an update from denver

Hey y'all from the mile high city. A quick update on how we're doing out west:

How many eggs you got? Something I didn't expect was that CCRM would schedule me for ultrasounds and labs every day and then just cancel them willy nilly dependent on how my ovaries were looking. Not complaining, but just a bit annoying and so thankful I don't have to be working during this time since my schedule is so wacky. On Thursday's ultrasound I was shocked to hear the tech say, "you've got a ton of follicles cooking! I count 33 total." If you've been following along, (pop quiz!) you know my baseline ultrasound was 20, so there must've been some little guys hiding that decided to show up and show out. All 33 are growing close together - which is great. It means that no one egg is getting all the love while the others are stunting. They're sharing and caring and we are here for it! Being the pessimistic, poke-holes-in-anything gal that I am, I questioned this massive increase and asked if this could be possible PCOS that we just never discovered before. The nurse simply shook her head and said, "No, you're just responding really really well to the medication." So I'd like to formally reintroduce myself as Fertile Myrtle. BUTTTT, and there's always a 'but' in this entire process (why can't it just be good news?!) because I'm responding so well to the meds, I'm at a higher risk for Ovarian Hyper Stimulation Syndrome, or OHSS. Basically this is a complication to the retrieval surgery in which the fluid that is filling up the follicles (remember these are cushy little beds for the eggs) fills up my abdomen and creates lots of pain and discomfort - particularly 2-3 days post-surgery. There is a rare (like 2-3% chance) that this requires hospitalization as that fluid can become so severe it needs to be drained. The only thing that they are telling me to do is to drink more than a liter of water a day and eat salty foods. So fingers crossed I don't get hit too bad by OHSS and can manage at home with my man nurse at my side. So all in all: good news - BUT we still don't know what the quality of my eggs are like. My doctor seems optimistic since she told us that we should consider upping our genetic testing from 4 embryos to up to 8, i.e. pay us more money. I will happily pay for that should we actually get 8 embabies - time will tell!

How are you feeling? At this point I'm on Day 10 of injections and I'd be happy to be done with them now. I started to feel fairly uncomfortable Day 8 and think I've just gotten used to it. Mostly just bloating and feeling like I've got weights on my ovaries. funnnn stuff! Emotionally, I'm feeling good, although I had a little cry this morning for literally no reason. Hormones, welcome to the party! I'm feeling hopeful and optimistic and generally just ready to get these eggs out. I am a little worried about OHSS, to be honest. But I know that even if that happens, I can go to the hospital and it's fixable. It might be worth it to get the amount of eggs we have cooking.

What's next? I've got another ultrasound and some lab work tomorrow and hopefully they tell us everything is looking good so that we can "trigger" tomorrow night. This means that Evan gets to play darts on my ass with 2 bigger needles. And if you know Evan, you know he is really, really bad at darts - so it's gonna require a lot of concentration on his end ("...but I'm better after a drink or two," he says.) These 2 shots are going to tell all the follicles that IT'S TIME and to get a move on. It's one final push to grow and mature the eggs for (as my Dad says) "the harvest." So with this timeline, surgery should be Wednesday (6/30) or Thursday (7/1). After the trigger shots, we wait 36 hours and then I head to CCRM for surgery. The surgery is minimally invasive but they knock me out for it so hopefully I just have a nice little nap while the eggs are removed by a needle that goes through my vaginal wall and into my ovary - it sucks up all the follicles and eggs. While I'm in la-la land, Evan is in the basement "collection" room, doing (you guessed it!) his difficult job one more time. After my eggs are removed and his "sample" is provided - they will use a specific IVF process called ICSI. In traditional IVF, they'd place hundreds of sperm around one of my eggs in a petri dish, but because of our morphology issues, they'll actually hand select individual swimmers and use a needle to insert it into a single egg. This has a really high fertilization rate.

So when will you know how many lil' larsens are possible? When I wake up from surgery my first question will be, "where are my glasses?" quickly followed by "how many did we get?" We'll know immediately how many eggs we were able to collect and how many were mature. If I've got 33 cooking now, I'd say anywhere from 20-30 should be mature. The next day we'll get a call saying how many have fertilized. This could be anywhere from 0-28. Then, should we have fertilized eggs we wait another 5 days to see how many make it to the blastocyst stage. This is basically an embryo that is "hatching" and ready to be placed back in the womb to become a lil bebe. This drop-off can be rough - but generally for women my age, average is 25% of how many mature eggs we collect. So if we collect 20 mature eggs (which is quite possible!) we're looking at 4-6 blastocysts. THEN, we wait 2 torturous weeks while those blastocysts are sent for genetic testing. For someone my age, 66% on average are genetically normal. So if we have 5 blasts, we can expect 3-4 to be genetically normal. These are all hypotheticals and we could be way off and either end up with 0 genetically normal blasts, or (plot twist!) 8 genetically normal blasts. That would really be a trip, wouldn't it?

So when will I know how many lil' larsens? When Evan and I feel comfortable sharing, we'll be sure to do so. I'm already dreading the 2 weeks of waiting for genetic testing and have made about 12893 reservations for fun dinners and other activities to take my mind off of all of this. So please please refrain from asking if we've found out yet. We'll share when we're ready.

Thank you all again for all your support. We are overwhelmed by all the heartfelt messages and gifts that have been sent our way. I am in awe of all the people who care about us - it's hard to comprehend.

Here are a few photos from our time so far - sending lots of love to you all and hoping everyone has a great 4th of July!

xoxo,