My IVF Story

I've been wanting to document the details of our IVF for those who are about to go through the process for the first time and also before I forget. I found it really helpful to read about other's cycle to understand what to expect. These shared experiences helped me get the courage to go through the process and when I was really freaked out, gave me a reason to calm down! I'm not saying that what I did, my protocol, or anything was the right thing to do and everyone's experience with the process is different.

We decided to pursue IVF after our first failed injectibles cycle. (note...I wished I was blogging back then so I could remember more about that cycle) All I remember is that it didn't make any sense to us why we were failing. At that point we'd done 3 IUIs, I was positive I was ovulating every month I didn't IUI and I had been doing TCM for at least 4 months (acupuncture, supplements, dietary changes). Matt's numbers were good enough. Quite frankly, we wanted answers. Were my eggs just bad? Were Matt's guys not getting the job done? Did I have endo? We figured we'd know what we were up against after an IVF cycle and know if we'd be better off pursuing adoption.

We read Couple's Guide to IVF (only somewhat helpful for Matt) and I started just reading up everything on the T-TTC board on the nest. We did research on my insurance coverage for IVF and also evaluated my current clinic on SART.org to see the IVF stats. My insurance covered some of the IVF and I knew it would be realistic to expect 2 or 3 tries, so we started saving up right away. We're both in our mid 30's and well, getting anxious.

Based on my less than exciting results being on injectibles, I wondered what protocol my doctor would recommend. It was very hard to understand the different protocols at first and I really had to do a lot of reading to get all the terms/drugs/options down. I recommend IVF connections and http://www.advancedfertility.com/ivfstim.htm as good sources of information (as well as T-TTC).

I scheduled an appt with my doctor for my IVF consult so that we met just as my second injectibles cycle failed. I knew I'd have to take one month off before my IVF cycle, but I didn't want to have to take 2 months off... so impatient!!

Below are the details of my cycle, some of which seem a little different from many other cycles I read about.

• I didn't have to go on birth control the month before because my cycle was regular
• On CD 21 of the "month before" cycle I started taking 1oml of Lupron every night
• We couldn't have unprotected sex during this month (or the IVF cycle). (Nothing like buying condoms when you are a married, 35 years old and infertile. But definitely have sex the month before, it may be awhile afterwards!!)
• I had to have a baseline u/s on CD 3 of my IVF month to make sure the Lupron worked (aka: suppression check)
• We started stims on the Friday after I got my period. Our clinic always starts stims on Friday, no matter what CD it was.
• Both Matt and I had to have infectious disease testing done the month before
• My clinic did not do a Saline Sonogram since my HSG was less than 1 year old, nor did they do practice transfer. Many clinics do this.
• My clinic did not do a Antrical Follical Count on CD3 which can tell you how many eggs you are likely to have.
• My stim protocol was the typical long lupron - start lupron the month before and then through the stim period to suppress premature ovulation. My stims were a medium level combination of Follistim and Menopur -- I think I was doing 300 or so IUs per day. 1 shot of Follistim at night and then 3 shots of Follistim/Menopur/Lupron at night.

The lupron made me headachy and pretty BLAH. My nurse told me that was because it was suppressing all my happy hormones and I did feel better once I started my stims. The shots for the stims and the lupron were really not all that bad, compared to my blood draws (for all my stim check appts) and my allergy shots (ow!!) I did the lupron on my thighs and the stims in my stomach. The menopur had more volume than the follistim and did burn a little bit. I had Matt help me with this injection every night. Once you get the first or two done, you feel very proud and then after that it is easy.

My cycle progressed like this:

• I had my first follie check on my 5th day of stims. I only had 4 measurable follies and an E2 of 200 something. E2 was good, but the egg count was on the lower side.
• On the 9th day they found 9 measurable follies and my E2 was 900. This was a huge jump and a good lesson not to get too discouraged early on in the cycle. E2 is a good measurement of egg maturity and for an IVF cycle it can be 2000-3000 at trigger.
• By the 10th day I was very uncomfortable at night. I only had 9 follies, but some girls have a lot more. I couldn't sleep very well and I could feel my ovaries.
• On the 11th day, my E2 was 1450, but there were no more follies
• I stimmed 13 days altogether and took my trigger when my e2 was over 2000. There were more than 9 follies measurable at that point but only 9 were expected to be big enough to retrieve.

