March 28, 2008

My "stash", my calendar, and IVF 101

As is a picture of my meds stash. Behold the awesomeness. Well, awesome - I don't know. But these are my many little friends who are accompanying me on the road to babyville. And I guess my Dr. thought I might be lonely because there sure are a LOT of them.

I arranged them from bottom to top in the order in which they will be making me clinically insane entering my body.

I want to make a special note of the box of Menopur that is lying on top of the other boxes of Menopur. This is a very special box of ridiculously expensive hormones. This box was donated to me by a perfect stranger. She found out I was needing meds and she stepped up, saving me somewhere around $300. The day I received her package in the mail, it felt like the best care package in the world. Because I have been having quite the shitty time of it lately (as you might have read) and here this stranger has reached out to me in this really surprising way. So now, I am calling it my lucky box of Menopur. I just have to decide whether I should start with it, or finish with it? Either way, when I open that box I will surely smile. Thank you Menopur fairy - you know who you are.

Also, I was inspired by another friend's post and decided to post my "IVF calendar". For those of you completely new to this whole process I will post some kind of short explanation of what this all means at the end, K? (also I am linking all the meds so you can click on them and get an idea of what they do.)

Day 1: March 19 - started my period
Day 3: March 21 - started Birth Control Pills
Day 14: April 1 - start Lupron and Dexamethasone (continue up till embryo retrieval), and take one cytotec (vaginally) in the evening to open my cervix for the laminaria placement the next day.
Day 15: April 2 - Laminaria placement (seaweed stick in my cervix to open it for embryo transfer in a few weeks - so the embryos aren't squished)
Day 16: April 3 - remove Laminaria.
Day 18: April 5 - take last birth control pill.
Day21: April 8 - expect period. again.
Day 23: April 10 - Blood work and ultrasound.
Day 25: April 12 - Start stims: 2 ampules of Menopur in the morning and 300u of Gonal F in the evening.
Day 28: April 15 - Blood work and ultrasound. (Mr. Spicy gives "back-up sample" this week) - adjust meds according to results.
Day 30: April 17 - Blood work and ultrasound. Adjust meds according to results.
Day 31: April 18 - Blood work and ultrasound. Adjust meds according to results.
Day 32: April 19 - Blood work and ultrasound. Adjust meds according to results. (get pre-retrieval physical some time this week)
Day 31: April 20 - Blood work and ultrasound. Adjust meds according to results.
Day 32: April 21 - Blood work and ultrasound. Adjust meds according to results. Tentative trigger shot (with Novarel)?
Day 36: April 23 - Tentative embryo retrieval (under anesthesia). Tentative start of Medrol and Tetracycline.
Day 39 or 41: April 26 or 28 - tentative embryo transfer. Also start estrogen patches (Vivelle) and Progesterone in Oil injections (PIO).
Day 50: May 7 - Tentative first Beta hCG test for pregnancy.

From start to finish, just over 6 weeks....I am hoping hard that all goes as planned!


For those not immersed in the world of IVF and infertility - here are the basics:

- The birth control pills kind of "shut everything down" so to speak, giving us a "clean slate to work with. They also help prevent cysts from forming on my ovaries.

-The Lupron will prevent my body from ovulating on its own during the cycle and will help prevent just 1 dominant follicle from taking over (as happens in a normal un-medicated cycle), allowing more follicles to form and mature all at once. It is injected through a small needle into my stomach.

-The Dexamethasone, taken orally, will help manage hormone levels during the cycle - this is supposed to help with egg quality.

- I need a laminaria because I have a very tight cervix. They put it in for 24 hours, 3 weeks prior to retrieval, to help the cervix to open up a bit so that when the ebryos are transfered back into the uterus through a catheter they don't get squished. (squished embryos = bad)

- The Menopur and Gonal-F will stimulate my ovaries to produce many eggs. They are injected through small needles into my stomach.

-The bloodwork and ultrasounds will be to determine how many follicles I have, how quickly they are growing, whether they are mature, how my uterine lining looks for implantation, in addition to general monitoring of hormone levels etc. - these results will determine what dosages of meds I am taking and when the retrieval will be scheduled.

- When I have several mature follicles and my hormones are at the right levels - they will schedule the embryo retrieval. Exactly 35 hours before the retrieval Mr. Spicy will give me an injection of hCG in my buttock. This injection should cause the eggs to "fully ripen" and become ready for retrieval. (I just typed "buttock", heh heh)

- The day of retrieval I will go under anesthesia and Mr. Spicy will give a sample (more fun with cups - yay!). During the procedure, an ultrasound guided needle will go through my vaginal wall and into my ovary where it will proceed to pull up the fluid in each big follicle - hopefully resulting in several healthy eggs. Obviously, this is repeated on the other ovary as well.

- After pulling out the eggs and looking at them, the embryologist will take half of them and mix them with some of Mr. Spicy's swimmers. They are led to a darkened room with soft music playing and left to fertilize on their own. The other half of the eggs are each injected with one perfect little swimmer. Sort of like dating vs. arranged marriage.

