Costly

Everyone has different insurance coverage and costs but I thought I would share what our out of pocket expenses were for the drugs I used during our IVF treatment. Had I chosen to wait another month before beginning IVF we would have researched having meds shipped in from overseas where they cost a lot less but since I didn't want to wait until after the holidays to begin I researched local pharmacies trying to find the lowest prices. I checked out Costco, Freedom, CVS, Walgreens, towndrugstore.com and MDR pharmacies. Even though towndrugstore.com had better prices on some items I did not go through them because of how long their shipping was going to take. When all was said and done I went with MDR.

Follistim AQ - 600iu injection - quantity 3 - $1,370.94
Menopur - 75iu injection - quantity 10 - $759.80
Ganirelix - 250mcg injection - quantity 4 - $331.72
Vivelle 'dot' - 0.1mg patch - quantity 4 boxes - $46.97
Estradiol - 2mg tab - quantity 60 - $34.79
Endometrin - 100mg tab - quantity 36 - $165.84
Progestrone - 200mg lozenge - quantity 60 - $179.40
Leuprolide - 4mg injection - quantity 2 - $89.73
Codeine - 30mg tab - quantity 10 - $9.73
Doxycycline - 100mg capsule - quantity 2 - $4.47
Reclipsen (birth control) - 1 month supply - $15.09

The above would have cost even more if I had not asked my nurse at the clinic if they had any patients who donated their leftovers to the clinic because I got lucky! I was given 600iu of Follistim, a box of Endometrin, and 1 injection of Ganirelix which helped to cut down my costs by about $500!

This was just the beginning I had to order additional supplies of the Vivelle, Estradiol, Endometrin and Progestrone as I had a positive result from my IVF. These drugs were all taken until the end of my 1st trimester since I was not released to an OB until I was 10 weeks along I paid the prices above over and over again for the refills. Once you are released to an OB some will agree you should stay on the drugs above and they will then be covered by insurance. If your OB doesn't think they are necessary you will continue to pay out of pocket for them.

Last Visit?

At 9w5d we had our next appointment with Dr. W, each time we have an appointment I hold my breath until we hear that heartbeat. This time was no different and this day had the potential to be significant in our IVF journey. Dr. W got right down to business. He asked how I was feeling, if there were any changes or problems since the last visit and then we did the ultrasound. After a few seconds that beautiful sound filled the room once more. The sound of the little's heartbeat still amazes us and is mesmerizing. 

I wish I could say that I do not have fear and anxiety about this pregnancy but that is just not true. It is a feeling that I am not sure will go away until we are holding our little one in our arms, till it takes its first breath and we hear its first cry. There are times that I am in disbelief that this is actually happening for us. I kept telling Paul that maybe I just have a sickness that lingers because maybe then if something happens it wont hurt as much (talk about denial). We have just been down such a long road to get here and I am afraid to let myself love this little too much (who am I kidding we all know I am smitten) because nothing is promised. 

So I continue to pray for strength, for my little ones life to continue, for us to be at the start of a new chapter and little by little we start to venture into the deep waters to begin to plan for this little one who WILL invade (take up residence in) our lives, our home and our hearts. 

Juniors heartbeat at a whopping 180 bpm.

Measuring Junior : You can actually see arm and leg buds now. Such an amazing difference from just 10 days prior when you couldn't really make out what anything was and it just looked like a blob. 

Since Junior is doing well and in just 2 days we will hit the 10 week mark we were told that this would be our last visit at the clinic! We graduated!!! This is a huge deal for those who go through IVF.

As a parting gift we were given a baby blanket, bib and spoon. 

Now comes the scary but oh so exciting part.... we had to find ourselves a good old fashioned OB!

And of course I am still taking these every day:

         - Progesterone lozenge: 3x a day

         - Endometrin insert: 3x a day

         - Estradiol tablet: 3x a day

         - Vivelle Dot patch: time to stick on a new one every 3rd day

         - Prenatal vitamin

         - Folic Acid

         - DHA

         - Fish Oil

         - Baby Aspirin

By the time we have our first OB appointment with Kaiser I should be off most of these!

The Saga Continues

The bleeding gave way to spotting and cramping day after day after day. Waiting 10 days until our next appointment was excruciating! Every day felt like an eternity. Every day of those 10 days included spotting, cramping, worrying, praying, hoping. The longer the spotting and cramping went on the more annoyed I got with it. I begged it to just go away! I was frustrated and scared that something would happen to #1 if it continued as it had been. Luckily for me a few of those days were spent being semi-distracted by a trip to visit TK to do wedding stuff. I made sure I was laying down as much as possible, taking it super easy and not over doing it.

