IVF #1, CD7, Friday 12/7/12
Well today was a pretty big day: I got my IVF Calendar and I had the sonohyst and trial transfer. I’ll devote this post to the calendar.
At this clinic, the agonist protocol apparently starts out the same for everyone: start birth control pills on Cycle Day 3. Then you stay on the BCP until you start the Lupron shots. And by “stay on the BCP” I really mean stay on the BCP: you don’t take the placebo pills at all like you would normally do with BCP. You have to do the BCP for at least 2 weeks before moving to the next step.
After you’ve been on BCP for at least 2 weeks, the next step is adding Lupron shots. Lupron is used to suppress ovulation (they don’t want you to ovulate too soon). At this clinic, everyone starts Lupron on a Sunday and you start with 10 units. For the first 7 days, you will take BCP and give yourself the Lupron shots.
The next week, on day 10, 11 or 12, they will do an ultrasound. This is called the Baseline or Suppression Check Ultrasound. This is to make sure that all ovarian activity has pretty much come to a stop before they start you on the stimulation drugs. Your period will also probably start sometime this week.
The following week, Sunday will be your last day of Lupron 10 units. On Monday, you start Lupron 5 units and you get to add 2 more shots of FSH, the stimulation drugs. At this clinic for FSH they use both Repronex and Gonal-f Pen at the same time. The dosage of these will be determined by your doctor. For me since my AMH (anti-mullerian hormone) is a little on the low side (1.02) I might be on a higher dose of these stimulation drugs. If your husband is donating sperm the old-fashioned way, then he will begin taking an antibiotic on Monday of this week. The antibiotic will ensure that the semen sample is good by preventing any infections as you head for the finish line.
The next two weeks become a lot less structured. The nurse today advised me that some people take these two whole weeks off from work because they are so unpredictable. Day 8 of the stimulation drugs, a Monday, you will start daily ultrasounds and blood work. The ultrasounds and blood work help them determine when you should administer the injection for triggering ovulation. It could be Monday or it could be Saturday. HCG is the drug that is used to trigger ovulation. You will inject HCG exactly 36 hours before egg retrieval and stop doing the FSH and Lupron injections. Also, the evening before egg retrieval you will take an antibiotic and stop taking it the day of embryo transfer.
On Egg Retrieval Day, your husband will take his last antibiotic in the morning and then give the semen sample after your egg retrieval. You’d think you’re done with all the shots once they get all your eggs, but you’d be wrong! After egg retrieval, you start giving yourself daily Progesterone shots. These continue sometimes all the way to the 14th week of pregnancy.
After egg retrieval comes Embryo Transfer Day. The doctor and embryologist will determine whether you have a transfer on the 3rd day after egg retrieval or on the 5th day. From what I understand, if the embryos are not the best quality or if there aren’t very many, your transfer will be on the 3rd day. If you have good quality embryos or if you have a lot of them, yours would probably be on the 5th day. After embryo transfer the doctor will probably ask you to be on bed rest for somewhere between 2-5 days.
The last step of the IVF journey is a pregnancy test, sometimes called a beta. At this clinic you have to wait 17 days. Other than these days that I’m waiting to hear if we will even have any sperm, those 17 days will probably be the longest ever! You might think you could just do a home pregnancy test instead of waiting, but you’d be setting yourself up to get a false positive. Remember that HCG trigger shot you gave yourself 36 hours before egg retrieval? Well HCG is the hormone that pregnancy tests are looking for. Only a blood test will tell you if your HCG is high from a pregnancy as opposed to still being high from the injection.
To learn how to give yourself the injections, here are some very helpful videos.
To summarize all of this, here’s a generic schedule:
Week 1 – BCP
Week 2 – BCP
Week 3 – Lupron
Week 4 – Lupron + Ultrasound
Week 5 – Lupron + FSH (Repronex & Gonal-f)
Week 6 – Daily Ultrasounds + HCG and Egg Retrieval
Week 7 – Embryo Transfer
Week 9 or 10 – Pregnancy blood test
I also found this really great link to an IVF calendar generator. Every clinic is different, so your schedule might not be like mine above or like the one this calendar generates, but these at least give you an idea of what you can expect.
I can’t wait to get off these BCP and really get started!