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The Regime
a blow-by-blow account of an IVF cycle


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#1 prue~c

Posted 20 August 2010 - 08:20 AM

I thought I would do a bit of a run-down on what is involved with a fresh IVF cycle, because unless you have done it, why would you know?  It's easy for some, difficult for others, both emotionally and physically. I would probably fall somewhere in the middle. I'm a pretty pragmatic kind of girl. I get on with the job. Only once have I cried over failed IVF. My problems are more of the physical type. Some people recover quickly and have little pain, but me -I'm a bit of a handful and have had a few post-op complications resulting in hospital admission and a lot of very nice pain relief. But I'm one of the lucky ones. I stimulate really well and one of the side effects is a fair bit of discomfort, because I have an abdomen full of ripe follicles. Some women are lucky if they get one. There are so many variables, but it's a whole other blog post. This is to tell you what I have been up to for the last couple of weeks.

So the regime begins on day two of the menstrual cycle. I'm doing what they call an 'antagonist' cycle, which has just become a lot cheaper thanks to the government adding the antagonist medication - ganirelix - to the PBS. Previously they had been about $90 a shot. That's the medication that stops ovulation. Day two begins like any other. I take my 5mg of folic acid, which helps prevent neural tube defects in the hypothetical developing foetus. I take ten times the regular dose, because I have a gene mutation than can cause deficiency of Methylenetetrahydrofolate reductase - I prefer the acronym MTHFR - which is thought to be a cause of recurrent miscarriage. I take the folate then three capsules of CoEnzyme CQ10, a cap of omega 3 fish oil, a general conception multi-vitamin, all washed down with a Berocca - not because I'm hungover, but it gets the vitamin B in and I really find it gives me a good boost.

Then in the evening, it's a shot of Follicle Stimulating Hormone (FSH) to the stomach. The regime continues for three days then I add a tablet of ethinyl estradiol to the mix in an attempt to coax my rather pathetic endometrium - that's the bit the embryo buries itself into and mine is borderline thin - to grow more than 8mm. The next day is the first of many blood tests to check my hormone levels.  Not much is happening, so my FSH dose is doubled and the regime continues for another two days. Another blood test and yay, estrogen levels are high enough to commence injection number two - the antagonist that prevents ovulation. The whole idea is to get the ovaries to produce lots of follicles - which are meant to contain the eggs - at the same time preventing the body's natural urge to trigger ovulation.

Regime continues for another two days, then another blood test - something thing I don't do too well; the poor nurses have a shocker of a time finding my veins and more often than not I end up having it taken from a painful spot on the top of my right hand - and then it's time for an ultrasound.

(Now if you know me in real life, you might want to tune out now - yes Mum, that goes for you - because I am going to talk about vaginas)

You do get used to them, really, but they are such an invasive procedure.  It's not the happy "ooh that's cold" tummy-style ultrasound that pregnant women get. This is something that is known across the IVF world as dildo-cam, DC for short. Because it's like a dildo, with a camera on top. Five times in the last two weeks I have lain on a skinny, uncomfortable bed in a freezing office in Bondi, and had my holiest of holies invaded by a long, cold, unforgiving sceptre. They call it a transducer - I call it cruel. But it's great we have the technology, right? DC gets dressed for action with a condom rolled over and held with a rubber band at the base, and a squirt of that ice-cold blue gel before, ahem, entering.

Unless the nurse is too vigorous - and none of my fave girls are - the procedure isn't painful, more uncomfortable, because it goes in a really. long. way. My last ultrasound on Wednesday showed I had around 30 follicles between 10 and 20mm. 20mm is the sweet spot and so that night, while at a charity party filled with self-congratulatory media types, I injected Ovidrel which triggers the follicles to release the egg. But don't get too excited for me, dear reader, because 30 follicles doesn't promise 30 eggs.  I'm hoping for ten good ones, from which I would like two embryos at the end - one to transfer, one to freeze.

Today I go in for the egg retrieval. My stomach is distended like I'm five months gone, and I waddle. Oh the cruelty! Any passing observer would think I was having a particularly uncomfortable pregnancy. The regime has reduced to pills-only over the past two days, but from this evening, I get to crank up the fun again, this time with a lovely little (you all get sarcasm, right?) gift from science called the progesterone pessary. It says a lot that I would rather inject myself every day than endure the PP. Imagine ladies, if you will, a small conical candle, 2cm high by 1cm across.  Twice a day, you stick the candle up your fanoir and let it melt slowly, stickily out. Chafe? Why yes, I do!

