Infertility-Our Struggle: IVF #1

As mentioned in A Non-Western Approach, once we had the healthcare coverage (such an incredible Infertility(1)blessing!), I was ready to dive straight into our first IVF cycle. To start IVF, though, is a huge pain in the ass. I had to have another HSG (you can read about my first one here), had to go through all of the day 3 testing again, and Jimmy had to have another semen analysis. After this analysis, we were diagnosed with Male Factor Infertility, which qualified us for ICSI. In laymen terms, that meant that instead of letting the egg and sperm join “naturally” in a petri dish, they actually inject the best sperm directly into the egg via a small needle. It is much more scientific than that explanation, but you get the gist ;) The whole process took about three months before everything was signed off on…not a fun wait when you have prepared your mind and body to begin NOW.

Can we talk for a second about the moment your first box of meds arrive? Boy is it an overwhelming mind-fuck. Before taking the very necessary inventory, Jimmy and I just sat there…staring with open mouths and bulging eyes. It’s a very unsettling moment to know that all of those needles, and all of those drugs are about to go into your body. It is quite overwhelming. I’ll say it again: it is QUITE OVERWHELMING! At the same time, though, it is exciting to be starting the journey.Once we received insurance approval, had a consultation about how to do the injections (#overwhelming), and had our complete home pharmacy of hormones, we were off to the races, and things started moving very, very quickly.

121

 

Below is my treatment schedule, and I will explain it as best I can. Also, it may seem organized, but in the beginning Jimmy and I were hot messes trying to figure everything out together. We used the wrong needle on my first menopur injection, so instead of the cute little subcutaneous needle, we used the 3 inch drawing trigger needle. Let’s just say…you don’t make that mistake twice!