- We will get a fertilization report telling us how many were successful. The average is about 50-70% (I think).

-For the next several days, all the little embryos will live in little dishes of specially prepared nutritious fluid (medium) - like little swimming pools full of chocolate pudding (if chocolate pudding were good for you and helped you grow).

-Then, depending on how many embryos we have and how healthy they look, the transfer will be scheduled. Basically, if we have many embryos and they are healthy and thriving 2-3 days post retrieval, they will let them grow another couple of days (in the chocolate pudding) until they reach the blastocyst phase. At this stage they are thought to be more successful in implanting into the uterus. But, if there are only a few embryos, or they are not looking too happy (not everyone likes chocolate pudding) - they will schedule a transfer 3 days post-retrieval as the embryos are much more likely to do better within the womb and there is a risk of losing embryos the longer they are left in the "chocolate pudding swimming pool".

- the embryos (we will only transfer 2) are transfered back into the uterus through a small catheter, guided by ultrasound. Then I will lie there for an hour. Then I will go home home and lie in bed for 24-48 hours watching movies and bad TV and willing those little embryos to stick, with every bone in my body.

- Any left over embryos will undergo cryopreservation - a fancy name for being very quickly frozen, for use at a later date (hopefully for future siblings).

- I will use estrogen patches and injections of progesterone during this time to help encourage pregnancy and to help the lining of my uterus be a nice welcoming place for the embryos. I mean, I will be competing with their memory of the chocolate pudding pools - I'd better have some prime uterus cushiness to offer them!

- And 2 weeks from the date of the embryo retrieval I will go in for a blood test to determine if we were successful.


If just writing it all out is overwhelming, what am I in for when this all really gets rolling? Jeesh!

(I am scared - but also? I can't wait! We could be pregnant in 40 days!)


mary elizabeth said...

Hi Spicy Sister,
I will have to thank Lori for putting my info onto her blog. And thank you for your comment on my blog too.

Reading your most recent entry sent me into a fog of memories, tears and excitement. Yep--all of that in one quick second. I too struggled and struggled and went into debt emotionally and literally to get my little beans. I remember your path. Although I didn't have to take the IVF route (the doctor rejected me from his program because of my high FSH). It was all a nightmare.

BUT I am excited because you are on the path to victory as well. It is all worth it. Trust me. Took us years to get pregnant and we were even given fertility meds (clomid the dreaded clomid) by the RE when I was already pregnant--which, I believe, caused a miscarriage. Arugh.

Trust me. I remember my husband putting that shot into my buttocks too...and guess all worked finally. It will for you too. Let go, put it the higher power's hands and surrender. It helped me tremendously.


Denise said...

Huh, that picture looks familiar! Sorry, I posted a med shot today too-I'm running out of pictures to post for my March photo journal challenge.

Just reading your post made me really excited and really nervous. And I've been through this before. I think it is so cool that our schedules are so close. We'll have to keep an eye out for each other at the palace.

I keep trying to tell myself, "one day at a time."

Alwen said...

wow--so overwhelming and also so exciting! thanks for sharing what this next 40 days will be like for you. my love, hope, and excitement will be with you!

annacyclopedia said...

Wow, that is a mighty stash! Very exciting that things are really happening! And thanks for the IVF primer - I'm not going that route, so I really don't know much about it. Your little course really helped me on some of the basics I've just been filling in with guessing.

Lori said...

I was foggy on what everything was for and how a protocol worked. This is an excellent post for clarifying it.

40 days...make it so!

Anonymous said...

Good luck Duffy! I am thinking all kinds of good thoughts for you!

Meg said...

40 days Spice. This really could be the start in a new chapter for you. I am so excited!

Your image and calendar make me admire you and every IF gal out there. I truly cannot wrap my brain around the commitment and personal journey you will go on this month. I am really hopeful and cheering you on that is for sure.

I am glad you are back from your trip! You should go to Posh, a yarn shop in my hood.

Mr. Spicy said...

We're on our way, beautiful. It's going to be a wild ride, but we're in this together.

Do you get an honorary nursing degree with this?

Mr. Spicy

Wendy said...

thinking of you...

all my hopes,

IVF Symptoms said...

Figuring out how to get pregnant seems to come effortlessly to some people and then others need to get it down to a science before they can finally conceive. I waited many painful years to get pregnant, month after month I was plagued with infertility. IFV finally helped me to conceive. I'm so glad I sought help because if it wasn't for IVF I think I would still be waiting.....

rjm said...

I just had to say that this blog and this post in particular helped me tremendously on my IVF journey. More than I can articulate in a comment. I just want to thank you for putting yourself out there so bravely and let you know that it provided a lot of support for at least one other IVFer even years down the road!

Spicy Sister said...

rjm, thank you for your comment! It's really moving to know that even after all these years my words are helpful to someone...