Luckily I get to fulfil that dream of injecting every day, because from this evening, I also need to shoot up Clexane - a blood thinner than I need because of my high percentage of Natural Killer cells - no explanation needed, really - which is an auto-immune issue that can affect embryo implantation. Or something like that. I'm only newly diagnosed so I need to read up on it all.

So if things go to plan, in five days I will be back in the clinic to have my embryo - which has been prepped using a technique called "assisted hatching" to help thin out the wall of the embryo and help it attach to the endometrium - transferred, and in ten days I'll either be pregnant, or not. Or I could be a bit pregnant. That happens too.

Oh and PS is it weird that I'm looking forward to the general anaesthetic? I love that two seconds of druggie goodness before you go under. Of course the recovery is a shocker, but those two seconds are pure bliss.

Edited by EBeditor, 20 August 2010 - 08:44 AM.


#2 Oma Desala

Posted 20 August 2010 - 04:23 PM

Hi Prue,

Thank you for sharing with us your journey so far.  You are incredibly brave and strong person and I admire you for that very reason.  I could not imagine going through what you have done time and time again.

I really do hope you have positive news in the coming weeks.

All the best

JM

#3 Dînerdescons

Posted 20 August 2010 - 04:29 PM

Thanks for your insight, honesty and humour Prue. And above all, thank you thank you for doing such a great service to the EB community in introducing them to the term 'fanoir'!

#4 belindarama

Posted 20 August 2010 - 04:32 PM

Wow, thanks for sharing that with such grace and openess. I knew it was not easy but only had a fuzzy idea what IVF involved.

I have never wanted to ask any of my friends what they had to go through but did want to know.

You have obviously remained strong and positive in trying circumstances and I admire that.

Good luck this time, I hope you get your precious baby!

#5 ampersand

Posted 20 August 2010 - 06:12 PM

Brilliant post, Prue. Through your humour, empathy and wonderful way with words you open a window into the reality of fertility treatment.

Thank you for sharing it all, even dildo cam, with us.



#6 prue~c

Posted 20 August 2010 - 06:24 PM

Thanks ladies. I'm home now and snuggly on the couch. It was the best egg haul yet. They got 24 eggs, 22 of which were mature. Excellent stuff. and even better, I'm not in agony, unlike previous egg retrievals. I daresay I will actually make it to the polls tomorrow. Fingers crossed for good fertilisation rates. I'll update tomorrow.

#7 LynnyP

Posted 20 August 2010 - 07:45 PM

It all sounds very promising.  You know, I never thought that it could actually be a pleasure to read about all of that stuff!  You are a funny lady.

Edited by LynnyP, 20 August 2010 - 07:45 PM.


#8 Guest_domestically~challenged_*

Posted 20 August 2010 - 07:58 PM

Well done on the egg haul. Glad to hear of no OHSS signs. Good luck!

#9 DecafJane

Posted 20 August 2010 - 08:06 PM

Thank-you for sharing. It was very helpful to hear it from somebody who has already been through the experience first-hand.

Best of luck with the coming implantation!

I always said that the sonographers who do the transvaginal ultrasounds were the dodgiest bunch in the whole hospital because no other department goes through as many boxes of condoms in a single work week. wink.gif

Edited by DecafJane, 20 August 2010 - 08:07 PM.


#10 Loue

Posted 20 August 2010 - 08:12 PM

Fabulous post, thanks for sharing.  Fingers crossed for you!

#11 cazbir

Posted 20 August 2010 - 08:12 PM

Thanks for sharing Prue, i know people who have been through IVF and i bet its extremely hard. I have always been very lucky to get pg easily, however 2 times have not ended in a great result. One a M/C and  a Stillbirth, but i know an IVF Journey can be very emotional and sad too, as i know people who have done several rounds. Good Luck xox

#12 cinnabubble

Posted 20 August 2010 - 08:15 PM

You bloody well deserve to get pregnant after going through all that.

Fingers crossed for a positive pregnancy test in a couple of weeks.