calendar

  • Day 1: (cycle day 1) Injections needto be done between7-10pm. Injections are at 3:00 and 3:15 on a belly clock (picture your abdomen as though it is a clock, with your bellybutton as the center of the clock, and alternate side each day).
    • 300 units of Gonal-F (it’s in a refrigerated pen that you click to the unit you need; remove pen from refrigerator 30 minutes prior to injection)
    • 75 unit of Menopur (1mL of fluid mixed in with the 75 units of powder)
  • Day 2: Repeat at 9:00 and 9:15 on the belly clock.
  • Day 3: Repeat at 3:00 and 3:15.
  • Day 4: Repeat at 9:00 and 9:15.
  • Day 5: blood work and ultrasound. LH and progesterone low (good). Estrogen level: 123. Have 2-4 follicles on the left, and 2-4 on the right-not yet measurable (generally start to measure over 11mm).
    • 350 units of Gonal-F (increase)
    • 150 units of Menopur (increase) (1mL liquid, 2 vials of powder)
  • Day 6: Repeat.
  • Day 7: blood work and ultrasound. Levels look good. Estrogen: 384. Lining measuring at 13.26 (10-15mm is the norm). Measurable follicles: (Left) 11, 9.5 (Right) 11.5, 10.
    • 450 units of Gonal-F (increase)
    • 150 unit of Menopur
  • Day 8: Repeat.
  • Day 9: blood work and ultrasound. Levels look good. Estrogen: 820.2. Lining 14.9. Measurable follicles: (Left) 13, 12, 11 (Right) 15.5, 14, 14, 13, 13, 13, 12.
    • 450 units of Gonal-F
    • 150 units of Menopur
    • 1 syringe of Ganirellex (preloaded injection, hallelujah) tonight, switch to AM tomorrow
  • Day 10:
    • AM Ganirellex
    • PM 450 units of Gonal-F
    • PM 150 units of Menopur
  • Day 11: blood work and ultrasound. Levels look good. Estrogen: 1888. Measurable follicles: (Left) 18.5, 15, 13.4, 9.7 (Right) 20.7, 18.7, 17.7, 17.3, 15.2, 15.4, 14, 8. TRIGGER scheduled for Monday at EXACTLY 10:30pm.
    • AM Ganirellex
    • PM 450 units of Gonal-F
    • PM 150 units of Menopur
  • Day 12:
    • AM Ganirellex
    • PM 450 units of Gonal-F
    • PM 150 units of Menopur
    • 10:30pm TRIGGER 10,000 units of HCG (1cc liquid into powder-draw with long needle, inject into belly with short needle)
  • Day 13: no injections. No food or drink after midnight. Retrieval at 10:30am tomorrow.
  • Day 14: RETRIEVAL DAY!! Anesthesia got me like whoa. 8 oocytes retrieved (which made me030 cry hysterically as I was expecting at least 12; I later learned quality is better than quantity). Jimmy had the pleasure of heading to “the porn room” (as he calls it) to deposit his orgasm into a cup. He says it is a very uncomfortable feeling. I can see that, and I also assure him that having your eggs surgically removed from your body is no walk in the park, either.
  • Day 15: 7 eggswere able to beinseminated. 5 fertilized overnight. Feelingsuuuuuper weak, groggy,crampy, and miserable, but so happy at the fertility report! Jimmy and I are so happy to find out that we can actually make embryos together. After five years of going at it like jackrabbits, we were certainly beginning to wonder:
    • Egg 1: 2pn (two pro-nucleate)
    • Egg 2: 2pn
    • Egg 3: 2pn
    • Egg 4: 2pn
    • Egg 5: didn’t make it overnight
    • Egg 6: didn’t make it overnight
    • Egg 7: 2pn
  • Day 16: embryos are now scored by the number of cells they divided into, and their quality grade (A-C). Possible transfer tomorrow (day 3), but hoping for day 19 (day 5).
    • 1: 4B
    • 2: 2B
    • 3: 2B
    • 4: 4B
    • 7:4C
      • Start Crinone suppository daily (THE WORST) and estrogen patch (changed every other day)
  • Day 17: embryos are now scored by the number of cells they divided into (number), how fragmented they are (first letter A-D), and how their symmetry is (good, G, or poor, P). We have 037an 8BG and a 7BG, and are only eligible to transfer one embryo. Transfer is today. This made me go off the deep end. I bawled my eyes outthe whole way to the clinic. I had hoped and prayed for a 5 day transfer. There’s just something about knowing that your little one is strong enough to survive 5 full days. And, this meant I had to miss my best friend’s baby shower :( Infertility robs you of control in so many aspects of your life.
    • The transfer itself is quite an interesting process. I will lay it out there for you, and yes, the process is as uncomfortable as it sounds. But you’re so excited at the thought of being pregnant, zero fucks are given. First, you show up an hour early, and begin drinking water. They want you to have a full bladder for transfer as it helps the doctor to see where the catheter is traveling to, and it helps to tip your uterus to a more conducive angle. After you sit there for a while with an uncomfortably full bladder, you get checked by an ultrasound tech to make sure you’re full enough. I guess I am an overachiever; I was told to go pee for 7 seconds then stop. Yes, it was hard to stop. Then you go back to your little room, and spread eagle. I had the honor of having med students, so there were plennnnnty of people staring at my who-ha. Again, zero fucks given…I was about to be impregnated! And see the exact moment my teeeeeeny tiiiiiiny little embryo began to live in my body. There could have been 20 people in that room and I wouldn’t have cared in the least. So, the med students, two nurses, the doctor (whom I had never met, and we were definitely on different pages), and the ultrasound tech checked my bracelet a few times, went over my date of birth and name, we signed consents, and then did a “mock transfer” to make sure everything looked good. While we were waiting for the embryologist to join the party, I burst into tears. The doctor thought it was because I was uncomfortable sitting there with a full bladder, a full room of people, a wide open speculum, and instruments galore. But it wasn’t. It was because I was SO HAPPY to know I was going to have an embryo that Jimmy and I created together alive in my body. The moment really took my breath away. I had to snap out of it when the embryologist exclaimed “READY!”. Mechanically, the door was opened, and in he walked with my baby in a long catheter. Jimmy and I watched in awe on the ultrasound screen, as the tiny, visible puff of air or liquid (the embryo is too small to be seen on the screen) was inserted into my uterus. That part of the procedure was the quickest. The embryologist exited the room, checked the catheter to make sure the embryo was in its new home, and yelled “CLEAR!” Then, the nurse let me know when my pregnancy test was scheduled, and one by one everyone left the room. I immediately turned to Jimmy, and with a HUGE GRIN said “I’m pregnant!” He reminded me that I was PUPO (pregnant until proven otherwise) and that we were supposed to practice cautious optimism. Screw that noise…PREGNANT AF. Now, back to the schedule…
  • Day 18: the first full day of my least favorite time; the two week wait, or TWW as it’s called in the infertility world. Continue the estrogen patches, and the dreaded Crinone.
  • Day 19: We had one blastocyst make it to day 5 to be frozen. The blast is graded differently, again, and we froze one 3BB. I am going to suggest that you google this scale if you want more info, as I do not fully understand it myself. It has to do with how close the embryo is to “hatching” out of it’s shell, the quality of the inner cell mass, and the quality of the trophoectoderm (outer layer). Basically, we were able to freeze a pretty good, but not great quality embryo (mommy thinks you’re great, though, microscopic one).
  • Day 22: I’m fast-forwarding a bit, as it would be boring to drone on and on about how terrible the waiting is. I go to day 22 because this is 10 days after the trigger shot, and supposedly the day when you should no longer test positive on a home pregnancy test (hpt).
  • Day 23: Even though they strongly advise against peeing on a stick, I decided to anyways (seriously women who don’t, props to you-wish I had your willpower). I watched with (sleepy) anxious anticipation as the dye spread, and one right hand line appear. No worries, I thought, it’s still so early, and we only transferred one embryo, so it shouldn’t be positive anyways. Back to bed I went.

Later that day, another TTC (trying to conceive) friend sent me an excitedly panicked picture of a positive pregnancy test. She had tested, thought it was negative, and threw it away. Only after getting out of the shower did she realize there was a faint line. After several more tests, the confirmation was there. I was SOOOOO EXTREMELY EXCITED for my friend who had waited so long to see that second line. Her story made me think about my morning. I hadn’t even given my test a minute before determining it was negative. It would be so exciting to be just days apart from my friend!

So, when I got home, I dug it out of it’s hiding spot. (Yes you read that right, hiding spot, not trashcan. Can’t have the husband knowing how crazy I am just yet!)

Wait…is that…what I think it is???????

To be continued…

Up next: IVF #1: The Result.

One thought on “Infertility-Our Struggle: IVF #1

  1. Pingback: Infertility-Our Struggle: IVF #1 the Result - MC Maternity

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