IVF Documentation

Yes, I know I said I didn't want to become a poster child for these things, but I felt this must be documented, as it was a HUGE part of my life. And this is really such a miraculous process, that I thought it wouldn't hurt to share a bit of modern medicine with everyone. If you haven't done this yourself, I think you'd be surprised at the detail and precision it requires. I did a few slightly different protocols, but I'll try to sum it all up for you.

Note: This will contain reproductive terms, that are otherwise not present on my blog, so they might come as a bit of a shock. But for this purpose pretend it's normal, everyday language for you, like it is for me. I'll leave out the really graphics terms.

When we went to see the fertility specialists, I thought we would start the IVF process immediately. Wrong. After months (about 6) of tests from several different doctors, my body not working, KC's doctors not cooperating, insurance being weird, blood test after blood test, lots of contracts, lots of signatures, and practically signing our life away, we finally began. (I think my nurse got tired of me practically begging to let us start, even though she couldn't without everything in place.)

It starts with old fashioned birth control pills. The doctor does this to get all my hormones in the right place, so he can fill me up with the prescribed meds on a clean slate, so to speak. I still remember when I nurse told me I could take that first pill. I cried, I was so happy. We had been through so much to get to that point. It's a long story about uncooperative hormones, interrupting doctors in their offices, and pleading. I really learned to push my weight around to get things done. It worked.After 21 days of those, I started the "stims" meaning the stimulation medication, to begin the process of growing many follicles in my ovaries. Usually, in a normal woman, one or two follicles are made producing one or two eggs. We needed a lot more than that to create many embryos, hence the stims. Infertility meds are extremely expensive, but we were lucky that our insurance did cover them (though not procedures) costing us only a couple hundred per cycle and saving us literally thousands of dollars.

My dresser turned into a small pharmacy. It later became all about adoption. I guess it's an easy, out of the way place to stash things that I want to keep an eye on.




Here are the specifics:

Lupon/Leuprolide-not actually a stim but taken before them, as a suppressant so that I don't ovulate until they are ready for me to or something like that. On another cycle I used something called Ganirelix instead that I took toward the end of stims to probably do the same thing.
The stims are just done with a tiny needle, right in my abdomen. I'd switch sides. My tummy would get all polka-dotted and bruised. But they didn't really hurt. Except sometimes when the needles were a little dull from measuring. Then you really have to jab. Here's is the process before taking most meds:

Gonal-F-taken usually in the morning and night.
First I have to mix it with this little kit.
Then I pull air to my prescribed amount of medication.
Wipe top with alcohol, and insert the air into the bottle to equalize pressure when the liquid is extracted.
Pull out amount needed, no bubbles, and you are ready for a subcutaneous injection (I chose the abdomen, but there are other places you can do this). I'll spare you the poking.
Menopur-taken in the evening. One mL of water mixed with two vials of powder (or more/less if needed) using this q-cap for easy mixing. The q-cap is twisted off, and replacd with a small needle that like the one above, then injected. This med actually stings a little going in, but it dissipates very quickly.

Remember, this was only one cycle. As they got to know my body, they'd try different things for different results. Every body's dosages are different. So I did about 3-5 shots a day, and took about three pills (mostly vitamins) for about two weeks as far as stims go (we really had to plan social events around this, or bring the gear with us).

So, those shots weren't so bad, right? Just wait.

I also began a series of blood work, and ultrasounds to track the progress of the growing follicles and my hormone levels. They can't see any eggs growing, but they can see follicles-sacs of fluid-that each, most likely, hold an egg. This is how they estimate how many eggs I will produce. In the beginning of the two weeks, I went into the office every 3-4 days, but as they grew closer to being "ripe" as I like to term it, they needed me to come in every other day, and then every day(sometimes 4 days in a row) to make sure everything was on track. My arms also became bruised and sore from getting poked so often, but it wasn't so bad. This office is a 35 minute drive from my house and my appointments were usually at 8 am and lasted about 15 minutes. They measured the follicles, (it looks sort of like a honeycomb, all the follicles squished together) and once they get to a certain size (if they are too small, the eggs won't be mature enough, if they get too big, the eggs with be too mature, and non-viable to make an embryo) I stopped the stims. Then KC gave me the trigger shot, the HCG hormone, triggering ovulation in exactly 36 hours. That must be precise. For example, we were given strict instruction to administer the injection at exactly 10 pm on a Sunday for a egg retrieval scheduled for Tuesday at 10 am. By this time my ovaries were really hurting. It actually hurt to sit sometimes. It's mostly just pressure since they were the size or walnuts. I was also extremely exhausted all the time.

HCG-This is where the fun shots start. Again, you have to mix a certain amount of water to reconstitute the powder, but this one has to be injected with this long needle intramuscularly (in the upper-outer quadrant of the buttox-really my hip). This is a pretty thin solution, so it goes in pretty easily. But it is a long needle, and my muscles don't like it. KC does these since it's hard for me to reach. I'm usually pretty sore for a couple days. Still more needle fun to come.
If I don't get into surgery exactly 36 hours from that shot, I will ovulate before they can extract the eggs, and there is no way to get them once they are out of the ovaries. It's a tense time.