Finally, after the longest week and a half ever, it was time to head back to HRC and have our appointment with Dr. W. We went over how I was feeling and what had been going since my last appointment. The spotting seemed to have subsided the day before our appointment! We keep on praying that it will stay that way!

Dr. W took a look to see what was going on inside and there was our little miracle measuring right on at 8 weeks 0 days. Once again we had the privilege of hearing that amazing little heartbeat pumping away at 167 beats per minute! Dr. W confirmed that #2 had not made it. The good news is that #1 was not harmed by any of the cramping or spotting.  

Measuring Junior

Checking out Juniors heartbeat

The appointment following this one is a biggie -- as long as everything still looks good and nothing major happens it will be 'graduation day' meaning that Dr. W would sign off on us and I would be transferred over to a good 'ol regular OB!

And of course I am still taking these every day:

                    - Progesterone lozenge: 3x a day

                    - Endometrin insert: 3x a day
                    - Estradiol tablet: 3x a day
                    - Vivelle Dot patch: time to stick on a new one every 3rd day

                    - Prenatal vitamin

                    - Folic Acid

                    - DHA

                    - Fish Oil

                    - Baby Asprin

Drama

I was taking a shower and didn't feel too good so I got out and dressed for bed. I laid down for a few minutes hoping it would pass but then I felt horrible pain in a straight line from my belly button all the way down my abdomen. I was frozen in the position I was in, it hurt too bad to even think about moving and I was afraid if I did move that it would make the pain worse so I just laid there. Praying. Lord don't take our babies.

This happened just 2 days after our visit where we got to hear the heartbeat for the first time. After about a half hour I got up to use the restroom and there was bright red blood. I was in shock. I was in denial. I went and laid back down. Praying. Lord don't take our babies.

At some point I fell asleep. In the morning I was still having some bleeding/spotting so I immediately called the clinic. I left a message for our nurse, G. She listened to my account of what happened and told me to lay back down she would consult with Dr. W and call me back in a couple minutes. I waited. Praying. Lord don't take our babies.

Nurse G. called back and said that Dr. W wanted me to be on bed-rest for the day, to only get up when absolutely necessary and that I needed to come in for another ultrasound first thing the next morning. I let my manager at work know what was going on and that I wouldn't be in the office for the day. Then I laid flat on the couch for the remainder of the day. Praying. Lord don't take our babies. I was restless all night willing the morning to come faster so that we could hurry up and get to the clinic for our appointment.

Finally it was time for us to get up and head to the clinic. Sitting in the waiting room was excruciating. The ladies at the front counter looked at me and asked if I was alright, I could barely muster a nod of my head. As I had spent much of the previous 24 hours going between feeling numb and crying so I am sure I wasn't looking so good.

Dr. W got everything set up quickly, asked how bad the bleeding/spotting was and then he made some notes in my chart. Finally it was time to take a look inside. We held our breaths steeling ourselves against hearing the worst. Then after a few moments he pushed a button on the monitor and we once again got to hear the woosh, woosh, woosh of our babies heartbeat. The 3 of us let out a collective sigh of relief. Dr. W then moved the camera around to get a look at the second sac. He told us it was collapsing. Our second little was not going to make it.

It is a strange and difficult place to be - elated because our little with the heartbeat was ok but grieving because we were losing the second little. I was sad, I cried for our little who would never be but thankful that we did not lose them both.

At just over 6 and 1/2 weeks we lost our second little. 

The good news from that appointment was that little #1 had a stronger heartbeat than just 3 days prior. 

Heartbeat @ 125!

Dr. W then took length measurements. 

Dr. W said that unless I began bleeding again, more than I had already or I was suddenly in a lot of pain again that he would see us again in 10 days. But, he did not expect anymore drama. This little was doing well and it would be our take-home baby. While we are thankful for his optimism and knowledge in this field it is difficult to block out the possibility that while this baby is currently thriving nothing is guaranteed. We are laying our trust in God that he will continue to protect and grow this precious little one whom we already love so very much.


Disclaimer: Everything is still going well with the pregnancy. We are well past when these events occurred.

