 |
| The day our baby was conceived. I still didn't finish that book. |
While we were going through
IVF I desperately wanted to read how the process was for other couples. I wondered about the specifics, the practical, the physical. So, for what it's worth, here goes my experience. After the ovarian stimulation period* (FSH / [Gonal or Fostimon] from days 3 to 10) and several blood tests (AMH, estradiol) to check everything was fine, and after closely looking at my follicles grow during those days, I had the trigger shot (hCG / [Pregnyl]) that would stimulate ovulation together with another injection (Ganirelix/ GnRH [Orgalutran]) that would actually prevent me from ovulating too early. Two days after the trigger shot (actually 34 hours later) I was scheduled at the hospital for the
egg retrieval.
I could choose between Dormicum (Midazolam) and a painkiller, which would have had me sleep through the whole thing or
Pethidine, a very strong painkiller. I had the latter, because they told me I could then stay
alert and see what was happening. The
egg retrieval
is done with a long, hollow needle that "sucks" each follicle, the needle is
guided transvaginally with the help of ultrasounds / echography. Mark liked this part he said
it was fun to watch, like a videogame (Call of Duty?), aiming and taking the follicles, who would turn from being black bubbles, to empty little dots. On
one of my ovaries it did not really hurt: each time they took a follicle it felt like a small "kick" or
"punch" and then it was done, it lasted just one second, and on to the next follicle. On the other ovary (I
think because it was higher and more to the back) it was a bit more painful, each aspiration felt
like being kicked in the stomach, but it was not super awful either. On that same
day Mark had to give a sample, the lab analysed the
eggs and they proceed with IVF or ICSI (intracellular sperm injection). They do the latter when the sperm volume is low.
Right after the aspiration I felt a bit dizzy (not during the procedure), I
think as soon as it was over my pressure went down. We stayed in
observation for an hour or so, until I felt better, and then we were
allowed to leave. Those days I had to drink 2 liters of water per day
and check my temperature and weight every day.
A day after the procedure we were informed that out of the 19 follicles that were
retrieved (they take all of them, regardless of the maturation state (size) even if some were not fully grown), 13
eggs
were mature and we had 7 fertilizations. 3 days after the
aspiration, the embryo transfer took place, which was quite
simple (similar to getting a PAP smear, except we were watching everything on the ultrasound screen). They only transferred 1 embryo, to avoid multiple pregnancies, the
rest of the embryos would have been frozen, but we were informed a few days later (in the middle of the 2 week wait, to add to the stress) that none of them continued their development further, so we don't have any frozen embryos. For the two weeks after the egg retrieval I had to take progesterone (to
support the endometrium / mucus layer). Depending on how many follicles
they get some people get an hCG shot instead of the progesterone.
So that was that... 13 days after the transfer we got the
happy news. We feel so incredibly blessed. My heart and hope and wishes are with everyone who is going through this.
------------------------------------------------------------------------------------------------------------------------
*The aim of the stimulation is to make your ovaries produce as many
eggs
as possible (superovulation). In my case I was stimulated with 225 IU FSH per day:
150 in the morning and 75 at night). These are subcutaneous shots (in
the belly) and are less painful than they sound, the needle is very
small (same as for insulin). It was Mark who injected me every single time. I am able to inject all kinds of animals but could not muster the courage to inject myself. It was also nice to have him do it, and he loved playing doctor. I did not really feel any of the side effects I half dreaded, except
maybe some bloatedness. The follicle growth is monitored with
ultrasound (the famous transvaginal wand, ugh). I think I had to go on
days 3, 7, 9 and 11. Once the follicles reached a certain size (around 20
mm) they injected the hCG (Pregnyl), which "triggers" the ovulation.
................................................................................................................................................................
Post edit: The boy read this and said it might be useful to clarify what all the acronyms are, so:
FSH: Follicle-Stimulatin Hormone, also known as follitotropin. (Commercial names: Gonal, Fostimon and others).As the name says, it is used to stimulate the growth of follicles, the little "bags of fluid" in which eggs mature / develop.
AMH: Anti müllerian hormone. It is used to test "ovarian reserve" (to give an idea of how many eggs are left in the ovaries) and "
to rationalise the programme of ovulation induction and decisions
about the number of embryos to transfer in assisted reproduction
techniques to maximise pregnancy success rates whilst minimising the
risk of ovarian hyperstimulation syndrome (OHSS)".
hCG: Human chorionic gonadotropin. It is in this case used to simulate t
he peak of LH (luteinizing hormone) that precedes ovulation. Also called "trigger shot" because it stimulates ovulation (34-36 hours after the injection).
GnRH: Gonadotropin Releasing Hormone. This is the boss of the hormonal axis that controls reproduction, as it starts the whole process. If given at certain times and concentrations it can actually act as negative feedback, blocking certain processes. In this case it is used to prevent early ovulation.
----------------------------------------------------------------------------------------------------------------------
The blog,
Fertility chronicles presents several articles explaining the causes of infertility, the different tests available and how they are interpreted, and different factors that can affect the outcomes of IVF. (I am linking to them because I think the information given in their articles is simple and easy to understand. They have developed a model to predict your chances at success with IVF based on your tests results however this is not a sponsored link.)
