What is IVF?

The basic run down went like this: 

*Consultation

*Baseline ultrasound and bloodwork prior to medications

*Starting of birth control pills to control the menstrual cycle

*Hydro Saline Sonogram - Saline infusion into the uterus to view the walls of the uterus (which was positive for polyps)

*Hysteroscopy - A scope of the uterus with removal and biopsy of polyps, multiple per doctor. This was done under general anesthesia 

*Stop birth control. Start cycle. Day 3 bloodwork and ultrasound, another baseline

*Start follicle stimulation drug injection (Gonal F) to produce multiple follicles to produce multiple eggs. A normal menstrual cycle produces one mature egg per month

*Start Ganirelex (Delays ovulation), Injection 

*Stop other drugs and Give trigger shot of HcG, human chorionic gonadotropin which is a pregnancy hormone to initiate ovulation

*Egg retrieval, light anesthesia to remove the extra follicles that have been produced is a long syringe that goes through the uterus wall

*ICSI, intracytoplasmic sperm injection where one sperm is literally injected into the egg with a needle to help fertilization 

*3-5 day embryo transfer depending on progress of fertilization in a Petri dish at lab

*Supplement with Progesterone into pregnancy

*Two week wait for pregnancy test 

Here is a good website from a fertility clinic in Chicago that explains IVF and also ICSI very well. There are some good pictures also. 

http://www.advancedfertility.com/ivfprocedures.htm

next...

I had another ultrasound this morning, this time with Dr Huang. It turns out that my doctor is on vacation for a few weeks. Thanks for letting me know....grrr. So Dr Huang will be taking care of me for the rest of the cycle. She is super bubbly and friendly. I really like her actually. So maybe this is a blessing in disguise. Awaiting my blood results as usual but I need to return on Monday morning. She said egg retrieval is Wednesday, Thursday or Friday. The follicles are about 12mm now and she said they won't do the retrieval until the largest follicle is 18mm. All is well otherwise!

Doctor called, estrogen level is currently 743, up from 415 on Thursday. I am to continue on the Gonal F 225 units in the evening and Ganirelex in the morning until Monday when I will return again for another ultrasound and bloodwork.

I started Ganirelex tonight. OUCH, it stings!!  Other ladies have posted how the needle is dull and it stings, some people even get a rash. TRUE. I do have a large welt at the injection site.. Hoping it goes away! I go in to the office tomorrow morning for ultrasound and bloodwork. Hoping for some growing follicles! 

Recheck

I had another recheck this morning. The doctor was able to visualize the right ovary which she couldn't see last time. There are still many follicles but they're still not very large yet. I did see one measure over 10mm just by snooping at the machine. I have to wait and see what my bloodwork results are this afternoon and will have to return sometime this weekend I'm sure.

My doctor called me this afternoon. My estrogen level is up to 400. I start the Ganirelex tomorrow night along with Gonal F. Ganirelex is the injection to delay ovulation. Saturday morning, I give another Ganirelex then have another ultrasound and bloodwork that morning.

What's next? I only have 5 injections of Ganirelex at my house so I imagine I only am taking those for a few days. And my Gonal F is almost gone. After that, I will take the trigger injection of HCG when they tell me to. Once I take that, the egg retrieval is 36 hours later. I've asked her when to expect the retrieval but she won't give me a date yet, just says "next week". Tick tock.

I can't believe that I'm  moving on to the next step. This is all so crazy and pretty much all that I can think about. 

First follow up after starting follicle stimulation injections

I had my first follow up ultrasound and bloodwork. The ultrasound revealed 7 follicles on my left ovary and my right ovary wasn't visible because I had a full bladder (whoops). She said a normal amount would be 5-7 follicles. She said that they start measuring the size of the follicles when they are greater than 10mm and the largest one today was 9.1mm. The bloodwork is testing my estrogen level and I will find out later on today the result. I will most likely have to adjust my dose of Gonal F.

I spoke to the nurse about what restrictions I should be having. She basically told me to act like I was pregnant. To limit caffeine to 1 to 2 cups per day, only take tylenol for pain but otherwise try to eat and act naturally.

My estrogen level was 208 today. I return Thursday for another ultrasound and estrogen level. Until then, I'll continue on the same dose of Gonal F. 

Here we go....

This is my third blog. I have never kept up with any of them. I don't know if this one will be any better. I'm not a writer but want to document our story.

My husband was diagnosed with testicular cancer in 2009. He had surgery to remove one testicle. And was scheduled for chemotherapy immediately. At age 24, he was asked, do you want to have children? Shocked, he quickly decided that he would want to someday and was told he needed to freeze a sperm sample before starting chemo. He did this... After a fight with his insurance company to cover the cost of storing the sample. It would have cost us thousands of dollars without insurance coverage which was NOT in place at that moment. He fought them hard to get coverage and he actually changed Blue Cross's policy on cancer patients. But this fight and lack of possible coverage caused him to only get ONE sample because time was running out. He needed to start chemo. He finished his treatment successfully, only missed a few days of work because he is a dedicated employee. Looking back now, he wishes he took a leave of absence. 

Years passed, I stopped birth control pills eventually.. thinking that I would get pregnant naturally, I wouldn't mind having a baby if it happened. Could it even happen? We eventually met with a fertility specialist in 2010 to find out what our options were. We didn't really plan on starting trying to conceive at this point. Speaking with the specialist, she determined we did have options. His sperm count was low, medically infertile, poor morphology. But with in-vitro fertilization with intracytoplasmic sperm injection, we would have success. We left the office with paperwork and possibilities. 

We went back in 2012 to talk. Is it the right time now? When is the right time when you have to PLAN your pregnancy? Why can't it happen naturally, by accident like normal people? 

A year passed, and we finally returned again May 2013. What are we waiting for? Let's do it! 

I went in for baseline bloodwork and an ultrasound and was started on birth control pills (?!?) to regulate my cycle. We were started with an antagonist IVF cycle. My ultrasound showed some small polyps on my uterus walls. I needed a hysteroscopy to have these further looked at and removed. It's was a surgical procedure that I had done at Newton Wellesley Hospital. I was under general anesthesia for this and absolutely terrified as I hadn't ever had surgery before this, other than wisdom tooth removal. It went well and I returned to work the next day, very groggy. My doctor informed me the polyps were removed and I was clear to start the cycle. 

I stopped the birth control pills on Sunday and went in for another ultrasound and baseline bloodwork last Wednesday. I was set to start injections on Friday (!!!!) but didn't have the medications yet. Of course, insurance didn't approve them without a prior authorization. It all worked out and I got my medications on Saturday. I gave myself my first injection of Gonal F on Friday night in my left upper thigh. The Gonal F is in pen form and has dial settings with different doses. I was absolutely terrified and irritable leading up to this. Turns out, this is very stressful! I have to give Gonal F every night subcutaneously, either in my stomach area or upper thigh. Tonight is night 4. So far, I haven't had any side effects other than being a little more tired. 

Tomorrow, I return for a follow up ultrasound and bloodwork and we will go from there. 

To be continued.