April 2016 - Not Quite Yet & Egg vs. Follicle?

Tuesday's baseline check had an unexpected twist.  The ultrasound, which should have shown nothing, or at most a couple very, very small antral follicles, showed 3 fairly sizable follicles.

Yes, you read that right.  I managed to grow more follicles after being off the medicine than while I was on it, and at the time we want no follicles, I have 3.  My ovaries just continue to not cooperate with the process.

For those who might have questions.  The egg is to the follicle as a seed is to fruit...kinda.  Here's a cartoon that might help:

This shows the ovary with various stages of the egg as it starts from being a primordial follicle (I have also heard this called "granulosa"), developing within a fully formed follicle, and then being released during ovulation.

The follicles measured 6mm, 10mm, and 18mm.  Unfortunately, none of these are worthwhile to perform another retrieval...I asked. Twice, just to be sure.  Each one of these little guys feels so valuable.  They said that these likely aren't fully developed and my other hormone levels in the blood test were not ideal for proper egg development within the follicles.  They just need to be out of the way.

You can also read more online.  This site has a pretty clear and short explanation, but is also a little dry.

So here's a little insanity for you.  Now we are getting rid of these unwanted follicles, after so desperately wanting follicles and not getting them in round #2, so we can move on to the wanted ones in round #3.  Ironic, right?

How do we get rid of them?  Well, Sharon (my nurse) handed me a trigger shot to take home and administer that would force me to ovulate 36 hours later.  Sound familiar?  Indeed.  This is the same trigger shot I took before the retrievals.  Ovidrel is the brand name they gave me, but the active drug is actually hCG (human chorionic gonadotropin), which is the same hormone a woman's body produces during pregnancy to support growth of the baby.  It is actually the hormone that if detected in home pregnancy tests and blood tests that confirm pregnancy.  It is also the same hormone that some athletes have used as a performance enhancing drug.  I guess I will have to put off qualifying for the Olympics this year.  

Sharon said that there is a small chance that the egg from the 18mm follicle might be good.  Still not good enough for us to go retrieve, but if we wanted to time intercourse around the 36-40hr mark, we certainly could roll the dice.  Before you get too excited, we decided against it.  While it would be great to skip round #3 and get pregnant, the cons are as follows:

• We would have to wait 2 weeks without medicines to take a pregnancy test
• If we were to get pregnant, given my history / situation is high risk for another miscarriage
• First, another miscarriage would really emotionally suck; as hard as the failed IVF rounds were, miscarriage is far worse
• Also, a miscarriage would put us several months down the road before we could try IVF again
• If we were lucky and got pregnant and had a healthy baby, it would be wonderful, but this would likely eliminate our chances for a second child, since my ovaries would likely be toast after a year or so has passed

So, while the idea was exciting, we decided to stick with the round #3 plan.  After taking the trigger shot Tuesday evening, I likely ovulated this morning about the time I was getting ready for work.  Anticlimactic, I know.

I go back to the RE's office tomorrow morning for another blood test and ultrasound to confirm that at least the biggest follicle has gone away.  The smaller ones, if not gone, will likely be able to be shrunk back down by the birth control pills, which hopefully they will give me permission to start tomorrow afternoon.