36 hours after I triggered I did my egg retrieval. This is minor surgery and hence, very scary. However, there is nothing to be scared of. We went really early the day of. I had to strip down and put on a hospital gown. The nurse then started an IV and gave me antibiotics to protect me from an infection from the retrieval process. That hurt a little, but not really all that bad. They wheeled me into the retrieval room, which was very surgical looking. The anesthesiologist put the mask over my mouth and nose... and that was all I remember! I woke up not more than 20 minutes later. They gave me my first pain pill and something to drink. In a few minutes when I was ready, I got up and got dressed and went home to rest. I was sick as heck from the pain pill and as soon as I ate something, I felt so much better. I was a little sore that day and the next, but not half as much as I expected. I didn't take any of my pain pills.

So they only got 8 eggs. Ugg!! The next morning at 7:30am, the embriologist called us and told us that only 5 were viable, but all 5 fertilized with ICSI. We decided to go with ICSI because we knew my egg count would be low and we didn't want to take any chances in case fertilization was the problem.

My clinic only does 3 day transfers. Research shows that rates of success are roughly the same between 3 day and 5 day transfers. This doesn't make much sense to me! However, we knew when our transfer would be. On the day of the transfer, I was so nervous because I didn't know if we would have any embryos left or if they would be any good. I did acupuncture before my transfer appt. (My acupuncturist works in conjunction with my clinic and my lifeline during this whole process.) When I got to the appt for the transfer, I stripped from the waist down and put on a gown. The doctor came in a showed me a picture of the 2 embryos they were going to put in and I was very relieved!! Right before the transfer they had me take my valium and then drink 2 bottles of water until I could drink no more. I was so afraid I'd have to pee, but it wasn't as bad as I thought. For the transfer they did an external ultrasound and the room was kind of dark. They threaded a thin catheter in to the tip of my uterus (it didn't hurt at all) and then the lab lady put the embryos in the catheter and the doctor pushed them in. We could see the little puffs of air around the embryos in my uterus when they went in and that was cool. Afterwards, I only laid for a five minutes or so, got up to use the bathroom, and then walked next door for more acupuncture. I had 3 other eggs still alive on this day and they froze these embryos that day. I haven't heard of many clinics that freeze only at the 8 cell stage.

The doctor wanted me to rest for 2 days after the transfer. I had read that laying down horizontal didn't have any higher results than not, so I mostly sat on my couch and worked on my laptop and tried to relax. Work was really busy during this time, and I did end up working more than I wanted to. I minimized how much I walked or went upstairs. It was boring as heck!!

I started endometrin 3 times a day after the transfer. This is a pill that you insert up as high as you can with a little applicator. It burned a little coming back out and was messy. However, many IVFer have to do PIO shots, so I wasn't complaining. The progesterone gives you lots of "pregnancy" symptoms - sore breasts, nausea, light headedness, hunger!! By 7dp3dt all of these symptoms disappeared and I felt pretty normal and I was sure I was not pg. My clinic does it's beta testing 12dp3dt as a rule.

During my stims and after I limited my exercise to light walking and kept my heart rate under 110. I didn't drink alcohol, caffeine or any pop. I only took baby aspirin and pre-nates during the whole cycle. After my transfer I tried to eat really healthy, including lots spinach and other veggies. I was having horrible GERD problems though, so it was easy to restrict my diet. Also, I made sure I had comfortable pants for work since you do bloat quite a bit.

I liked my clinic because they do 200-300 IVFs a year (according to SART) and their success rates were among the best in my area. I also suspected they had a decent lab and I thought that was important. However, it was very hard to be one of the many many patients of my doctor. I really don't think she had me on the right protocol and I often worried she didn't remember all the details of history. I was very tempted to try a smaller clinic to get a second opinion or to see how the quality of care changed. It's a very tough call to make.

Please send me any questions you have. If you are pursuing IVF, I hope this helps.