IVF Prime Time aka Sweet Talkin’ Those Ovaries

It’s week 3 (outta 5) of BCPs (birth control pills) and Monday I added testosterone patches (Androderm) and estrogen pills (I take estradiol, the generic of estrace) to the mix.  We are in: the priming cycle.

I look at it as time to stroke my ovaries’ egos.

“Look how pretty you are, little ovaries.  My you look nice today. Hey….how’s about some of this testosterone, it’ll make you feel real nice.  Oooo….have some of this estrogen….see isn’t that good. Wow, you are just the best little ovaries. I bet you could make lots and lots of follicles if I asked you real nice.”

Ew.

I just creeped myself out.

What is a priming protocol you say? Yeah, I had to research it myself.  There’s actually not a super ton of info on this online but I was able to find some – and, I’ll be able to ask some more questions when el hubbo and I go in next week to sign all the consent forms.

Here’s some info I found on Estrogen Priming Protocol (EPP) at http://estrogenprimingprotocol.blogspot.com/:

  • Like BCPs in longer IVF protocols, estrogen is used in EPP to down-regulate FSH receptors. By providing external estrogen, the hope is that the pituitary gland will think a follicle is developing (follicles produce estrogen) and will thereby reduce the amount of FSH (Follicle Stimulating Hormone) it pumps out. This “break” in follicular development give the ovaries a little time off at the spa, and allows the RE (Reproductive Endocrinologist, aka puppetmaster) to take control of the woman’s cycle. In addition, it will promote estrogen dominance in the follicular fluid, which is believed will help protect the developing eggs
  • EPP is an aggressive form of an IVF Antagonist Protocol. It is used for low/poor responders — often women with high FSH and/or over 35 years of age. It’s a sort of “slow burn” methodology — the hope being that they slow you way down and protect egg quality while allowing you to stim longer. In addition, the slower stimming allows the hope that all active follies can catch up to each other, allowing for as many mature eggs at retrieval as possible.

There’s less information regarding testosterone priming, but I did find the following posted on the forum page at fertilitycommunity.com – it is one woman’s experience with testosterone (and a bit on ganirelix, which I’m also using) and her RE’s information:

  • “…..my RE felt that our egg quality may improve if we could increase the amount of estrogen reaching the follicles prior to stims. Based on his research, there has been some success in increasing natural estrogen levels by using nightly testosterone patches. We also used ganirelix/cetrotide during the week before stims to ensure that no lead follicles developed (which would have deprived the remaining follicles of estrogen/stims). So we were tackling two problems at the same time – the testosterone was purely for quality issues, while the ganirelix (plus a higher dose of stims later) was designed to increase the number of eggs retrieved.” 

But that’s all the science. What’s the day-to-day like?

Last time I had no side effects from either the testosterone or the estrogen, and I’m expecting that’ll be the same again this cycle. The estrogen (estradiol/estrace) is a tiny blue pill that super easy to swallow.  The Androderm patches have a sticky surface and you just slap them on and leave ’em ……IN THEORY.

I’m not sure if I mentioned it last cycle, but those Androderm patches would not stay on my person all by themselves.  The first morning I woke up and that sucker was stuck to the sheets. The stupid little two-timer was already cheating on me. I had to use medical tape to tape it to myself, which is fine, except that when you take the tape off it leaves that sticky gross residue that dust and dirt and other crap just clings to.  So basically, I spent/will spend a few weeks having lots tape residue gunky splotches all over myself.

Not the sexiest….unless grundy Pigpen is your thing.

Also, I had more discomfort pulling off the tape every night to switch the patches than I did from most of the shots. Just sayin’.

I was told the patches can go on your belly, your thighs, your fanny can, even your back – just make sure to rotate them around so that you’re using a new patch of flesh over the course of the week – i.e. don’t use the same place twice in one week.

Alright, enough of this, I gotta get back to complimenting my ovaries.

“Hey there ovaries, ooooo damn, you lookin’ SO FINE.”

Yep.

Still ew.

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The 2WW: The Beatles Were Right

So we’re about halfway through our slightly abridged 2ww and are 6dp3dt. For any of you not in the acronym know, 6dp3dt = 6 Days Past 3 Day Transfer – and we’ll blood test on Day 12.

I’m having a much easier time with this wait than I did with other periods of waiting in the process: waiting to stop birth control, waiting for meds, waiting between scans, etc. It’s an odd thing to know that right now, as we speak, I am either pregnant or not pregnant….it’s simply too early to tell.

Throughout the time I’ve been trying to get pregnant I’ve read a lot about the 2ww (and have been in it many many times) and mostly I find myself shaking my head at people.

You just have to wait!

Time has to pass – there’s no changing it.

So for me, I’m NOT going on the internet to read too many opinions by too many people without any medical knowledge, I’m not reading into every little thing my body’s doing, I’m not over-thinking every little moment, and I’m not going out to buy pregnancy tests before there’s any chance of them registering anything accurate.

You know why?

Because I’ve done some of that before and it got me nowhere. I also hate to pull the age-card, but I am 42….at this point there’s some life experience to lean on. I know that to do any of the above things is pretty much like punching myself in the face, running around the house with a scissor, or like covering myself in peanut butter and then taunting a bear.

I’d be knowingly setting myself up for confusion, discouragement and frustration.

And frankly, I like none of those things.

In other news, I’ve been doing progesterone shots since last Saturday’s egg retrieval and so far so good. The nurse was kind enough to draw a circle on each fanny so that I’d have a target – and I’ve been retracing her lines every few days. Man I hope I’m not in an accident or anything, though I’m sure it would give the EMTs a good giggle to see a grown lady with circles on her butt cheeks.

A note on these shots: the needle is intimidating, because it’s an inch-and-a-half long and you know it’s all gotta go in. Honestly though, it’s so sharp that by simply resting it on my skin and pressing a bit the needle does all the work and after the initial sting from the tip of the needle it really hasn’t hurt at all. I shit you not. Perhaps I’m lucky and have a high threshold for pain, but after reading so many things on the interwebs about how awful they are, I really have thankfully not had that experience. I’m able to do them myself and they go pretty quickly.

I put a bag of frozen vegetables on first, do the shot, rub it around and then sit on a heating pad for a few minutes afterwards to help the oil work its way in. This is what works for me.

The progesterone’s another reason it’s easy not to read into every symptom, because likely it’s the progesterone’s fault. I’m a little sleepy, yesterday had a teensy bit of nausea and I suddenly have a decent set of knockers. They’ve grown enough that I really don’t need to wear my “smoke-and-mirrors” bra unless I really want to vavavoom it.

So alas, we’re in a good place: lots of movies, books, cooking and general chilling out. Time’s actually passing fairly quickly, we’ve been laughing a lot and life kind of plods on as usual.

Soon enough we’ll know which road we’re taking next and in the meantime, in the words of the great Paul McCartney, we’ll Let It  Be.  

Wow, that was super cornballs, even for me.