#13 Razman

Posted 20 August 2010 - 08:24 PM

1st and importantly roll2.gif  eexcite.gif on 22 mature eggs. I truely hope you get lots of nice little embies that end in a BABY.

2nd - oohhhh DC.... bringing back repressed memories.

#14 prue~c

Posted 21 August 2010 - 02:08 PM

*****UPDATE******

Of the 22 mature eggs, 17 fertilised overnight. I am feeling overwhelmed. This was so unexpected. I only had three fertilised eggs on my last cycle with one to transfer and none to freeze. Fingers crossed they continue to progress.

#15 Kitty_2010

Posted 21 August 2010 - 08:46 PM

Fingers crossed for you


#16 ThatsNotMyName

Posted 21 August 2010 - 11:56 PM

FANTASTIC Prue!!

#17 arrow

Posted 22 August 2010 - 12:16 AM

Thanks for sharing in such an entertaining and educational way. Great result so far! Good luck from here.

#18 kitty005

Posted 22 August 2010 - 01:10 PM

That is fantastic news prue, so happy for you.  Good luck for the rest of this cycle!

#19 winterleaf

Posted 22 August 2010 - 06:02 PM

That's great news Prue. Am crossing everything for you.

Does your doc have you on steroids for the NK? I am sorry to hear you have this diagnosis. I have it too and it is very frustrating.

#20 mummyinahurry

Posted 22 August 2010 - 06:17 PM

Thanks for sharing this Prue - I'm embarrassed to admit I had no idea of what ivf really entailed before I read your story.

Good luck and fingers crossed for you. Hopefully things will all be over between you and DC very soon!

#21 Becs77

Posted 23 August 2010 - 10:35 AM

QUOTE (prue~c @ 20/08/2010, 08:20 AM) <{POST_SNAPBACK}>
I thought I would do a bit of a run-down on what is involved with a fresh IVF cycle, because unless you have done it, why would you know?  It's easy for some, difficult for others, both emotionally and physically. I would probably fall somewhere in the middle. I'm a pretty pragmatic kind of girl. I get on with the job. Only once have I cried over failed IVF. My problems are more of the physical type. Some people recover quickly and have little pain, but me -I'm a bit of a handful and have had a few post-op complications resulting in hospital admission and a lot of very nice pain relief. But I'm one of the lucky ones. I stimulate really well and one of the side effects is a fair bit of discomfort, because I have an abdomen full of ripe follicles. Some women are lucky if they get one. There are so many variables, but it's a whole other blog post. This is to tell you what I have been up to for the last couple of weeks.

So the regime begins on day two of the menstrual cycle. I'm doing what they call an 'antagonist' cycle, which has just become a lot cheaper thanks to the government adding the antagonist medication - ganirelix - to the PBS. Previously they had been about $90 a shot. That's the medication that stops ovulation. Day two begins like any other. I take my 5mg of folic acid, which helps prevent neural tube defects in the hypothetical developing foetus. I take ten times the regular dose, because I have a gene mutation than can cause deficiency of Methylenetetrahydrofolate reductase - I prefer the acronym MTHFR - which is thought to be a cause of recurrent miscarriage. I take the folate then three capsules of CoEnzyme CQ10, a cap of omega 3 fish oil, a general conception multi-vitamin, all washed down with a Berocca - not because I'm hungover, but it gets the vitamin B in and I really find it gives me a good boost.

Then in the evening, it's a shot of Follicle Stimulating Hormone (FSH) to the stomach. The regime continues for three days then I add a tablet of ethinyl estradiol to the mix in an attempt to coax my rather pathetic endometrium - that's the bit the embryo buries itself into and mine is borderline thin - to grow more than 8mm. The next day is the first of many blood tests to check my hormone levels.  Not much is happening, so my FSH dose is doubled and the regime continues for another two days. Another blood test and yay, estrogen levels are high enough to commence injection number two - the antagonist that prevents ovulation. The whole idea is to get the ovaries to produce lots of follicles - which are meant to contain the eggs - at the same time preventing the body's natural urge to trigger ovulation.

Regime continues for another two days, then another blood test - something thing I don't do too well; the poor nurses have a shocker of a time finding my veins and more often than not I end up having it taken from a painful spot on the top of my right hand - and then it's time for an ultrasound.

