IVF: Checking on My Ovaries

Another big part of the Ovarian Stimulation Phase was going to my fertility clinic for blood draws and ultrasounds.  The purpose was to see how my ovaries were responding to the medications.  I would go in right at 7:30 when they opened and then they would call Adam in the afternoon once they had the blood work results in.  Since I'm a teacher, it's hard for me to answer my phone during the day, so Adam took over that responsibility.     

After being on the stimulating medications for two days, I went into my fertility clinic to see how I was responding.  I was told that things seemed to be progressing, but they upped my Gonal-F dosage.  We ended up having to order more medication as we went along.  Thankfully, Adam kept a close watch on this and our fertility clinic was able to give us some samples towards the end so we wouldn't have to purchase entire vials.  

I had to miss part of school each morning I went in to the clinic.  I wasn't pleased about getting my blood drawn so much or missing so much school.  After each blood draw, on my way back to school, I would stop and get hot chocolate from Starbucks.  It was my reward for having to put up with blood draws.  

The other part that just about broke my heart was that I was restricted from doing any sort of exercise and was expected to take it easy.  Since my ovaries would be producing multiple follicles, they would be getting very heavy.  There was a risk of my ovaries flipping over, which would cut off the blood supply and result in having to have a surgery to remove them.  That was enough to scare me into listening!  I had some very kind co-workers who helped me limit all the walking around I typically do in a school day.

But, boy was it hard to give up my walks with Jazzy!  It nearly broke my heart and made me cry when I would come home from school and Jazzy would be so excited to go for a walk.  But I couldn't take her and I couldn't make her understand why.  She would sit patiently by the front door as if saying, "Um...excuse me.  Now's when we are supposed to go on our walk!"  Adam really picked up the slack for me and took her when he got home from school and right before he went to bed.  He even took her some mornings before he left for work.  It's a good thing he was around!  Especially since I was feeling like a deadbeat dog mom at this point.  

I went in two more times for blood work and an ultrasound and the last time I went in, I could tell the nurse wasn't super excited about how my ovaries were looking.  When I asked how things were, she said I had a few follicles that were the right size and would probably contain eggs.  She didn't say much more and I felt like she was holding something back.  But she did rave about the lining of my uterus!  She said it was nice and thick, which is what you want at this stage in the game.

The call we got the afternoon of my final blood draw and ultrasound wasn't the news we were hoping to hear.  The nurse told Adam I ended up with 9-10 follicles and they expected to retreive 4-5 eggs if we went forward with the retrieval.  I remember Adam emailing me at work and told me to call him when I could.  I knew something was up.  He told me we had the option of moving forward or canceling the cycle and trying again later.  I'm not going to lie, that was hard to hear.  We had gone through so much already and spent lots of money on the medications.  If we canceled now, we wouldn't have to pay the full amount of an IVF cycle.  But then we would also end up right where we were before we started IVF: without a baby.  

After Adam and I talked, he decided to call and ask to speak to Dr. Brabec to get her opinion.  She told Adam that she still had hope that this cycle would be successful if we moved forward, but wanted us to understand our odds weren't as great since there wouldn't be as many eggs.  She said that she has told patients in the past that they should cancel a cycle and she wasn't saying that to us now.  

Adam and I felt like we were already in this thing.  I didn't think that I would respond differently to different medications or during a different cycle.  During all the times we tried IUIs, I never seemed to produce many follicles.  I just felt that things wouldn't be different if we tried again.  We decided to move forward and remain as hopeful and positive as we could.     

So we scheduled our egg retrieval for December 9, 2016.

Two days before the egg retrieval, I had to administer a trigger shot, which promotes the completion of the egg maturation process.  I had to take it at exactly 9:00pm.  This was also one that I injected in my belly fat with a tiny needle.  It didn't hurt, but was a bit stressful since I had to inject it at 9:00 on the dot.  But Adam was there and told me exactly when to stick in the needle.  There was no turning back now!  

IVF: Ovarian Stimulation Phase

This next step of the IVF process was the most intense for me.  This was the part that required the most injections, office visits and blood draws.  Here's what my timeline looked like: 

OVARIAN STIMULATION PHASE 
11/27/16- Continue taking Lupron; remain on dosage 0.1 ml (10 units) injections once daily.  Start taking daily dexamethasone at bedtime.  Begin your evening (between 6 p.m. and 10 p.m.) fertility drug (Gonal-F and Menopur) injections following the treatment schedule provided.  You will need to be available by phone or email between 1:00 p.m. and 4:00 p.m. each day that you have a blood test and ultrasound performed. Your medication instructions and your next appointment date will be given at that time.  You will probably require about 10 days of ovarian stimulation (fertility) drugs. 

The part that scared me most about this step was all the injections involved.  Not only were there injections involved, but I would have to actually do the injecting part!  Yikes!  I felt as though people should have some sort of medical degree in order to stab people with needles.  I definitely didn't feel qualified!

