Stimulation Injections and Monitoring Scans

Stimulation Injections

My protocol for this cycle was Menopur 150iu daily and Cetrotide O.25mg daily (Cetrotide started on day 5 and is to help prevent ovulation).

Through this cycle I have discovered that I much prefer injections in the leg to injections in the tummy :). Didn't mind the leg ones at all; something creeps me out about having a needle pointed at the stomach though, it's such delicate and tender skin. Everyone's different, some people prefer the tummy.

First Monitoring Scan

On day 6 of the stimulation injections we had our first early morning scan and blood test. The scans are done internally - ie vaginally. At the first scan, 17 follicles measuring between 8-12mm were counted and I was over the moon! Hubby and I went to a local country park to walk the dog afterwards, I wasn't feeling too uncomfortable at that point and just had a stitch-like feeling from the follies growing. It was a beautiful day and full of peace, we just floated around all over the place!!! The clinic called at 2pm and told us to continue medication as before (my blood test results were normal - the clinic are looking for risk of OHSS) and to come back for another scan in two days.

Second Monitoring Scan

On day 8 of the stimulation injections we had our second monitoring scan and blood test. It's not normal to have so many blood tests, but due to having PCOS, being under 35 and slim, and having lots of follies responding I am a high OHSS risk.

At this scan I had 19 follies over 8mm, but I was quite disappointed as they didn't seem to have grown much in size, and one was miles ahead of the others in size at 16mm. It was at this point that I learned that clinics look for 3 follicles of 17-22mm in size for egg collection, and I felt really disheartened as we seemed miles away from that (little did I know!).

The clinic called in the afternoon and told me to drop the Menopur from 150iu to 112.5iu that night. Cetrotide stayed the same. Blood work was normal.

I was very sore this day; it was the sorest day. I could physically feel the follies stretching and growing inside, it felt like a burning. Walking began to hurt. I had a training day for new job and it was very unpleasant!

Third Monitoring Scan

On day 9 of the stims we had third scan and blood test. Felt relieved and overjoyed when my lovely original follies had grown lots and lots more, an incredible amount (guess that's what the pain was!). I had 30 follies over 8mm and we had two ready for egg collection at this point. Blood work had increased fairly dramatically but not enough to worry them. After this scan, a lovely nurse (all the staff at Care Nottingham have been so lovely) took us into a private room and told us that our egg collection was likely to be Friday and that my trigger shot would likely be changed from Gonasi (containing HcG) to Buserilin (which doesn't contain HcG). The reason for this is that HcG triggers OHSS.

I was not so sore this day, although this scan was the first to hurt (I guess as my ovaries were taking up a lot more room!). Hubby and I were 'intimate' this night in preparation for EC (sorry TMI!); we were told to be intimate 2-5 days before egg collection, and it was quite sore for me.

When the clinic phoned us in the afternoon, they told us to drop the Menopur from 150iu to 75iu that night. I became very anxious as I was worried that we wouldn't have very many follies ready for collection by Friday, and I couldn't feel them stretching and growing any more.

Fourth Monitoring Scan

On day 10 of stims (our trigger shot day) we had our fourth and final monitoring scan and blood test. The blood work determined whether egg collection would be Friday or Saturday - if it showed me to be at risk of ovulation it would be Friday, but otherwise they would leave it 'til Saturday to give the little follies time to grow. At this scan I was again thrilled and overjoyed as the follies had grown lots and lots.

We saw a nurse after scan and blood test who taught us how to do the Buserilin trigger and prescribed me some Cabergoline to prevent OHSS. She warned me that this would likely make me feel very poorly - in her words, 'not many ladies tolerate it'. This made me feel very nervous - what was I letting myself in for? She predicted that if we did egg collection on Friday I would have 17 eggs and I was OVER THE MOON!!! It felt like God specifically and personally addressing my concerns.

That afternoon the clinic phoned and confirmed that egg collection would be Friday and I should do trigger shot and start Cabergoline that night. I didn't have Cabergoline side effects that night (phew!!) but Buserilin gave me heart palpitations and hot flushes and I only slept about two hours that night.

Luckily I had no warning signs of OHSS - the clinic said that my blood work was at the higher end but not abnormal or dangerous, and my stomach was no more bloated than before a period. However, I spent most of this week on the sofa as walking was sore, and the clinic told me to rest as an OHSS preventative measure.