Egg in Hiding

Had another appt for an u/s and b/w at the clinic this morning. Bright and early this morning, at 6am to be exact.

Since my expectations were more appropriately set, I was in a much better mood to handle what they might have to say. The follicles on the left ovary are measuring well and are pretty much ready for retrieval, there are even four instead of three. And surprise of all surprises, the right ovary does contain one measurable follicle that will also be available for retrieval. The little stinker must have been hiding behind some of my bowel yesterday.

For those of you who are not familiar with the IVF process, or the female reproductive process, for that matter, here is a little education for you. (interjected with my additional comments in italics)

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The ovaries are magnificent glands which are part of the female reproductive system. The ovaries are about the size and shape of an almond and sit just above the fallopian tubes -- one ovary on each side of the uterus. Every month during ovulation, either the right or left ovary produces a single mature egg for fertilization (which is contained within a follicle). Although only one egg usually fully matures during ovulation, somewhere between ten and 20 follicles begin the process of maturation monthly. (This is where the IVF process differs, as the object is to stimulate and grow as many of those follicles as possible, so that more eggs can be retrieved and the likelihood of success is increased) The excess ovarian follicles are reabsorbed before ovulation occurs. (which is likely what happened to the other follicles on my right ovary…the bastards )

The process of ovulation is started and controlled by a drop in the hormone estrogen (mostly estradiol) to a low level (this is the hormone they are testing for every time I go in to get blood work). When the drop in estrogen levels occurs the hypothalamus (a part of the brain) is signaled to increase its secretion of gonadotropin-releasing hormone (GnRH) thus sending a message to the pituitary gland to increase its secretion of follicle-stimulating hormone (FSH) (these are the hormones I am injecting in mass quantities on a daily basis). The increase in FSH causes the growth of ten to 20 of the ovarian follicles.

Estrogen is secreted by some of the cells in the follicle. Just before ovulation occurs, the follicle that contains the maturing egg eases toward the surface of the ovary. Once the matured egg reaches the ovarian surface, ovulation occurs when the follicle and the ovarian surface open allowing the egg to drift out of the ovary. (I am also taking another daily injection of meds called Lupron, and this drug is preventing my body from triggering ovulation on its own. Instead of the egg breaking through the surface of the follicle on its own, it will be extracted during egg retrieval…I will explain this process in my next post or so)

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Overall, I am feeling a little more positive and hopeful today. The news this morning definitely helped, but I also had a nice chat with my nurse yesterday afternoon that made me feel better. She pointed out that egg quality over egg quantity is what they are looking for and that having fewer, more quality eggs, gives us just as good a chance as someone with a lot of eggs, some of which could be of lower quality. She also said that my E2 (estradiol) level was great. Came back at 580, which is where it should be. Typically they like to see the E2 number double every 48 hours, so at that rate, I should have been around 560 on Monday morning (roughly 72 hours after my last test). Can’t wait to hear what that number is today!