Sneak Peek

Five days after our 2nd beta test we had our first ultrasound to see what was going on in there. Dr. W was looking for a few specific things such as a gestational sac, yolk sac, fetal pole and hopefully a heartbeat. Early in pregnancy the gestational sac and embryo change drastically every day, so being off by even a few days with dating can make a difference in whether or not the ultrasound should detect a heartbeat. Around 5 weeks a gestational sac becomes detectable, at 5.5 to 6 weeks the yolk sac should appear and around 5.5 to 6.5 weeks the fetal pole appears and it is possible to detect a heartbeat through a vaginal ultrasound. The fetal pole is the first visible sign of a developing embryo. This pole structure actually has some curve to it with the embryo's head at one end and what looks like a tail at the other end. The fetal pole allows for crown to rump measurements (CRL) to be taken, so that pregnancy dating can be a bit more accurate. The fetal pole may be seen at a CRL of 2-4mm and the heartbeat may be seen as a regular flutter when the CRL has reached 5mm. 

We had our ultrasound when I was 6 weeks 1 day so we expected to see a gestational sac, yolk sac and fetal pole. I made sure to tell Paul that at this point we may not see or hear a heartbeat and that we shouldn't worry about that at this point (but of course I was worried). 

Dr. W was able to see everything he should! Below you can see the fetal pole between the two + signs.

Dr. W then moved the wand around a little more and saw our second gestational sac, he was very cautious in telling us this because the sac was significantly smaller than the first one. He said we would wait and see but that he did not think our second embryo would continue to grow. Then he moved back to look at embryo number one and take some measurements.

Dr. W pushed a button on the monitor and all of a sudden a woosh, woosh, woosh came through... we heard the heartbeat for the very first time and saw the little flicker on the screen! He pushed some more buttons on the computer and it calculated that the heart was going at 106 beats per minute! He would have liked it to have been a little higher but since the heart could have begun contracting just day before he was not worried about it being just under "normal".  So long as the heartbeats kept going up by about 3 beats a day between then and our next appointment he said everything was looking good. 

Our first look at the heartbeat, the lines at the bottom of the screen show each beat. 

Double Time

One week after our original beta test, I went in for a second blood test. As I said the important thing to look at is doubling time. So you need at least two points of reference to determine if your numbers are good. Our second number was.....

Yes, you read that correctly 12,441 at 5 weeks since LMP

Generally doctors are looking for your hCG to double every 48-72 hours. My doubling time is at  43.32! So my doubling time looks fantastic! This is great news. The next big hurdle is an ultrasound to take a look and see if there is a heartbeat. 

And of course I am still taking these every day:

                    - Progesterone lozenge: 3x a day

                    - Endometrin insert: 3x a day
                    - Estradiol tablet: 3x a day
                    - Vivelle Dot patch: time to stick on a new one every 3rd day

                    - Prenatal vitamin

                    - Folic Acid

                    - DHEA

                    - Fish Oil

                    - Baby Asprin

Testing

hCG levels vary greatly from woman to woman. You cannot really measure yourself against another because the hormone levels can be on opposite ends of the spectrum but you can both still end up with a take-home baby, or the woman with super high results might miscarry and the one with low results may have a healthy baby or vice versa. You can check a chart to make sure you are in the normal range but it is best if you wait until you have had two beta tests and then calculate the doubling time. Your hCG should be doubling every 48-72 hours. That is the best indicator as to if your pregnancy is heading in the right direction. Here is a chart showing the normal range for a beta test. 

The day after I took my pregnancy test I went in for the beta test (blood pregnancy test). I stopped by the clinic first thing in the morning and then sat around waiting for the entire rest of the day constantly glancing at my phone to see if the clinic was calling yet. Let me tell you it is quite nerve wracking even though I had a positive HPT the day before. I prayed and prayed that the number would be high enough. I waited and waited (seems to be quite the theme for those of us in the IVF circuit). Finally around 2pm my phone rang, it was a 626 number, the clinic was calling. I picked it up and stepped outside. I held my breath.

Did I hear that right? I asked her to repeat the number again. Nope that was what I had heard the first time. Wow! Is this really happening? The lab tech congratulated me. I was in shock. I immediately called Paul who was also waiting on pins and needles for me to call (he had already texted hours earlier asking if they had called yet). About an hour and a half later Dr. W called to personally congratulate us and noted that the number was high. He even said "what have I done to you" at one point during the call. Our number of 846 falls during the 4 weeks LMP on the chart above. We were almost double what the high end of normal is.

