My IVF cycle – The Technical stuff

 

I’ve spoken about emotions a lot on this blog so far but I haven’t really touched much on all the scientific stuff. I’m currently on Day 16 and finished my injections a couple of days ago, so I thought it may be useful to do a post about my specific cycle and give a rundown on any side effects I experienced.

Firstly, it’s important to note that each IVF cycle will vary slightly from person to person. This will be dependent on the circumstance as well as the specialist’s informed opinions and preferences.

There are different protocols for IVF treatments.

The protocol I’m doing for this cycle is what is know as ‘IVF Antagonist’ (sounds fancy right?)

There are two main types of drugs involved in this Antagonist cycle.

1.Follicle Stimulating Hormone (FSH/ Stims)

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Scott armed with the Gonal-F EpiPen for my very first injection – would you trust this man?

WHAT IT DOES: Stimulates the ovaries to produce many follicles (which hopefully contain healthy eggs)

WHAT I’M TAKING: GONAL-F (125IU)- In the form of an EpiPen (subcutaneous injection into the lower abdomen)

HOW SCARY IS IT REALLY: Not scary at all!!! I could inject this one myself after Scott did the first injection (I will reiterate that I am not good with needles at all- if I can do this anyone can!) It honestly doesn’t hurt at all, it’s super easy to insert because it’s such a fine needle. Sometimes you may bleed a teenie tiny bit (1 tiny drop). Also, I bruise easily yet never got a bruise from this one.

SIDE EFFECTS: Hardly anything significant at all – woooohooo! Just a little bit of bloat going on, nothing terrible. Some mild hot flashes.

2. Gonadotrophin Releasing Hormone (GnRH)

WHAT IT DOES: This is where the antagonist part comes into play, as it prevents the pituitary gland from producing Luteinising Hormone (in a normal cycle this is the hormone responsible for releasing an egg).

WHAT I’M TAKING: ORGALUTRAN – In the form of a single use needle (subcutaneous injection into the lower abdomen). Must be taken at exactly the same time each day!

 

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Orgalutran – a teenie tiny needle that had me terrified for no reason

HOW SCARY IS IT REALLY: How on earth can this tiny little needle strike so much fear in me? They should have just encased it in gigantic white plastic cylinder, so you can’t see the syringe part (like the EpiPen) because for some strange reason that plastic cylinder makes everything seem ok. So the nurses kind of had me freaked out about this little guy right from the start. They kept saying that it’s a slightly thicker needle, so a bit harder to go in. So I spent the first few days being a total chicken and forcing my mum-in-law to inject me haha!

Once I got to the point that I could watch it go in, I started thinking “hmmm, I think I can actually do this”. One morning as I was trying to psych myself up to do it, my mum-in-law messaged saying “Am I doing your injection today?” I took that as a sign and decided that I would be really brave and do it myself. I didn’t do a very good job to be honest because I was really shaky and the air bubble was not really in the right place inside the needle, so I could kind of feel it which felt a tiny bit strange. But the sense of accomplishment afterwards was pretty damn good! And I definitely got better at it after that. I only got one tiny little bruise from this guy.

SIDE EFFECTS: Immediate side effects at site of injection, nothing dramatic, just a tiny rash, a little bit of stinging and itchiness. It all subsides within 2 hours.

I was also getting a bit more bloated after taking Orgalutran but I can’t distinguish whether that was due to Orgalutran or Gonal-F. My boobs were super dooper sore and massive too (well massive for me haha), once again not sure which injection is the culprit for this or whether it was a joint effort from the two.

Other drugs involved are:

  • MELATONIN – in the form of a tablet – YAY it’s not another needle!! (apparently a powerful antioxidant to improve egg quality)
  • OVIDREL (which is ‘Human Choriogonadotrophin Alfa Hormone’ or ‘HCG’ – thank goodness there is an abbreviation!) In the form of an EpiPen (subcutaneous injection into lower abdomen) This is the Trigger Shot (to complete egg maturation and to release the eggs, taken very specifically at exactly 37 hrs prior to egg collection surgery, the eggs will release at 38hrs. Yes it is that specific – isn’t the human body amazing!!)
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Ovidrel – My final injection to release my eggies!

Below is a calendar of what my IVF cycle looks like:

DAY 1 (of cycle/period) – Advise clinic, collect drugs & learn how to administer them with the nurses at the fertility centre.

DAY 2

  • Blood Test first thing in morning – 7am
  • Await instructions from Specialist as to whether you can start injections.
  • Take 1st FSH injection of Gonal-F (125IU in my case)
  • Take 5mg of Melatonin at night (tablet)

DAYS 3, 4 & 5 

  • Daily FSH injection of Gonal-F (125IU)
  • 5mg of Melatonin at night

DAY 6  & 7

  • Continue FSH injection of Gonal-F. Continue Melatonin
  • DAY 6 – Commence Orgalutran injections (must be done at exact same time every day)

DAY 8

  • Transvaginal Ultrasound & Blood test to determine whether dose of FSH needs to be increased/ decreased or cycle cancelled.
  • Gonal – F was increased in my case to 200IU as my follicles weren’t the right size (too small)

DAY 9, 10, 11

  • Continue Gonal-F, Orgalutran & Melatonin

DAY 12

  • Return for additional ultrasound and blood test to determine if we proceed to egg collection.
  • Follicles have increased in size. Egg collection booked for day 15
  • Continue FSH, Orgalutran and Melatonin

DAY 13

  • Last day of Injections – Continue FSH, Orgalutran and Melatonin
  • Take trigger shot at 10pm (this is 37hrs prior to egg collection surgery on DAY 15

DAY 14

No injections today!

DAY 15 

  • Egg collection
  • Arrive at Day Hospital at 9:30
  • Semen sample to be provided to hospital
  • 11am Surgery
  • Release from Hospital 2-3hrs post surgery time
  • The scientist will take any eggs that are mature and inject them each with a single sperm (they will select the best sperm of the bunch to do this). This process is called ICSI and is different to IVF. ICSI is used when the sperm sample is not as strong.

Next step is waiting to see which eggs fertilise (this happens overnight)

Then to wait and see if any fertilised eggs divide to form Embryos

If everything is full steam ahead you will commence taking further drugs to support your lining and to encourage the embryo to embed.

Embryo Transfer usually occurs within 2-5 days if you have some healthy Embryos and your hormone levels are sufficient.

In my instance we will only be transferring a single embryo. This is because multiples actually increase your risk of many issues throughout your pregnancy.

So there it is, the technical stuff so far, I’m sure there will be more to come!

 

 

 

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Small milestones

Today is day 4 of injections (FSH or ‘stims’ for those who are really down with the lingo). They come in an epi-pen that is very user friendly. Oh and I am so happy to report that there are no side effects! Hooray!!!!!!

Oh and guess what?!!! I have been injecting myself the past 3 days! Gosh I’m so proud!

If the needles have been putting you off IVF, let me tell you that you can’t even feel the needle! I mean NOT AT ALL! It’s quite a phenomenon really and I promise I’m not lying.

The next needle won’t be quite so nice so I’ve got my mum-in-law lined up to help me out with that one! Scott will probably be at work at the time I need to take it, and you mustn’t miss the time by any longer than 10 mins (it’s a very strict one!)

I’ve been really focusing on being kind to myself the last few days. I’ll do a specific post on the steps I’ve been taking to keep my stress under control.