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An IVF Cycle
Trying for baby
As a young woman, you spend most of your late teens and twenties making sure you don't get pregnant... you are one the pill, use condoms or some other form of contraceptive. When you do want to have a baby, it can come as quite a shock when despite all you do, it's just not happening. I found myself in that situation a few years ago. My husband and I tried for a year with no pregnancy. We finally turned to IVF and had a successful pregnancy (after 5 IVF cycles). Our daughter is now almost 18 months old and we are hoping to have a second child. This hub is about the current IVF cycle we just went through in hopes of a pregnancy.
On April 9, I got my period.
On April 18th I went in for blood work to see if I had an LH surge. An LH surge detects ovulation. I didn’t so was scheduled to go back two days later on April 20th. An LH surge was detected on that day which meant the cycle would begin.
Using April 20th as day 1, I was instructed to apply the Climara patch on day 8 or April 27th. I would need to change the patch every other day until I got my next period. At that time I would leave the last patch on until it fell off or until the day of my HCG trigger shot. On April 28th, 29th and 30th I was to take an injection of Ganirelix.
Climara is a patch that contains estradiol, a form of estrogen.
Ganirelix is used to regulate hormones. The injection is no biggie as it is a short needle but I did find I was itchy for about 5-10 minutes at the injection site
On May 2nd I got my period. I called the nursing team but it was after hours so didn’t hear back from them until the morning of May 3rd. Normally you’d go in for blood work and ultrasound on day 2 of your period but since I called so late, they scheduled me to go in on day 3.
On May 4th I went in for blood work and ultrasound. The blood draw was not fun that day. It hurt and I had to have blood taken from both arms. I guess the blood flow was a bit slow and the technician didn't get enough out of the first arm so she had to tap the other. Not sure what was going on with me. I made sure to drink water and have breakfast. This is important for early morning blood draws. If you are dehydrated, it is hard for them to find a vein and even if they do, the blood could be unwilling like it was for me.
The nursing staff called later that afternoon to instruct me to start my shots; Lupron and Gonal F (morning and night), as well as a half tablet of dexamethasone (once a day). I would continue to take them through Tuesday May 8th,when I would go back in for blood and ultrasound monitoring.
Lupron (leuprolide), is a hormone that overstimulates the body’s own production of certain hormones and reduced the amount of estrogen.
Gonal F is a hormone that stimulates follicles and regulates ovulation as well as the growth and development of eggs.
Dexamethasone is a steroid
On May 8th I went in for blood work and ultrasound. Not much had changed (my follicles are slow growers) so it was just more of the same until Friday May 11th when I would go back in for blood and ultrasound again. I did have to order a refill for Gonal F. I always do…for some reason the insurance company only lets the pharmacy send out so many pens per shipment.
By this time the hormones started to kick in as I was feeling a bit frazzled and wanted to cry for no reason.
On May 11th there were not changes. No follicles more than10mm in size, which is when they start to track them. It seemed like with this cycle the growth was slower than it ever was. I was beginning to wonder if they would ever grow.
I was also tired, emotional and extremely grumpy.
The nurse scheduled me to go back in on Monday the 14th for blood work and ultrasound again. By this point my arms were starting to look like an addicts (ok not that I really know what that would look like..but they had seen better days).
On May 14th there was finally some change! Follicles in the 12 to 16mm range, which meant back the next day for more monitoring.
On May 15th I went back for more blood work and ultrasound. When the nurse called she advised I would only take the Gonal F that night as well as the dexamethasone at my usual time, no Lupron. Then at precisely 8:30 pm I was to take the HCG trigger shot IM (intramuscular). Not the most pleasant experience but not too bad.
HCG (human chorionic gonadotropin) is a hormone that supports the development of eggs and stimulates the release of the eggs.
Egg retrievals are scheduled 36 hours after the trigger shot which made mine at 8:30 am on Thursday May 17th. You are instructed to arrive 1 hour prior so that they can get you checked in and prepared which includes:
Blood pressure check
Fill out paperwork for doctor and anesthesiologist.
You cannot eat after midnight the night before and you cannot wear anything with fragrance, nor any make up.
On May 17 we arrived at the office at 7:30 am. The procedure went well and we had 5 eggs retrieved. Not a stellar number but good for me. They actually took me a bit early as the women who was scheduled before me was running late. Not really something you want to be late for but …well, what can I say.
Sometimes you have cramping after the procedure but this doctor must have had the magic touch because I felt great! We went home and I had a big breakfast and then slept for a few hours. The anesthesia usually tuckers me out for the day.
On May 18th the nurse called to schedule the embryo transfer time for 1:40 pm the following day, May 19th. I’m usually on a 2/3 day flex but other women are on 3/5 days. It depends on the individual and the cycle you are on. 2/3 day flex just means that they plan on implanting the embryos on day 2 or day 3 after the retrieval.
On May 19th we went in for the transfer. We had two embryos that fertilized out of the five eggs they retrieved. Both were assessed the same; 4BF which was a first for us. Usually we have one good/ok embryo and one not so good. What does the assessment of 4BF mean?
4 means the egg has divided into 4 cells which is a good number for the second day after retrieval.
B is the fragmentation. An A is less than 5% fragmentation, a B is 5-25%. The degree of fragmentation is reflective of the quality of the embryo. A's and B's are optimal.
F describes the symmetry of cells. Cell symmetry describes the evenness of size and distribution of cells in the embryo. Symmetry is graded as Good, Fair and Poor.
So... now we just wait until May 31st when I go back in for a pregnancy test (of course I will do a home test before then!). When we did the transfer for our now 18 month old daughter, I was so crazed and anxious that a bought a pregnancy test during my lunch hour at work and then went into the bathroom of a Thai food restaurant and peed on the stick. Yes I'm crazy! While I was waiting for my takeout I took a home pregnancy test in the less than pristine bathroom. I blame it on the hormones.
That in a nutshell is what a cycle looks like. Of course every woman is different as is each cycle. It all depends on your situation as well as your doctor.
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