Sunday, November 11, 2007

Lady Business 101

Okay, it's time for a biology lesson to set the stage for the next step in this cycle. As most of you ladies know, each month an egg is usually produced by one of the ovaries. This is certainly not the case in my situation, since my cycle has been known to last up to 80 days, but if you are "normal" a few egg gets crankin' up in your ovaries every month. The eggs mature before they can be ovulated, and they are sort of racing to be the fastest one to mature because the fastest one is the one that is actually ovulated/released.

During the maturation time, each egg grows inside a fluid filled sac in your ovary called a follicle. Liane is currently taking a medication called follistim that makes her ovaries overproduce eggs, which means she currently has several follicles in her ovaries that are racing to the finish line and maturing at about the same speed. Right now, she has precisely 5 that are about the same size.

Liane's monitoring appointments are now daily to see the number of follicles and their sizes, as well as measure her estrogen levels (estradiol is the blood measure). As the eggs mature, they release estrogen, and blood estradiol gives an indication of how mature each egg is. The level is typically about 200-600 per mature follicle. She is currently in the 200 range, which means only one egg is getting even close to maturity. That is normal, since it's still early in the cycle.

The development of the follicles is monitored using vaginal ultrasounds. These are very pleasant. Billy compared the wand that they use to a curling iron without the thing that clamps around the hair. I'm glad that wand isn't wicked hot...that's about the only thing that could make it any worse. I hate the nasty, goopy feeling when they load that thing up with K-Y or whatever it is.

At each visit the ultrasound nurse documents the number of follicles and the size (diameter) of each one. A mature follicle is typically about 1.8 cm. When several follicles get close to that size, Liane will have to give herself a shot of human chorionic gonadotropin (HCG) to force ovulation. 36 hours after that shot, she will have her eggs retrieved.

Her 5 follicles are currently measuring around 1.0 cm, which means they are not near maturity. She will begin to administer a shot called Ganirelix when her follicles grow a little and her estrogen gets higher. This medicine will keep her body from ovulating on its own. They will let her know when it's time for that.

The nurse called me this afternoon and said that everything was going wonderfully, and I should just keep up the same medications. Liane will keep up the same dose of the follistim, as well. I was sure glad about that because if she needs more, I'll need to rob a bank. That stuff is almost $1 per cc. I bought a 600 cc vial on Friday for $490...that was the discounted rate.

That's the latest and greatest for now. Liane will be monitored again tomorrow, and I'll post a follicle update. My next appointment is on Wednesday morning to ensure that the medicine I've been using is doing its job and making my uterus a happy place for embryos to make themselves at home.

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