Our second beta was scheduled for 1 week after the first, and we knew that we needed that number no matter how high it was to be doubling every 2-3 days. So we entered the next phase of the waiting game.

Resistance is Futile

I am weak. I gave in the day before my beta. I did it. POAS. While Paul was still in bed I quietly got up and went to the restroom. It was premeditated, I did not have any tests at home. I drove to a store with the intent to buy a pregnancy test the day before. I executed the purchase of said test, I took it home and shoved it in the bottom of a drawer. I tried to wait until the beta, but I couldn't. This is one of those things that I didn't want IVF to take from me. I wanted to be the one to POAS and tell Paul the news either way. So that we could celebrate together or grieve together. I didn't want a phone call while I was at work that could knock the breath out of me or be fantastic news that I would immediately want to share with Paul who would also be at work.

So I took the test. 

I sat. 

I stared. 

I waited.

And waited. 

And waited. 

And then when the result popped up I kept staring and waiting. I kept waiting for the NOT to show up. I was in shock. You know like back in the day when kids would say stuff like "You are the coolest.... NOT" how they waited a beat to knock you down to size. That is what I was waiting for. The punchline. It never came. The word PREGNANT just stared back at me. My heart was racing and the rush of adrenaline was crazy. I didn't just want to go running out into the bedroom like a crazy person waving a pee stick so I quietly got dressed and went to pick us up some coffee. Paul was awake in our room when I got back. So I handed him the cup and waited for his reaction. Then I thrust the pee stick towards him as further proof since of course it was possible, and maybe he was thinking she must be hopeful about the beta test. I practically shouted WE ARE PREGNANT at him. We hugged, we kissed, I shed a few tears (happy happy tears). 

For IVF patients we all know that it is best to wait for a beta test to confirm a pregnancy. If your beta number is too low it can spell trouble. If your beta number isn't doubling every 48-72 hours there could be a problem. So of course as happy as we were in that moment I knew that we still needed to see what those numbers were over the next week. If they are high and doubling that is a great thing. 

Anticipation

This may involve some rambling -- be forewarned. 

So many women who do IVF have an obsession with POAS (peeing on a stick aka a pregnancy test). Some of these women start POAS starting at just 6dp5dt (six days past a five day transfer) and continue to do so all the way until they have their beta test (blood pregnancy test) which is usually done about 2 weeks after transfer. They analyze and scrutinize photos of these tests trying to determine if the lines are getting darker, honestly a lot of the time I cannot even see a second line on them. Occasionally they will even invert the colors so that you can make out the test lines better. I know I may be in the minority here as so many ladies do this, maybe it helps them get through the 2 week wait but I think if I had done that I would have driven myself nuts.

Read those sticks carefully too, many of them tout that they can tell you 6 days before your missed period on the ads that are run on TV. Once you get that box home read the instructions as it will lay out what the odds are each day for how accurate their test is. Here is the info from an e.p.t. test. Notice that they don't even give you accuracy rates for more than 4 days before your missed period! Who knows exactly what these percents represent, are those women who do not get a 'pregnant' result not pregnant or are they pregnant and they took the test too soon? I'm just saying don't drive yourself nuts taking these tests if you have a regular cycle and you know about when your next period is due. The tests claim 97 - 99% accuracy but that is not until the day of your missed period! Many tests even say to wait until a week after you have missed your period.

A few friends asked if I would take a pregnancy test as it got closer to beta day but then if you get a light line or no line at all it could send a gal into a panic. Plus if you wait until your beta you get to be PUPO (pregnant until proven otherwise) longer, you get to keep that hope alive. On the other hand, if it was positive you would be able to have more of a special moment between you and your spouse when you tell them or if you do the test together, than going in for a blood draw and getting a call while you are at work later in the afternoon when the clinic gets the results. One thing is for sure I will not become a POAS professional, I couldn't take staring at a test and trying to decipher what it means, in my opinion just test once, a day or two before your beta and please give me the stick that has a happy or sad face just so there is no confusion.

