

All in all, it has been smooth sailing. On Friday we went back in to talk about the third injection; they still haven’t told me if I will need it.

But I have three boxes of it; same injection format as the second drug – all evil scientist style. At least we are getting accustomed to it. Next step, is to go in on Sunday to check my estrogen levels to see if I need to take Cetrotide and keep stimming until late next week. Other good news: I have 8 follicles all going strong and equally so. This is great; while 3 was a hazard in the IUI world (see past entries), they are looking for good numbers and high counts here (as long as it doesn’t get too high) because that means potentially higher successful eggs to harvest. Having them all progress equally means that they won’t risk having to leave some good, but slower, candidates behind if other follicles are ready faster.

Sunday I will know what to do next: email the nurse with the count of follicles and wait to hear the estrogen level so we know when to take Cetrotide. (And maybe none of this is useful to anyone but me, but I really wish that I’d known how long, what, where, how and wtf was going on, so if it helps anyone, and keeps me on track with the things we are supposed to do, then… yay).