The good news is my coasting and using Cetrotide seemed to work. My estradiol levels was much lower today and I was given the green light to trigger. I am so glad we are in the final stretch.
We spent the weekend relaxing and I started to calm down about OHSS. When I didn't move on the couch, I felt great. When I got moving around I was really full and uncomfortable. By Sunday night some of the fullness had resided and I was confident things were looking up.
This morning's appointment went fine. The NP really scared the crap out of me about OHSS and said if I were a "risk taker" she would suggest I continue with the trigger. If I were "more conservative" it might be best to withhold the trigger and cancel. She said most people do take the risk and continue with the trigger. The morning went by slowly as I waited to hear.
My follicles had continued great growth. I had 2x13 mm, 3x14 mm, 2x15 mm, 1x16 mm, 2x17 mm, 4x18 mm, 3x19 mm, 1x20 mm, and 1x24 mm. Estradiol was 1215.
So then I spent the afternoon worrying that it dropped too low. When the nurse called and told me the levels and that I should trigger I asked whether it was a problem they dropped so much. She said "that's what we wanted." When I asked whether I should do any more Gonal-F she said no.
I also got a prescription for Dostonex to help prevent OHSS. I start that tonight with the trigger. They will also put me on Lovenox which doesn't start until after the retrieval.
How can one go from fear of too high of numbers to too low of numbers in 2 days? I think the most important thing is that the follicles had continued growth and still look good. I consulted Dr. Google and found this:
"If you started cetrotide just before the estradiol drop it may simply be due to this; cetrotide and ganirelix will artificially lower your estradiol level and doesnt actually have any clinical relevance. (In other words the estradiol level becomes unreliable as a gauge of follicle size or growth when one uses cetrotide or ganirlelix). In such antagonist cycles you must go by the follicle sizes and their development in order to know when the stim is adequate, and most importantly, when to trigger with hCG."
So trigger is tonight at 9:30 and I go in for retrieval at 9:00 on Wednesday. I am so ready for retrieval it's not even funny. Man, IVF is such a ridiculous roller coaster!