Days 12 through 18           

                    - Progesterone lozenge: 3x a day

                    - Endometrin insert: 3x a day
                    - Estradiol tablet: 3x a day
                    - Vivelle Dot patch: day 12 and day 15 time to stick on a new one

And of course I am still taking these once a day

                    - Prenatal vitamin

                    - Folic Acid

                    - DHEA

                    - Fish Oil

                    - Baby Asprin

More of the same

Days 7 through 11
                    - Progesterone lozenge: 3x a day

                    - Endometrin insert: 3x a day
                    - Estradiol tablet: 3x a day
                    - Vivelle Dot patch: day 9 time to stick on a new one

PUPO

In the IVF community once you have transferred embryos you are considered 

PUPO or pregnant until proven otherwise. 

Day 6 - Progesterone lozenge: 3x a day

           - Endometrin insert: 3x a day
           - Estradiol tablet: 3x a day
          - Vivelle Dot patch: time to stick on a new one

This medication contains Estradiol, it is just in a different delivery method than the pills I take. Vivelle also helps make sure I have enough estrogen in my system. The medication is slowly released over a 3-day period. Side effects include: skin redness/irritation at the application site, breast tenderness, nausea/vomiting, bloating, headache. It is rare that any serious side effects occur but if they do you should contact your doctor immediately. 

Transfer Day

2 of our 6 littles did not make it to transfer day. 

I was given explicit instructions to make sure that when we showed up to the clinic that I had a FULL bladder. Since I didn't plan on getting up any earlier than I really had to I figured I needed to start drinking like I was in the desert from the time I got up till we arrived at HRC. I drank a 16 oz bottle of Gatorade and approx 750 ml of water! At first I was really worried that I wouldn't have enough liquid in my bladder and that it could cause problems. Then as the minutes ticked by and it was 15 minutes past our appointment time I started to feel like there was a good amount of liquid, then we hit 20 minutes and I started to think "uh-oh" I may have had too much to drink, at 30 minutes past I looked like a little kid doing the potty dance... finally at 45 minutes past I began to feel like my bladder would actually explode! I kept squirming in my seat telling Paul I didn't think I could wait any longer, that it was painful to sit there with a bladder so full. I walked up to the counter and explained how long it had been and couldn't I use the bathroom to release just a little bit of the pressure, I was given the ok and told to count to five and then stop. I ran down the hall to the bathroom just in the nick of time. As soon as I got back out to the lobby they called my name to get ready for the procedure at which point I started to wonder if I had enough in my bladder again. 

We found out later that it was because 8 of us patients all belonging to Dr. W were having our transfers done. One of the other patients had blood in her uterus which cancelled her transfer (any blood in the cavity  can mean the demise of any embryos and Dr. W will not waste any embryos with that possibility), because of this it took a little longer for the doctor to get her situated and move on to the next patient. 

My nurse got me all set up with my gown and booties and asked us to verify some information. I got situated on the table and then Dr. W came in to discuss the littles and how they were doing. We were told we had the best looking embryos out of all of the 8 patients. Fantastic news for us to hear. The lab guy who cultured our littles for the last week brought them up and took one last look under the microscope and signed off on them. Dr. W got all of his tools set up and the embryos set for transfer. The nurse got out the ultrasound wand and started pushing around on my belly to get a good picture up on the screen which is very important because this is how the doctor sees where to put the embryos, and placement means a lot. Paul stood by my head with a hand on my shoulder and our eyes were transfixed on the monitor. I had very minor discomfort due to the tools he used for the procedure, the ultrasound wand being pushed into my bladder was more bothersome. 

We watched as the catheter moved in so it could be seen on the screen and then as Dr. W pulled it back slightly you saw a bright dot emerge, then it pulled back again and a second bright dot emerged. There they were, our babies. The reason we decided to transfer two is because of how long it has taken us trying to conceive we wanted to give ourselves better odds of having one stick. After the procedure I laid on the table for about 15 minutes before being taken to a recovery room where I laid flat in a mostly dark room listening to music that was being  pumped into the room to help relax the patient for another 30 minutes or so. I was finally allowed to use the restroom, I went only after I asked for assurance that they weren't going to fall out or anything. Then we signed some final paperwork and headed home with instructions for me to lay with my feet up as much as possible though I was allowed to sit up to eat. Then I was told to just take it easy for a few days before resuming light activity. Then begins the long wait before you can go in for a blood test, the dreaded two week wait (sometimes longer if your clinic doesn't do blood tests on the weekend). 

