Too many eggs

I went in for my CD11 ultrasound yesterday to check the lining and see how my follicles were developing. To recap, everybody believes I ovulate regularly and have slightly long (32ish day), but regular cycles. I also have 40+ resting follicles. That’s a lot. This cycle, our first with ultra-conservative-by-the-book RE, I was prescribed 100 mg clomid, CD 4-8. Both my wife and I suspected that this new surge of estrogen would produce a lot of eggs. And it did.

As of yesterday, I had one 16.4 mm leader, a 14 mm runner-up on the other side, three 12 mm tagalongs, two 11 mm friends, and two 8/9 mm squirts. Add that up. Nine. Nine developing follicles. Say hello to the world’s next octomoms! Just kidding. Gross.

So now what? I go back in tomorrow for another ultrasound. In a perfect scenario, the 16 and 14 will continue developing, and the others will fade away. In a less ideal scenario, three to five of the smaller follicles (the 11 and 12’s) will continue to grow, leaving us 5-7 viable follicles. That is still too many, but statistically, it is unlikely that all of those will fertilize and implant. I have read that follicles over 14 mm at ovulation are viable. Since follicles grow 1-2 mm per day, I could have as many as 5 viable follicles today. Trigger should happen when the lead follicle is 20 mm. I’m guessing that we will be there tomorrow.

I know that one of the conversations we will be having tomorrow will be about selective reduction. And honestly, I don’t know what to think/feel about it. If you’re unfamiliar, the basic idea is if three or more eggs fertilize and implant, a doctor will terminate one or more. I know this is a super touchy/loaded topic, and I don’t want to step on anyone’s toes. For the record, I am very pro-choice and believe that this is a decision that should be made by parent(s) and their doctor. However, when faced with the possibility of having to make that choice, I’m stumped. On a theoretical level, I think I could do it to give the other remaining embryos a chance at a healthy pregnancy and birth. But when I think of the real nitty gritty details, I kind of want to vomit.

The alternative is cancelling the cycle and trying a lower dose of clomid next month. This isn’t the worst plan out there, but it sure is painful losing another cycle without trying.

Honestly, I’m not even sure that we will get a choice. We haven’t been consulted by the RE on any of the plans thus far, so I’m probably kidding myself to think that he would ask us what we want to do. If he had asked us, I would have told him 50 mg clomid was the place to start, since I already ovulate. It is funny (or not so funny) thinking that one of the first things I told him was that we are concerned about multiples. Twins we can handle. It would be a hard, and that’s an understatement. But we can make it work. Triplets? The probability of problems/complications skyrockets.

What would you do? Did any of you have to consider selective reduction?

In lighter news, here are some photos from a quick backpacking trip we took this weekend. Our friends visited from San Diego, and they were thrilled to get out of the heat. The leaves are changing here, and the nights are cool, so it was a really lovely trip.

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Four days pregnant

So, you know how once you find out that you’re pregnant, you are already four WEEKS pregnant? Well, I’m not going to let those four weeks go to waste. I’m going to count every single one of those days of pregnancy and see if I can’t use them to trick my body into actually BEING pregnant. I’m sure you’re thinking, “but you can’t actually BE pregnant this early.” And you’re right. But why not think like I am? Why not convince my body that it IS pregnant, so that when the IUI finally comes along and fertilizes the giant egg I’ve grown, my uterus is ready to catch and snuggle it? I will already be about two weeks pregnant at that point. Then, it should really come as no surprise when my period doesn’t show up two weeks later, because, gosh, I’m already four weeks pregnant. I’ll let you know how this mindgame turns out…

In other news, I had an HCG test and U/S yesterday to determine that my lining is thin and I’m not pregnant from a former cycle (our last try was February, so I’m pretty sure we would all have noticed if I were pregnant). The clinic was supposed to prescribe me Clomid, but they didn’t get the blood test results back yesterday, so they couldn’t write the prescription. On CD 3. How they could not get tests back in one day baffles me. And why they had me drive an hour to the clinic to have the tests done when they couldn’t even process them the same day also baffles me. But, I’m refusing to get pissed off, calling the local clinic today, and assuming they will just have me do Clomid days 4-8. It’s incredible that we pay this clinic so much money, babysit them by giving them reminders EVERY time we visit about what the plan is supposed to be, and yet, they still can’t get the basic stuff taken care of.

So, here I am, four days pregnant, looking forward to the Clomid Crazies and waiting for the clinic opens so I can call and get a prescription.

Waiting for CD 1, Again!

Well, it feels like it’s been WEEKS of doctor appointments without any real progress, but we seem to be finally heading toward our first medicated IUI. To recap, I had all of the initial blood work on CD 3 (one month ago), the clear HSG test about a week later, and an ultrasound to see that my uterus and ovaries look fine. The blood work turned up elevated bilirubin, which is very common, but the ultra-conservative RE would not move forward until my PCP cleared my liver. So, I ended up having another ultrasound on my liver, plus a series of blood tests including hepatitis and many other liver details, which I won’t pretend to understand. Much to my great appreciation, my PCP scheduled my tests and cleared my liver in about 72 hours flat. He was a champ. We then met with the RE and “developed a plan” (read: he told us what we are going to do).

The Plan: 100 mg clomid on CD 3-7, monitoring ultrasound, HCG trigger shot, insem 36 hours later. Seems to be pretty standard procedure around these parts. N and I are a little apprehensive about that dosage of clomid, because I have 40+ resting follicles, so I feel like there is a high likelihood of twins. Or more. Let me go a step further and say that I almost expect there to be multiples. Which, frankly, I am okay with. I am nervous, because it means the higher likelihood of complications, but I would be thrilled to get a couple kids having to only have one pregnancy!! N would be much less thrilled… The RE will cancel the cycle if there are more than 4 follicles. Or maybe he said “four or more.” I’m not sure, but either measure is fine by me. On the bright side, the RE told us the chances of conceiving with this plan are 45% the first cycle, 15% the second cycle, and 5% the third cycle. I’ll take those odds.

So here I am, on CD 29, waiting for my period. It should show up any time now. And then we will FINALLY get started on trying again. Our last shot was an unmedicated/unmonitored IUI in February. It feels like we’ve been waiting forever.

Between the 10,421 doctor appointments I’ve had in the last month, I’ve also had a few dentist appointments. I hate going to the dentist with unbridled passion. Yet, I was blessed with teeth made of chalk, so I have fillings or crowns on nearly every tooth. I promise, I am a really good brusher/flosser, but somehow, these suckers keep rotting away. God help my future children – I’m going to enforce dental hygiene like a prison guard monitors inmates popping their meds. “Open up, tongue up, tongue left, tongue right, cough.”

Around the blogosphere, I’m super excited to see a few positive HPTs popping up! It seems like a new round of babies are just starting their gestational journey, on the tails of the adorable bundles who were just born! Cant’ wait to get some weekly updates from you newly preggo ladies!