Day 21 - Progesterone 6.3

Ok, so jumping straight in on a little biology. Egg freezing is essentially like IVF - a bunch of weeks of hormones and then egg extraction. Except in IVF the eggs get fertilized and put back in, but in egg freezing, the eggs are frozen for later use.

1. Depending on your age/fertility level, you take shots of a gonadotropin-releasing hormone ( GnRH) agonist to shut down your reproductive system for a bit (if you're a little older, you might skip this part)
2. Some days or weeks later, you take shots of a different hormone stimulate the hell out of the ovaries to make tons of eggs. Actually these eggs are already there, but usually, in a given month, your body produces only enough hormone to "ripen" one - and the rest just dissolve. By taking added hormone, you get as many as possible to ripen. (it's not like you're pulling forward or borrowing future eggs - you're just giving all the eggs already tossed out for that month the hormone they need to get to mature stage. Those eggs, whether you took shots or not, would never be available in the future).
3. Once all the follicles are large/ripe enouogh, you get one big shot to cause ovulation. This is the only real scary-ish shot. It goes in the butt (the fertility clinic can draw a circle on your butt to show you where to do it) and it's a biggish needle because it has to reach muscle
4. Right before ovulation would have occurred (36 hours after that big shot), they put you under light anesthesia (you don't need intubation - but you're out of it) and empty each follicle to get the eggs. Decent egg retrievals should get between 10 and 30 eggs. Average is probably 10-15. Lower than 10 is considered pretty low, and near or over 30 means you were hyperstimulated and are probably in a little bit of medical messiness. For what it's worth, if you end up with fewer than 15 worth freezing, they will probably recommend another cycle. 15 or above is considered stellar so long as you haven't overstimulated. If I end up with 18 or more, I'll be ecstatic.

There are two basic protocols for the egg retrieval procedure. There's the short (most common) protocol, and the long day 21 protocol. I'm on the day 21 protocol, which means I start the program on day 21 of my cycle before the cycle where eggs are retrieved. For people on the shorter protocol, they don't do anything until day 2 or 3 of the same cycle when the eggs are retrieved. I could say a bunch about my understanding of who gets put on the long vs. short, but basically, if you're a "good" (i.e. young) candidate, they may choose to put you on the long protocol because it produces higher quality eggs and because younger candidates are at higher risk of responding too well to stimulation, which can be a problem. The longer protocol just involves a longer period of time when they shut down your system before stimulating it. If you're more borderline, they don't want to shut you down for too long, for fear that there will be problems waking everything up

These are some of my stats that make me a good candidate for the long cycle

Age: 32
Day 3 hormone tests:
FSH: 6.1
Estrogen: 24

Ovarian Ultrasound: Many Follicles. Like up to 30% of women, I have a very very high number of ovarian follicles. This can be bad, as it's the biggest sign of PCOS (polycystic ovarian syndrome) which is a major cause of infertility (most women with PCOS don't ovulate) and other problems, like excess hairiness and acne. However, I probaby do not have PCOS since I definitely still ovulate and don't have those other symptoms (i.e. not hair and not prone to acne). Only about 1/3 of women with high follicle counts on their ovaries actually have PCOS. But the high follicle count means I *should* make lots of eggs with very little help needed. So it's actually a plus here.

Ok, that was more background than I intended. Anyway, so although this is day 1 of my "treatment" I could also call today "day 21" for me - because I started my last period 21 days ago and in fertility stuff, they often reference the day by where yo are in your cycle. So I'm going to go from 21, 22, 23 ..... back to day 1, day 2, day 3 etc and will probably have a retrieval in the early teens of my next cycle. Anyway, so today being day 21, and my being on the day 21 cycle, I went to the fertility center this morning to get a blood test to make sure I've already ovulated this month - my progesterone came back at 6.3 which means I ovulated a few days ago. So we're good to go. That means my first shot is tonight.

I'll be on lupron (the antagonist - there's another brand called "antagon" and the choice of which you're on might just vary with what your insurance covers) until I start my next period (expected 8-12 days from now) and then 2-3 more days. Then I'll go back for bloodwork and an ultrasound. And then suddenly I'll start calling myself on day 2 or day 3 as if that makes sense to come after already being on day 21, day 22, etc. It makes sense. You're smart - You get it. Right?