Stimulation, round two

I've been "stimming" for over a week now.  This means that I've been getting several injections each day, which stimulate my ovaries to produce follicles, which will hopefully have a mature egg once egg retrieval comes around.  This is the second time we've been through this, so we knew what to expect--bloating, cramps, moodiness, headaches, sleep deprivation.  The one thing we didn't expect--a prescription for Viagra.  For me.  That's right, I am now taking Viagra.  Apparently, the Viagra helps the stimulation meds be more effective.  I'm all for it if it's going to give us a baby.

After a few days on the "stims" I had a ultrasound and blood work to see how my ovaries are responding to the meds.  That ultrasound found that I had only 8 follicles--6 on the left, 2 on the right.  My right ovary has a large endometrioma, which is ovarian endometriosis in the form of a cyst.  The endometrioma is preventing the ovary from cooperating and producing follicles.  This leaves me with fewer than average follicles.  We were disappointed, but we also know that, in the end, it only takes one.

The few and slow growing follicles prompted the Viagra prescription.  By the second ultrasound, I had 10 follicles--8 on the left, 2 on the right.  However, many of them were still slow growing.  We only had three that were growing at an almost normal pace; the others lagging behind.  At this time, the nurse said one of two things could happen.  One being that the doctor could recommend retrieving the largest follicles at their appropriate time, which means that the smaller follicles will not be mature and cannot be fertilized (this would leave us with approximately three eggs).  Or, the doctor could recommend stimming a bit longer to grow the smaller follicles more.  However, in this case, we risk losing the biggest follicles and mature eggs, and stimming for too long can result in poorer quality eggs.  We knew we wouldn't have an answer until the next ultrasound and blood work.

Today, I had my third ultrasound.  I now have 11 follicles--8 on the left, 3 on the right.  The growth patterns indicate that I will likely be ready to retrieve on Friday, and that we may only get 8 mature eggs from the 11 follicles.

While eight sounds like a great number, it's really low, relatively speaking.  The attrition rate could knock us down to 1-2 embryos (just like the first round).  Not every mature egg will fertilize, not every fertilized egg (or embryo) will make it to the blastocyst phase, not every blastocyst will be chromosomally normal.

Once the retrieval happens, we will learn within 24 hours how many eggs were retrieved, how many were mature, and how many fertilized.  We will then have to wait five days to learn how many embryos grow to the blastocyst phase.  The embryos that make it to that phase will then be genetically tested to "weed out" the non-viable embryos.  We will have to wait 2-3 weeks to learn how many embryos we will have from this process for transfer.  Once we know that number, we can start prepping my body for the transfer, which will unfortunately take another 6-9 weeks.  We have been advised that our transfer will likely take place in December.  It's going to be a long wait, but will hopefully be worth it.  What a wonderful Christmas present it would be :)