Today was our fourth scan, and man, did it hurt! When she started the ultrasound today, I winced in pain because I could feel that my ovaries were swollen from the follicles that are growing inside. I might’ve also been just hangry because I had to fast this morning so they could run some blood tests and a urine analysis for the anesthesiologist. By the time we got to the clinic by 1030am, I was pretty ravenous and asked Anna if I could get the blood and urine work done pronto so I could eat something, and she helped set it up right away.
Then we got called in for the doctor, and K stood by as she started measuring, and the largest one is 15.8mm, which is great! In the past cycles, I would usually trigger around 16 – 18mm, and wondered if this would speed up my egg retrieval, but instead she changed my protocol to decrease Gonal-f to 150, and upped the Merional to 225. She also started to put me on Cetrotide so that I wouldn’t ovulate early, which is what I was concerned about.
Next scan is this Saturday, but in the meantime, I’m hoping my ovaries will behave and relax so that the next ultrasound won’t be super painful. I am starting to look like a bloated fish, so I know the time is pretty near. She is still estimating next Tuesday, which seems far and close at the same time, haha.
We also asked if they would do ICSI, and they said they would. I also asked how long it would delay the embryo transfer to do PGD on all of the embryos. She recommended that we should do a fresh transfer with the first 3 blasts without PGD first, and if that failed, we could do PGD on the rest of the embryos that they would freeze on day 3. The doctor said that she wants to attempt doing a fresh cycle at least once before moving onto the frozen embryos. In this clinic, they really are big believers in fresh over frozen, and since we’ve never had a fresh embryo transfer because I always had OHSS, we thought this plan was a good idea.
Today we came in for our second scan at the clinic, and I was a bit nervous to see whether my follicles were developing. I have already been feeling the heaviness that comes with the stimulation, but since it had only been 4 days of stimming, it wasn’t too bad. We met with our doctor, and she took a look and told me that she could see a ton of little follicles, but since we’re so early in our cycle, that she wanted to see me again the following Tuesday. Before she took a look, I made sure to have K stand next to the ultrasound machine and look at the screen, because the more information, the better! He said he could see a bunch of them, but they were still tiny. I’m guessing in American standards, they were all less than 10mm.
The doctor decided to up my stims so that I’m now taking 200 Gonal-F and 150 Merional, and since I had already had my shots that day, had me go downstairs in the clinic to get the additional 75 Merional from the nurse. In general, our trip was really quick, although the clinic was very busy, and full of surrogates and clients waiting for appointments. I’m realizing more and more that the long wait in the clinic that I’ve read about from other reviews are solely dependent on which package you choose.
After meeting some other nice folks in our hotel, I’ve also come to realize that there is some confusion about the room size at the Venice hotel. Apparently, on the website, the pictures that they have are of bigger rooms, which is not like the rooms that most of us stay in at the hotel. Also, all the rooms are a little bit different in the fact that the bathroom might have a completely different decorating scheme.
One of my personal goals while being here is to lose the weight that I gained while doing fertility treatments in the past 5 years. I would say that I’ve gained about 40 pounds from start to finish, so I have been focusing on eating low carb and doing some sort of exercise everyday. Ever since the pool opened up, I told myself that I would do 10 laps every day, but on some days, it has been too cold to go in the water, so I try to walk instead. Also, since we’re on the 4th floor and the elevator is currently not working, we get some built-in cardio every time we leave our room to go anywhere :)!
So for better or worse, the time has come where I start my IVF stimming meds. Every time I think of doing injectibles, I think of salmon roe as pictured above, because my ovaries always feel like this! Today, we went to the clinic and sat down with the doctor and our manager Yaryna. I told them of my egg retrievals and that due to my PCOS, I develop a LOT of eggs, and it can be easy for me to get hyper-stimulated, which has happened twice in the past. The last time I did an egg retrieval was about a year ago, and in hindsight, I realize I probably should have gone to the hospital a day earlier since I was in a lot of pain just walking. The obvious solution to this problem would be to do low dosages of the hormone medications, but the tricky part with me (also due to the PCOS) is that I don’t respond at all to low dosages. So it’s a constant rollercoaster because I have to high dosages to start, but me monitored a lot to avoid hyperstimulation. Back in Boston, this meant going to the hospital every two days before work, and the process just wore me out, so I’m thankful that everything is convenient here.
My doctor, Yulia Kotlik, decided that I should start off with 200 Gonal-F and 75 Merional, and that I should start my stims the following Wednesday. Merional is something that I had never encountered before, but it’s pretty much the same thing as Menopur, except that it is an intramuscular shot for some reason. This was new to me, because all of the IM shots that I’ve had in the past were the progesterone-in-oil shots, but I was relieved to find out that unlike the PIO shots, it is relatively painless, and it doesn’t feel like the hard lumps that I’ve had in the past with the PIO shots. I’ve been directed to go down to the nurse’s office inside our hotel at 10am everyday so she can give me the shots. I’m used to doing them myself, so I’m not sure if this is part of them making sure that I’m following the protocol and not doing anything funky, or if it’s just a nice plus for us because of we’re staying at Venice. Either way, I’m going to follow directions (for now, haha) and see how things go.
After the clinic, we met up with a friend named Valentina, who was introduced to us through Shabana. We asked her to take us out for some authentic Ukranian food, and she said we should meet near St. Andrew’s Church, one of the many beautiful churches in Kiev. One thing that Kiev and Boston have in common is the turbulent weather, where it can be sunny one second, and pouring another. On this particular evening, it decided to pour, and I was fascinated by how the roads just filled up with water, rushing towards some storm drain that I couldn’t see anywhere. It literally covered the sidewalk, and for a second, I thought we would get stuck in the water, but it died down quite quickly.
We arrived at Andriyivskyy Descent, and went to Kapana, which is known for authentic Ukranian cuisine. We had so much fun with Valentina, learning about Ukraine and its history, relations with Russia and Genghis Khan, and the beautiful buildings that surround the street. Because it rained, there were no vendor in the streets, but usually, this is the place to get some awesome souvenirs, which we made a mental note of for the way back. We ordered some potato croquettes, a bowl of borscht, a fish dish, and chicken kiev, and it was all very tasty! They are famous for a particular dish, but the waiter was honest with us and told us that there is no cabbage right now, so it would not be as good as it would be in September, when they have fresh cabbage in season. I thought it was so nice for him not to try to rip us off, especially since he could totally tell that we were foreigners.
Tomorrow, we plan to go to check out the Pechersk-Lavra, which is the famous bell tower in the city and includes the monastery caves (eek), along with the Miniatures Museum. More to come soon!