Tuesday, March 25, 2014

Project Butterfly: The Plan

With our appointment starting at 9am on Monday we decided to just work from home that day.  Since traffic can get crazy in our area we left the house around 7:30 and stopped for a leisurely breakfast.  I was starting to feel nervous and couldn't eat much.  Work has been incredibly busy and frustrating so I really hadn't had the time or energy to be anxious about this appointment.  I pushed the negative thoughts aside and ate as much I could, taking the Metformin on an empty stomach has never ended well.

We got to the office a little before nine and only waited a few minutes for Nurse V.  Once settled in her office she started to go over the FET schedule.  I would finish out the active pills in my current BCP pack with the last pill being take on 4/6.  The protocol includes a Lupron overlap which will start at 10iu on 4/2.  After stopping the pill we wait for CD1 to schedule baseline.  FET monitoring takes place on a Tuesday and Friday schedule.  Once CD1 arrives my baseline will be whichever of those days comes first.  If everything looks good and quiet in ovary land we will begin.

Lupron will drop down to 5iu once the estrogen injections begin.  I will continue the Lupron daily until progesterone injections start.  The estrogen will be Delestrogen, an intramuscular (IM) shot.  It will be taken every Tuesday and Friday night, the dosage being determined by that morning's monitoring appointment, until Dr. S is happy with my lining.  Once perfect lining has been achieved the progesterone stage will begin. 

I will start taking IM PIO (progesterone in oil) shots every morning.  Six days later we will have our embryo transfer.  The day of transfer we add in a vaginal progesterone as well that will be taken nightly.  There is no need for anesthesia for transfer so I will take a sleeping pill the night before and a Valium 90 minutes prior to transfer.  After our little butterfly is in my ute they’ll keep me for about 30 minutes before sending me home for 24 hours of bed rest.  The PIO and vaginal progesterone will continue daily until beta (blood pregnancy test).  If our butterfly has snuggled in and pregnancy is achieved the medications will continue through the first trimester.

With our preliminary calendar in place it was time to learn about IM shots.  IM shots are, as their name suggests, injected straight into the muscle.  The injection area is the upper outer quadrant of the buttocks.  When Nurse V pulled out the syringe I felt my heart race.  The needle is 1.5” long and extremely intimidating.  Dave will be administering the injections and we shared a nervous glance.  Nurse V assured us that it really isn’t that bad and gave instructions for icing beforehand and using a heating pad afterwards.  After going over the shots she took my blood pressure.  The number was high and she chuckled, remembering that she should have taken it before bringing out the enormous needles.

The last topic we covered was choosing our embryo.  Dave and I had already discussed it and were ready to meet with Dr. F.  Nurse V called her down and she went over our results.  Since the CCS results showed all four were normal she felt any of them would be a good choice.  In her opinion #2 and #3 were best.  #2 is a 5bb Day 6 blastocyst while #3 is a 5bb Day 5 blastocyst.  We decided to go with butterfly #2.  Overall Dr. F felt we had a great chance and was very happy with our embryos.

On the way home Mandell’s called to confirm my order.  I arranged to pick it up this weekend.  It all feels so real now.  Come late April/early May we should be transferring our little butterfly into my uterus.  I’m trying to stay guarded, but the excitement is starting to build.  Our IF journey could soon be transitioning to a pregnancy journey.

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