This a continuation of the history of our infertility struggles from IF up until now – Part III
So here’s my protocol for IVF#1:
I start with a 175IU Follistim shot in the AM, 2-vials of Menopur mixed in 1ml of saline water in the PM. Both Menopur and Follistim help with follicular growth. I was instructed to give myself these injections in my belly sub-cutaneously (just under the skin as opposed to in the muscle) exactly 12 hours apart. 7:30 was the time I picked. My RE’s office wanted to monitor me every 2 to 3 days with an ultrasound to check my follicle growth and blood work to check my estradiol levels (the amount of estrogen in my blood — the higher the levels, the higher the activity in my ovaries). Depending on the results from the u/s and b/w, they would adjust my meds accordingly. Later in the stimming process, I would add a couple more drugs called Ganarelix and MicroDose hCG to mature my follicles and finally, Ovidrel, the hCG trigger shot that would induce ovulation. After ER and just before ET, I start the mondo PIO shots!!! That freakin’ thing scared me the most. 1 and a 1/2 inchs of needle that needs to go in my hip! I dreaded this the most.
Here’s my time line for IVF#1…
Aug 7th – We celebrated our 5th wedding anniversary and as a gift, we picked up our box of IVF meds today. Fun fun!! I was really excited. I had been waiting for this day for the past couple of months. We ordered our IVF meds through a local pharmacy. I will post some pics later.
Aug 19th – Base u/s and b/w. E2 levels:32. Apparently right where they should be.
Aug 22nd – First day of stims: 175IU Follistim (AM) + 2 vials of Menopur (PM). Hubs had to fly out of town early morning for work… which means I was left all alone at home to do my first ever injection on my freaking own…AHHHH! That morning, my heart was beating so hard and fast that I could literally hear it. It was just the Follistim in the morning… a thin (29 gauge) and tiny (1/2″) needle. I decided… OK pinch skin with one hand, hold syringe in another hand, count to 3 and then poke it in. Got everything ready, needle all ready to go in, 1…2…3 and nothing… I COULD NOT get myself to poke myself! (Who in their right mind would want to inflict pain onto themselves!?!) God… this is nuts! After doing that for about 20 times or so, I got the needle in…whew…but guess what, I couldn’t reach the plunger to push the medication in!!! When I tried to get to the plunger, the freakin’ needle came out and poked my hand! Ouch! Oh… I was such a mess! Replace the needle, do the dance again, and finally administered myself my first IVF shot! YAY!! I was sooo proud of myself… I couldn’t contain it! :) In retrospect, Follistim is a piece of cake… (I could do that in my sleep today if I had to!) It was the smallest and thinnest needle I encountered throughout IVF. But once I got through my first shot, I could handle the rest pretty well.
Aug 25th – 1st u/s and b/w. E2 levels:153
Aug 26th – 1st Acupuncture appt. Yeah… I know… I still hate needles! But apparently studies have shown that acupuncture can boost the chances of success for IVF patients! I decided to give it a try… anything I can do to help the process. Actually, it wasn’t bad at all. My acupuncturist was awesome. She was very mindful of the fact that it was my first time and it was great…I didn’t feel a thing.
Aug 28th – 2nd u/s and b/w. E2 levels: 840. Lots of follies. Total of 11, averaging about 9mm. Follistim still at 175IU in the morning but my RE lowered my Menopur dosage to 1 vial
Aug 30th – 3rd u/s and b/w. E2 levels: 2388. Follistim lowerd to 125IU. Add Ganarelix and 50ml of MicroDose HCG along with 1 vial of Menopur to the list. That meant 3 separate shots in my belly in the evening! Yikes! Also had my 2nd acupuncture appt today.
Aug 31st – 4th u/s and b/w. E2 levels: 4200. My E2 levels were very high that my doc was concerned about hyperstimulation. He asked me to stop Menopur. But asked me to continue other meds. Follies were looking great. I had a total of 17 follicles, biggest being 17mm. He wanted to see atleast 6 follies above 18mm before I trigger.
Sep 1st – 5th u/s and b/w. E2 levels:5480. My E2 levels had increased even more. Follistim was reduced to 75IU. Follies were all finally ready — about 8 or so follicles were above 19mm. Yoohooo! I was asked to stop all meds. I was to give myself the hCG trigger shot at exactly 7:30pm and was asked to come in for ER @ 7am two days later. Ah… the drama for the hCG trigger shot…that deserves a separate post. Let’s just say that I had to get the Ovidrel replaced from my pharmacy. Thank God we opted for a local pharmacy. And I can’t thank the pharmacist enough for coming into work on Labor day just to refill my Ovidrel prescription! If not for her, we would have cancelled my cycle!
Sep 2nd – 3rd Acupuncture appt
Sep 3rd – Egg Retrieval. Got 18 eggs. 16 were mature. 12 fertilized w/ ICSI. By this time, I couldn’t even walk straight. The pressure and the fullness from my ovaries that were filled with all these amazing >20mm follicles was quite a situation. I just wanted them out. The procedure was as smooth as it could be. I was given a general anesthetic for the procedure and my hubs did a pretty good job of keeping me doped up with hydrocodone (narcotic pain killer) at home. I just lay in bed and slept all day! Because of my very high E2 levels, I was now at risk of developing a serious condition called Ovarian Hyperstimulation Syndrome or OHSS. Apparently my ovaries responded too well to the medications! Were they actually blaming my ovaries for doing their job?!.. these docs I tell you! As my RE explained it to me, OHSS is a condition where my veins are unable to hold water within itself. So water tends to ooze out of its walls into the abdominal and chest cavities. Gross! I know… but very serious! So I was told to keep my protein and electrolyte consumption high. So I drank nothing but Gatorade for the next week! I was also told that they would postpone ET if I have any symptoms of OHSS as a pregnancy can worsen the condition. Bummer! So here I was… chugging as much Gatorade as my bladder could handle and praying that ET would not be canceled.
One awesome thing that happened was that the RN that looked after me during the ER said I could use 23G, 1″ needles for my PIO shots instead of the 22G, 1and 1/2″ needles! I was sooo happy.
Sep 5th – Start 1ml of PIO shots in the evening. After the Follistim drama, hubs promised to be there for the PIO shots. He administered my first shot. I was soo freaked out but it wasn’t as painful as I had imagined it. My trick… Ice the area long enough so that it is practically numb to the touch. This way, I don’t feel the needle go in at all. Hubs had to go out of town for an entire week during this phase, so I had to learn to give myself the PIO shots. I started doing that from the 2nd day onwards. It wasn’t bad at all! I got used to it pretty quick.
Sep 6th – Embryo Transfer. The RE evaluated me for any OHSS symptoms. I was OHSS-free as of that moment but the peak time for contracting OHSS was at least a couple of days away. It usually peaks 8-10 days past the hCG trigger shot. Since I was OHSS-free on that day, the RE agreed to transfer that day. YAY! We transferred 2 8-cell grade 3 embryos. DH and I wanted to transfer 3 embryos but the RE wasn’t comfortable with that (given my age and my increased risk for OHSS). We even got a little ultrasound picture of our 2 3-day old embies! I will post the pic when I get a chance.
Out of the 10 remaining embies, 5 embryos were frozen that day at the 3-day phase and the other 5 were left to mature till day 5. Only 1 made it to the freezing standards of the clinic. So we have one frozen blast.
Sep 18th – Beta… which we now know as a BFN. Booo!
So there you have it my friends… We are all caught-up now.
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