A nurse explained how to prepare and administer the injections at our previous appointment.  She did a pretty good job and I took a lot of notes, but I was still overwhelmed with all that was involved.  Thank goodness Adam was there to be a second set of ears.  He helped prepare the injections and offer moral support for each round of injections.  I ended up giving myself 3 different shots each evening.  I had the option of combining the Lupron with another injection, but all the mixing and switching of needles was just too much for me to handle.  Besides, the Lupron injections turned out to be pretty painless and straightforward.  

The other two injections were more complicated.  The Gonal F required mixing different vials together and doing math to make sure I drew up the correct dosage.  Then any leftover Gonal F needed to be refrigerated.  It got easier as the days continued, but that first evening was pretty stressful.  Preparing the shot was harder than injecting it.  The actual injection was very similar to the Lupron.  A small needle was used and I stuck it into my belly fat, so it didn't hurt.    

The Menopur was a different story.  It also had to be mixed and prepared before I could inject it.  And it burned when you injected it.  Again, a small needle was used and it was injected into my belly fat, but the actual liquid burned as it went in.  It wasn't as bad as I anticipated it being after the nurse warned me about it, but it certainly wasn't pleasant.  The good thing was that the burning didn't last very long.  Just a few seconds.  

Along with the injections, I also started taking dexamethasone, which is just a pill you swallow.  The purpose of the Gonal F and Menopur was to stimulate my ovaries.  Each month, women typically grow one follicle which has the possibility of producing one egg.  The goal of ovarian stimulation is to make your ovaries grow as many follicles as possible so lots of eggs can be retrieved.  

I didn't seem to have very many side effects from the medications.  I did end up having some hot flashes, which seemed to flare up in the mornings when I was blow drying my hair.  I would just turn the ceiling fan in our bathroom on full blast and sometimes I even rolled down the windows in my car while I was driving to work.  My stomach also got very bloated and full-feeling by the end of this phase, which is to be expected.  I definitely was a bit emotional during this time, but I feel like it was more due to the stressful nature of the situation rather than because of the medications.

On a side note, I would recommend not reading all the side effects listed on the medications.  When I first got the medications in the mail, I started reading all the different side effects listed.  And then I stopped a few lines into the first set of side effects.  There were gobs listed and they didn't seem particularly pleasant.  From then on I just blindly took whatever I was told to take.  I figured I would know if something terrible was happening to me.  But thankfully, nothing ever did.    

The one thing that helped make all these injections bearable (except for the possibility of a baby, of course) were my shot gifts!  My sweet mom gave me a bag full of little gifts.  She told me I could unwrap a gift each day I finished giving myself the injections.  Is that not the sweetest thing in the world?!  The gifts were things like band-aids, lip balm, lotion, candy, socks, etc.  If you know anyone getting ready to embark on this IVF adventure, I highly recommend getting them a bag of little gifts.  It definitely gave me something to look forward to!  Thanks, Mom!     

Once I started the ovarian stimulation phase, I went into my fertility clinic every few days to have my blood drawn and do an ultrasound.  The point of those were to see how I was responding to the medications.  I'll save information about those for the next post since this one is getting a bit wordy!  

As someone who is deathly afraid of needles, this was a difficult time for me.  But I surprised myself (and those who know me well) by doing okay with all the needles.  You actually get kind of used to it all and it really wasn't all that bad.  

IVF: Suppression Ultrasound and Blood Work

On November 22, Adam and I went to our fertility clinic for a suppression ultrasound and blood work.  The purpose of the ultrasound and blood work was to check that my reproductive system had been completely suppressed, or basically shut down.  The doctor wanted to be able to have as much control as possible over when and how quickly my eggs would grow.  

I started out getting my blood drawn.  This was the first of many blood draws.  I was lucky that our fertility clinic had a lab on site, which apparently isn't always the case.  So I got to know the nurses who drew blood really well over the next few weeks.  And I was super thankful that they were good at drawing blood, which made the process pretty painless each time.

Then came the ultrasound.  They did a vaginal ultrasound, which doesn't hurt or anything, but isn't exactly pleasant.  It's essentially just a wand thing they stick up your vagina.  Pardon my bluntness, but that's what it is.  I just like to clarify these things in case you are really wanting to know what to expect.  

The ultrasound showed that my uterine lining was thinned out, which is what they want at this point in the process.  And that my ovaries weren't actively growing follicles.  It also showed that there were no cysts on my ovaries and that my uterine lining didn't have any cysts or polyps, which was thanks to the polypectomy that I had back in June.  

Since my ovaries and uterus were cooperating, we could move onto the next step in the IVF process.  The next step is the Ovarian Stimulation Phase.  I'll chat about all the fun injections that are a part of that phase in my next post.     

Source