How's it flowing? (post by Jessi)

Appointments, appointments and more appointments.

 

Dr Merhi

The Vermont Center for Reproductive Medicine has a "work-up" of required appointments necessary prior to moving forward with the actual egg retrieval process, fertilization and transfer of the embryo back into Maggie, the carrier. (Yes, this is our new lingo, Maggie will be the carrier!).  Way back in March (I think) Ben and I met with an IVF physician and began the process of prerequisite testing to rule out any pre-existing fertility issues. Good news, no fertility issues were identified.  My ovaries look stellar for the ripe old age of 33 and Ben's sperm count is, to say the least, admirable.  Dr Merhi, who we met with initially,

actually raised his eyebrows in surprise as he read Ben's tests results for the first time in the exam room.  After hearing the results, Ben immediately puffed out his chest like a peacock and I was unmercifully subjected to commentary regarding his proud and mighty sperm army for, at least, three weeks following.  

So here we are. My stellar eggs, Ben's undefeatable sperm army and Maggie's superb and pristine uterus.  This is nothing short of a winning combination and although they'll never admit this out loud, I can sense that the fertility clinic feels like they've got this one in the bag. The only obstacle is retrieving my eggs without complications.

And, about that! Usually, egg retrievals are low risk outpatient procedures. They pump you full of hormones to confuse your body into thinking it needs to produce as many eggs as possible.  In order to manipulate when your body is ready to ovulate however, the IVF clinic puts you on birth control pills.  This "quiets down the uterus" and any related menstrual cycle activities. (So far, the preceding phrase in quotes is our friend Kate's favorite new terminology). Once your normal hormone bodily functions are suppressed with birth control pills, the egg producer (me) would take several hormone injections for about 7 days, assuming all goes well, and then one giant dose of HCG to kick of the ovulation party.  Precisely 35 hours later, the egg retrieval procedure is conducted and, BAM, you got eggs!

In my particular case, the IVF team chose to avoid the use of birth control pills because it would unnecessarily add additional hormones to an already hormone-filled body.  Also, hormones increase the risk for blood clots and stroke (which is rare but it still happens) and given my unique cardiovascular condition, why subject me to any more risk than necessary?  So what does this mean for me?  It means we have several, in-depth conversations about my periods, how long they are, how heavy they are and how often I have them.  

For my entire life, I’ve been an open book when it comes to personal medical issues.  It probably has something to do with growing up as the child prodigy equivalent of a pediatric cardiac patient.  If I had a dollar for every medical student that wanted to listen to my heart murmur…!  But somehow when being an open book involves talking about one’s cycle, the conversation inevitably becomes awkward.  

One of the last appointments required to move forward was a joint meeting with the IVF Fellow, Dr Davenport.

Dr Davenport

 Maggie, Jim, Benny and I met as a group in a tiny exam room with Dr Davenport to discuss the process at a high level and make sure everyone had a common understanding of the procedures, potential risks and likely outcomes.  However, the conversation quickly evolved into a discussion about how the clinic decided not to put me on birth control pills, opting instead to time the hormone-laden injections with my natural ovulation cycle.  And, as you can imagine, much discussion about my cycle commenced.    

Here we are, arranged in a tight huddle discussing the details (and boy, do I mean DETAILS) of my menstrual cycle.  “Basically, you’ll start hormone injections on the third day following your first real flow,” Davenport said.  To which I replied, “well, I don’t really have flow.  I have an IUD and I just spot.”  Davenport - “But does it get heavier at any point during your cycle?”  Me: “Not really, just spotting.”  Meanwhile, both Jim and Benny are slowing sinking in their chairs, avoiding eye contact with everyone in the room.  They looked like school boys doing their best not to get called upon by the teacher.  They wanted to evaporate, to spontaneously combust or be abducted by aliens.  Anything would be better than listening to the nitty gritty patient-doctor details of my menstrual cycle.  I could feel the flushing in my cheeks as this discussion continued for another 10 minutes but they hung in there like champs, nobody fainted or vomited and soon we all went on our merry way.  

So that’s basically where we stand now.  All of the prerequisites have been completed and we’re patiently waiting for Aunt Flo to grace us with her presence so we can get this baby train moving.