Our first step in this IVF journey was to attend the mandatory class that the fertility office puts on for couples, which we did on Tuesday of this week. There we learned the ins and outs of IVF, different options that can be added in to the process, and how to administer the butt load (pun intended) of meds. I know I for one did not know a lot about IVF prior to doing this, so I am going to outline the process for you all below, and I will update you along each step of the way! An IVF cycle is much longer than a normal female cycle, varying by response to medications and also by options such as PGS (genetic testing) which we are opting out of for this first cycle. A typical IVF cycle can be as little as six weeks and up to 10-12 weeks. We expect ours to be about 6-7 weeks with transfer right around Thanksgiving.
Every IVF cycle starts with something quite surprising when you first hear it…BIRTH CONTROL! Can you believe it? All we want is a baby and here we are back at prevention methods. However, this is not actually to “prevent” pregnancy. It is really all about suppressing your ovaries and giving them a rest. Essentially, this is to give the docs complete control over my cycle. So, cycle day one, I will start taking birth control, and aspirin. The aspirin is to help with absorbtion of the medications by my body. Also during this time, I will start taking two different antibiotics, and Aaron will start taking one as well. These are to prevent infection during the process and also to rid the body of any bad bacteria that may hinder pregnancy or cause a miscarriage if successful. Add in the five other supplements I am already taking for this process and the sum will be 9 medications a day. Thankfully, all oral…until our next phase! Down regulation lasts for approximately 3 weeks.
Another process I will be taking care of during my down regulation is the removal of ANOTHER uterine polyp.🙄 I previously had one removed in May, but the doc thinks that the Clomid I took during our IUI attempts to boost ovulation may have been the cause of the reoccurrence. This will be an outpatient surgery where I am sedated, the polyp is removed, and I am sent home to rest for the remainder of the day.
The next phase of the IVF cycle are where things heat up! This phase takes 7-10 days depending on how my body reacts to the injections. I will be doing an injection in my stomach of one medication in the morning, and another in the evening for the first part of the stimulation phase. An oral steroid will also be started to enhance absorbtion of these medications.
I will be required to have blood drawn and a vaginal ultrasound done every 2 days for the start of stimulation. They will be following the size of the eggs that should be developing because of the injection medications, as well as trending my blood estrogen levels. When these both get close to what the goals for retrieval are, I will then be required to go in daily and have these done. The doctors are looking for a goal estrogen level of 1000 (200-300 per mature egg) as well as correct sizing. When the doctor determines it is time, I will be instructed to give myself a trigger shot! This is to release the eggs from the wall of the ovary and make them easier to retrieve. The timing of this shot is important, as egg retrieval happens exactly 35 hours after this injection is completed. I will most likely give this to myself late at night with the plan of retrieval early 2 days later. All oral medications are continued through this phase minus the antibiotics.
Finally, all the hard work will hopefully pay off! Egg retrieval day! I will go in to the office on this day, and be sedated once again. The doctor will poke a small hole through the vaginal wall with his surgical instrument to get to my ovaries. There he will literally suck out all of the eggs that are there. An average IVF cycle produces 10-12 eggs, however, this varies greatly between diagnosis and patient. The eggs will immediately be taken by an embryologist and placed under a microscope for a count. Aaron’s big job that day (other than to supply his little gladiators) is to remember how many eggs were retrieved because the sedation medications have an amnesia effect and they say I will be asking him all day how many and not remembering 😂 This number is a big deal, because of the eggs retrieved, on average only 50% of them will successfully fertilize, and only 50% of the ones fertilized will fully mature enough to be placed back in the uterus. So, we leave the clinic. Sperm is injected in the eggs, and they are put away in a climate controlled environment for 5-6 days. The first difficult waiting game. After hearing how many were retrieved, we will not know how many matured until 5 days later. This part is my biggest fear, because if the chemo or radiation that I received as a kid did affect my eggs, I will at this point find out that my eggs are bad.
After retrieval, I will be started on two new medications. One is an injection that will be administered in my rear end (hence the pun from before). I will continue this until I know if I am pregnant or not. If not, I will stop and start over with the process. If I am, I will continue giving myself this injection through 12 weeks of pregnancy. It is progesterone, which helps thicken the lining of the uterus, making a nice comfy nest for my embryos. The other is a patch that I will also have to wear through 12 weeks of pregnancy. This patch is also to maintain the lining of my uterus.
Assuming I do have mature egg(s) after that 5-6 day period, I will return to the office for my transfer day! This is when they will push no more than 2 eggs through a long skinny catheter into the perfect spot in my uterus. On this day, I will be given a Valium pill and a vaginal suppository to relax the uterus which makes it easier for the embryo to implant.
I will get an ultrasound picture this day of (hopefully!!!!) my future child. However, after this procedure, we will endure another brutal waiting game. We will have to wait another 12-14 days to know if the embryos “stuck” to the lining of my uterus resulting in pregnancy. They can put them where they need to be, but there is no telling if they will attach or not. I will return after this waiting period for a blood test that will tell me definitively if I am pregnant or not.
So that’s it! The IVF process in a nutshell. All in all, including my supplements I will be taking a grand total of 17 medications (not including any Tylenol or lidocaine for any discomfort along the way). It’s a lot, it’s emotional, its going to be a roller coaster…but we are ready. Ready for some hope and science!