We even got a picture to take home

Pill Poppin

Day 5 - Progesterone lozenge: 3x a day

           - Endometrin insert: 3x a day

           - Estradiol tablet: 3x a day 

Estradiol is simply estrogen. During the early part of the menstrual cycle, estradiol levels remain nearly constant. This is followed by a rapid increase reaching a peak the day before or of the LH (Leutinizing Hormone) surge, also known as ovulation. It is generally believed that the rise in estradiol is the factor which triggers the LH release. Following ovulation there is a drop in estradiol followed by a second rise which corresponds with the formation of the corpus luteum. Some REs (Reproductive Endocrinologists) prescribe estrogen supplements to help support the growth of the endometrium.

Our Littles

Many clinics (including ours) have begun favoring a 5-day transfer with the thought that those who make it that far are stronger and more likely to implant. A clinic will wait to make the choice between a 3-day and 5-day transfer because if there aren't enough viable embryos on day 3 to risk culturing to day 5 then it could result in the loss of a cycle. For example, if only two embryos are present on day 3, one or both, could stop growing by extending the culture to day 5 or 6. However, if six good embryos are available on day 3 (which was us), the chances are very good that 2 or more will survive to day 5 making blastocyst transfer feasible. 

The ones who look like they are "two", are not. Those ones have begun hatching, which is a really good thing! Hatching is when the cellular blastocyst hatches (breaks through) from the zona pellucida. This has to happen before implantation can occur. 

Day 3/4 - Progesterone lozenge: 3x a day
             - Endometrin insert: 3x a day
             - Estradoil tablet: 3x a day (photo and info to come)
Day 4  - change Vivelle Dot patch (photo and info to come)

Thrice

These medications are started from the day after egg retrieval so that your body begins to develop the best environment possible before transfer day. 

Day 2 - Progesterone lozenge: 3x a day

Endometrin insert: 3x a day

Endometrin is a vaginal insert containing progesterone 100mg. This is the same active ingredient as the progesterone lozenge, just administered in a different way. As noted yesterday it helps make your lining more receptive for a fertilized egg to attach at the beginning of a pregnancy. It is utilized because of the lack of natural progesterone in the body when a woman uses ART (assisted reproductive technology). Endometrin has its own list of side effects including: mild nausea, vomiting, stomach cramps, bloating, constipation or diarrhea, dizziness, drowsiness, joint or muscle pain, increased urination etc. and of course if you experience any severe side effects you should immediately seek medical attention. 

Estradiol tablet (photo and info to come): 3x a day

Update: I have a 4th medication I forgot to mention Vivelle Dot Patch which is applied once every 3 days

The Call & New Meds

 Six out of eight eggs fertilized. 

New medications for the next phase of our treatment:

Day 1 - Progesterone lozenge 

Progesterone is a hormone that naturally occurs in the human body, levels rise after ovulation to help build and sustain a lining in the uterus. This lining is where the fertilized egg will implant. The ovaries will produce progesterone during the first trimester, until the placenta takes over this function around the 9-10th week of pregnancy. Doctors will prescribe progesterone supplements for women who have undergone ART (assisted reproductive technology) such as IVF. One of the reasons for this is because the woman did not ovulate (the eggs are taken from the ovaries before ovulation occurs) so she may not produce enough of the hormone to sustain the pregnancy. 

This medication tastes terrible. I have to place under my tongue and wait for it to dissolve which takes about 15 minutes but sometimes up to a half hour. I received grape flavor (though I recently found out they have cherry, chocolate and mint -- don't know if those would taste any better) which is just gross. The fact that it is in the shape of a square isn't helpful either, it is pointy! Why not make it round?

          

Endometrin insert (photo and info to come)

Estradiol tablet (photo and info to come)

Each of the 3 medications above will be taken 3 times a day (every 8 hours)!

Still taking these once a day

Prenatal vitamin

Folic Acid

DHEA

Fish Oil

Baby Asprin

Egg Retrieval Process & My Procedure

The Process

The process of egg retrieval is known as follicular aspiration. Follicular aspiration involves inserting a hollow needle through the top of the vagina and into the ovaries. This needle is then used to suction out any eggs that may be present. In order to guide the needle into the appropriate area of the ovary a transvaginal ultrasound is used. This allows your doctor to insert the needle into your ovary at just the right place. 

Immediately following this procedure the eggs will be examined under a microscope to ensure that the egg is mature and viable. They are then placed in an incubator. Depending on the age of the patient and the effect that the fertility medications had it is normal to see between 5 and 20 eggs. The entire process takes about 30 minutes. 