This is surgery, requiring anesthesia, so there is also no eating/drinking 12 hrs. prior, and I have to take this nasty antibiotic, that makes me extremely nauseous. I HATE it. KC also underwent a minor surgery only during the first cycle. He is hilarious when recovering from anesthesia, btw. Also, I love going under. I actually looked forward to that nice nap.

After, we are told the number of eggs I have produced, sometimes different from the number of follicles, and I have ranged from 8-14 in the few different cycles we've done. We are called everyday with a fertilization update. Usually, not all of the eggs fertilize. I usually had about 50% fertilize. The second day after fertilization, we were either told to come into the office tomorrow for a day-3 transfer, or when we got in the office, were told that we could also wait until day-5 blastocyst trasnfer to really weed out the strong ones from the weak. It is hard to tell sometimes, and they really don't like to transfer more than two into someone my age. (Don't even get me started on the scary octuplet lady. My doctors are not happy at all with her and her doctor's unethical procedures and giving IVF a bad name.) About 50-75% of my remaining embryos made it to transfer date. I have transferred two every time-twice on day-3, and once on day-5. Oh, and you have to have a full bladder for this. It's very uncomfortable considering my positioning and the ultrasound pressing on my tummy. I'll leave it at that.

Then the horrifying waiting begins. I turn into a nervous wreck during the two weeks between transfer and blood test to detect the HCG-pregnancy hormone. I have to be on bed rest for about 24 hours, and then light activity for the next few days. But still, even though they said moderate to normal activity after that, I was still so scared that I was doing something wrong, and would hurt our chances of a positive test. It's truly an agonizing time. But we got through it. I watched lots of movies, gave into cravings (since I was pumped with pregnancy hormones, I had the same cravings) and said lots of prayers. Oh, and I had to take new pill and a new injection.

PIO-Progesterone in Oil. The thickness of this med is the annoying part. You measure it with a really thick needle (easier to extract), making the one that you are actually going to inject with (same as HCG) look less scary, though it still kind of is. I like to ice my hip for about 5 minutes numbing the area. KC swabs, then pokes in a darting motion (I'm glad he has to do this, because I don't want to see that 1 1/2" needle going in), and pulls up on the plunger a little to make sure he hasn't hit a vein and no blood comes out (pretty rare). If he sees blood, he has to take it out, replace the needle and poke again. We had to do that a few times, no fun. I usually watch TV while lying on the floor, or just lay on my bed while he does this so I can relax. (During the first HCG shot, I was standing up, like a lot of instructions say, and I was so stressed about the timing, and that he had seen blood in the syringe and had to start over, that I started to black out from all the anxiety. I started lying down, even though I wasn't nearly as anxious as that instance with the rest of the shots.) Then he covered it with a band aid, and gives me a little massage with a heating pad to distribute the oil. I also like to walk around to help it along. If you don't it can clump up and be really painful. It's weird, I could feel the oil going into my legs sometimes. We had our routine down pretty well. And with this system, it didn't hurt too bad. It was just when I could feel it hit the nerves of that deep muscle that gave a little cringe. But KC always took good care of me. This continued every night for the whole two-week-wait.
And that phone call after the blood test is something I wouldn't wish on anybody. The whole day is horrible, and if you get bad news, everything you had just been through was for nothing, and everything you thought about the future (as hard as you tried not to) was non-existent. Yet, somehow, life goes on.

So, the whole process takes about 2 months from pills to preg. test. We did it 4 times over the course of a year. The first cycle seemed like an eternity, but they seemed faster the more we got used to it. I gained weight (and thankfully lost most of it after I was back on my workout routine), had massive mood swings, and lots of tears (to put it mildly), but I am grateful to have been a part of this. It does work for many people, proving that it is a true miracle. I began to forget that it is supposed to result in a baby because it just became a second-nature, way of life to us. But I am glad some people were blessed to have this be the solution to their heartache. Even though it didn't work for us, we still owe our R.E. and all the dozens of professionals we came to know, a lot for what they did for us. I know for a fact that our doctor really pulled some strings for us and I hope he knows we are grateful, even though I wasn't the easiest patient to get along with during all of this. I guess Heavenly Father just has a different plan for us, since it's really a mystery that someone of my age and health can't find success in this process. But we continue with faith. Our children will come to us someday, and man, that day will not come soon enough.

By the way, here are two of our "cute little embryos" as she put it when she gave us this picture after our second transfer. I like to think of them as my babies. It was weird when I knew we had embryos in a petri dish, I felt like they were babysitting for me or something.

There you go. My IVF experience in a nutshell. I hope you enjoyed this little blog webinar. It is quite fascinating what doctors can do these days.