Monday, 31 March 2014

A day by day guide to IVF - Pre-retrieval.

A lady asked for a breakdown on a message board, so I thought I'd post my response here as well. The bottom line is that every IVF cycle is different - clinic to clinic, woman to woman, and cycle to cycle.  Here is the general schedule of events, based on my two IVF rounds:

Once you have the green light from your clinic (which involved endless testing, some quite invasive and uncomfortable, and may have taken months), then you wait for a new cycle to begin. This is the down regulation part of the cycle, and involves roughly 3 weeks of birth control pills. There is a fair bit of flexibility in this portion, but mine always started with blood tests and ultrasound on day 3, and starting pills that night. On the 18th day of taking pills, I had another ultrasound to make sure the pills were doing their job of "quiet ovaries and thin lining", which they were, so then with some flexibility the decision is made as to when to stop the pills. There is some unpredictability as to when bleeding will occur after stopping pills, so I was more involved in my second cycle planning dates with my clinic, based entirely on my first cycle. Symptoms of pills are much more pronounced when you just take it one cycle after 10 years off, and they suck. For me, it's headaches & irritability. No wonder I didn't have any long-term relationships when I was young and on the pill, makes me wonder why I was on it in the first place ;)

Cycle 2, again, on day 3 go for blood tests and ultrasound. this day 3, coming off the pill, I was not as actively bleeding when I went for my ultrasound, which is pretty awkward for me but old hat to them. It's not something you think about until you're standing in the change room, sheet wrapped around you like a skirt, hoping you don't start bleeding down your leg while you wait for them to call you in. Oh, and internal ultrasounds (aka vaginal ultrasounds) are sometimes uncomfortable, sometimes not, and you get used to them. I've had days when I was quite tender and it's very uncomfortable, but other days when it was fine. During my first cycle I got more tender as the days went on. During my second cycle I was tender on the left only two occasions early on, but then it got better. On the basis of this day's "monitoring", the decision is usually made to start injections. This day 3 now becomes day 1 of injections.

You're left alone to inject yourself daily until day 5 (of injections), when you return for monitoring. At this point, estradiol is starting to get pretty high so this is when I start leaking extreme amounts of cervical fluid. This is also the day when, depending on monitoring results, a GnRH antagonist is added to the injection routine, to prevent the high estradiol from prompting a lutenizing hormone surge. It was at this point in my second round that we discovered I was responding a bit slower than the first time, so I knew my perfectly planned schedule was in jeopardy. I was a day behind at this point.

Day 8 (of injections), more monitoring. After this point, it really could go day by day. This is also when my boobs became really sore. On my first round, growth was progressing nicely and they had me back on day 10, when I was instructed to take a partial dose of injections at my usual time, my trigger injection at a specific later time, and given the appointment time for my retrieval. On my second round, I was back on day 10, 12, and finally on day 13 they said I was ready to go. My schedule wasn't completely shot, in fact it worked out pretty well for the most part.

My clinic requires you to take 7-10 days off work after retrieval, and 14 days restricted activity, so put your feet up and relax!

Sunday, 16 March 2014

One month decaf

It seems I'm always in countdown mode. I was counting down to my appointment. Then I started the second cycle right away, within the week, starting with the birth control pills, and counting down to the next scan, the last pill, crossing fingers that my period would start as predicted (it did, perfectly), counting down to today - the first day of injections.

Nine more days of injections
Three more uncomfortable ovary scans
Three more days of injections until I see the progress!

Antral follicle count: 13

The kit - three injections. The dial-a-dose pens are great! Mixing Menopur, not so much fun but easy when you get the hang of it. No one should have to get the hang of it.

Monday, 10 March 2014

Caffeine free me

I've been caffeine free for a few weeks now. By which I mean I switched to decaf. The most caffeine I ingest comes from an occasional green tea, a rare afternoon pick-me-up (not often enough). So it should not come as a surprise, that when I made chocolate peanut butter cookies yesterday, and ate a few extra chocolate chips left in the bowl, I had a really hard time falling asleep. It's funny how the body adjusts. The bigger pick-me-up comes from the gym. I'm loving my cardio workouts, and they are loving me. I finally hit my long aspired target weight (only to eat the cookies), and so now that I've officially had the last birth control pill before my IVF cycle, which starts in FIVE DAYS, no more scales, it's just about feeling good, stress relief, and eating well.

And with that, I'm off to the gym to spend 30 minutes on my favourite elliptical, followed by some arms.

Wednesday, 5 March 2014

Dear Visa

Dear Visa,

Yes I did just spend $6K at the hospital. I know this is unusual activity on my card. Thanks for giving me that gold card all those years ago, it really came in handy today.

Loyal customer with a very valuable fridge.

Tuesday, 4 March 2014

The Watched Pot

Remember the expression, a watched pot never boils? I'm sitting here, 18 hours until my scan and meeting with my nurse, repeatedly checking my countdown timer. I'm very excited, and just a tad anxious about the massive amount of money I have to fork over tomorrow as well. It may not be quite a down payment on a house, but I'd get a house. This is more like buying the dream lottery ticket if the ticket cost $6500. Or like paying a year's tuition for a program with a 30% graduation rate. It's a lot of money with a pretty high chance of coming away empty-handed. But I'm trying not to focus on that. Instead, I'm focused on all the things we did to make this shot have the highest chance of success. I'm not thinking about if it fails, only when it succeeds. I'm picturing myself in summer maternity clothes. I'm imagining multiples - like do they make strollers for triplets? How long can twins or triplets sleep in the crib together? How do parents tell them apart? This exercise makes twins seem like a walk in the park because at least I have two arms, two breasts, but I never did learn to juggle three balls. I even have names picked out that work for all scenarios except more than one boy. But that won't happen ;)