My Procedure

We headed to HRC first thing in the morning on egg retrieval day. I was given my lovely bracelets, signed the consent for anesthesia, and then got dressed up in my hospital gown and fancy socks. 

I was taken back to the procedure room and waited for the anesthesiologist to get set up. The guy doing my anesthesia was sadly not the same one I saw for my surgery. It took this guy multiple tries in 5 different areas to get my IV set up! Ouch! He was finally able to get it going in my wrist. Last time the guy had no trouble getting it done on the first try. 

After all that Dr. W came in and we exchanged pleasantries while he made sure everything was set up. I do not remember anything beyond that point until they woke me to tell me they were all done.  I was taken to recovery where Paul was able to join me and given some juice. Dr. W came in to tell us that everything went smoothly and that he was able to get 8 eggs! If you remember we were worried that often times you will end up with less mature eggs than you had follicles so it was great news to hear. He said that we would need to wait for the lab to confirm that they were all mature and of good quality but he was quite pleased. Yay!

We had a celebratory breakfast and then I took it easy the remainder of the day. I was told there would be some discomfort and  possible bleeding from the procedure.

Beginning the day after an egg retrieval a whole new regimen of drugs will begin and you will find yourself (if you are like me) staring at the phone waiting for it to ring with news from the clinic as to what is happening. This is because a few hours (this varies clinic to clinic) after the egg retrieval process the lab will allow the viable mature eggs and your partners sperm to meet. They will be cultured overnight until they can be checked for fertilization.

Last injection of the cycle!

Paul was the lucky one this time around as he only had to give me 1 shot (with the IUIs he had to administer every single shot). This was the big one, intramuscular in the back of my hip, the trigger shot. 

Novarel contains human chorionic gonadotropin (HCG) which is a hormone that supports the normal development of an egg in a woman's ovary and stimulates the release of the egg during ovulation. Side effects can include headache, feeling restless or irritable, mild swelling or water weight gain, depression  pain or swelling at injection site and OHSS. If any side effects are severe in nature medical attention should be sought. 

Novarel should be given approximately 36 hours before an egg retrieval takes place (the doctor will give you an exact time of day this medication should be given). I was injected with 10,000 units. This medication is mixed in the same manner as Menopur. 

Checking the Follies

Had another appointment with Dr. W to check and see how things looked internally. He seemed surprised that we were down to 8 follicles though they were measuring at a good size and told me that I had a muted response from what he was expecting. Generally less than 6 is considered a poor response and more than 20 is considered hyper-stimulation. So most doctors would like to see you somewhere in that range. In addition each follicle may contain 1 or more eggs or it could contain NO eggs! Also not all eggs are of good quality which means they may not fertilize or could fertilize abnormally. This is why I believe Dr. W is showing concern. We are praying that each follicle contains at least 1 egg. 

Here is a close up of the above screen the larger the number the bigger the follicle and closer to maturity it is. My ovaries are still even showing 4 follicles on each side. 

Last day of this drug regiment! 

Menopur Day 7: 1 ml saline solution dissolved into 2 vials of Menopur powder (150)

Follistim Day 7: 300 iu injection

Ganirelix Day 3: 1 syringe (.5)

Additional needling

Ganirelix is used as part of a treatment program for certain fertility problems in women. It is generally used in combination with other hormones (FSH and hCG). Ganirelix works by blocking the release of a certain hormone (luteinzing hormone). It helps delay ovulation and increases the chance of producing fertile eggs. 

Side effects for this drug include: Redness or pain at the injection site, headache, mild nausea/stomach pain and tiredness. This medication may cause a condition known as OHSS, this condition may occur during or after treatment. Rarely, serious OHSS causes fluid to suddenly build up in the stomach, chest, and heart area. You should seek immediate medical attention if you develop the following side effects: severe pain or swelling in the lower abdomen, severe nausea/vomiting, sudden/rapid weigh gain, change in amount of urine.

 

Menopur Day 6: 1 ml saline solution dissolved into 2 vials of Menopur powder (150)

Follistim Day 6: 300 iu injection

Ganirelix Day 2: 1 syringe (.5) This drug is also quite simple to inject, it comes ready to go. The medication is in they syringe with the needle attached. All you have to do is wash your hands, use an alcohol swab to clean the injection site and then insert the needle making sure to only inject the amount prescribed by your doctor.