(Now if you know me in real life, you might want to tune out now - yes Mum, that goes for you - because I am going to talk about vaginas)

You do get used to them, really, but they are such an invasive procedure.  It's not the happy "ooh that's cold" tummy-style ultrasound that pregnant women get. This is something that is known across the IVF world as dildo-cam, DC for short. Because it's like a dildo, with a camera on top. Five times in the last two weeks I have lain on a skinny, uncomfortable bed in a freezing office in Bondi, and had my holiest of holies invaded by a long, cold, unforgiving sceptre. They call it a transducer - I call it cruel. But it's great we have the technology, right? DC gets dressed for action with a condom rolled over and held with a rubber band at the base, and a squirt of that ice-cold blue gel before, ahem, entering.

Unless the nurse is too vigorous - and none of my fave girls are - the procedure isn't painful, more uncomfortable, because it goes in a really. long. way. My last ultrasound on Wednesday showed I had around 30 follicles between 10 and 20mm. 20mm is the sweet spot and so that night, while at a charity party filled with self-congratulatory media types, I injected Ovidrel which triggers the follicles to release the egg. But don't get too excited for me, dear reader, because 30 follicles doesn't promise 30 eggs.  I'm hoping for ten good ones, from which I would like two embryos at the end - one to transfer, one to freeze.

Today I go in for the egg retrieval. My stomach is distended like I'm five months gone, and I waddle. Oh the cruelty! Any passing observer would think I was having a particularly uncomfortable pregnancy. The regime has reduced to pills-only over the past two days, but from this evening, I get to crank up the fun again, this time with a lovely little (you all get sarcasm, right?) gift from science called the progesterone pessary. It says a lot that I would rather inject myself every day than endure the PP. Imagine ladies, if you will, a small conical candle, 2cm high by 1cm across.  Twice a day, you stick the candle up your fanoir and let it melt slowly, stickily out. Chafe? Why yes, I do!

Luckily I get to fulfil that dream of injecting every day, because from this evening, I also need to shoot up Clexane - a blood thinner than I need because of my high percentage of Natural Killer cells - no explanation needed, really - which is an auto-immune issue that can affect embryo implantation. Or something like that. I'm only newly diagnosed so I need to read up on it all.

So if things go to plan, in five days I will be back in the clinic to have my embryo - which has been prepped using a technique called "assisted hatching" to help thin out the wall of the embryo and help it attach to the endometrium - transferred, and in ten days I'll either be pregnant, or not. Or I could be a bit pregnant. That happens too.

Oh and PS is it weird that I'm looking forward to the general anaesthetic? I love that two seconds of druggie goodness before you go under. Of course the recovery is a shocker, but those two seconds are pure bliss.



#22 Becs77

Posted 23 August 2010 - 10:37 AM

Fantastic post! Never thought I would see the word "fanoir" on an SMH linked site - love it!!  All the very best - I hope this is the cycle that brings you your longed for little one..Good luck!!

#23 Tough love

Posted 23 August 2010 - 01:12 PM

Wow. That is full on.

I was just complaining to a work colleague about how much I hate how uncomfortable it is being pregnant. After reading this blog I will stop and consider the alternative before I ever complain again!

#24 mel333

Posted 23 August 2010 - 01:26 PM

All I want to say is "THANKYOU"!

I have been through IVF and it is rotten in so many ways but you made me smile for the first in a long time about it. I have decided to give up for my own reasons but wish everyone good luck on their quest!

Prue, I wish you all the luck in the world and praying that you are lucky in having a   BFP.gif so very soon!

Mel

#25 Guest_onehappymum_*

Posted 23 August 2010 - 02:08 PM

Good luck, Prue.  I wish I didn't know the in's and out's of IVF so well...I hate being a little bit pregnant, when your results are 'not as high as we like to see them at this stage'.  I am booked for a frozen implant on Thursday with Clexane for three months (if I get pregnant).  The Clexane is new for me, I've been a little bit pregnant twice and super +ve pregnant once in the last 12 mths, with no baby to show for it.  So hopefully the Clexane will help.  Funny thing is, on my first cycle, first fresh embryo transfer in 2007 I got pregnant, and he is currently bugging me as I type.  For some reason this time my body is not working with me.  

Great news on the number of fertilised eggs!  I'm lucky to be usually left with one for fresh transfer and one or *maybe* two to freeze.  I hope they keep developing for you.  Bec




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