IVF: Lupron Suppression Phase

The official start date of our IVF process was October 24, 2016.  The first step was to call our fertility clinic on Day 1 of my cycle.  Day 1 is considered the first day of your period.  Neither one of us was surprised when my period arrived, it was just what we expected to happen each month by now.  I wasn't upset this month because I knew we had IVF to look forward to in our future.  

After calling the clinic, they sent us a basic timeline of the different steps of the IVF process.  Each person's timeline is a bit different, includes different medication and can change depending on how they respond to the medications.  I will share my timeline with you so you can get a general idea of what the IVF process looks like:   

LUPRON SUPPRESSION PHASE 
10/24/16- Date of menstrual period. Call to report menstrual start and schedule any testing/labs required prior to starting fertility drugs. Outstanding testing / labs still to be performed include: 
1) Please fax maternal fetal medicine consult note
2) Order IVF medications ordered. Please be in contact with them to schedule delivery. Also check with insurance to see if you have any drug coverage. 

10/26/16- Start oral contraceptive pills. Take home pregnancy test prior to starting oral contraceptive pills. You will be taking only the active pills, not the placebos (placebos are inert pills and are usually a different color). You may not use the full pack or may require an additional pack (refills have been made available on your prescription).

11/15/16- Begin evening (between 6 p.m. and 10 p.m.) Lupron injection 10 units once daily subcutaneous in the abdomen. 

11/20/16- Last active oral contraceptive pill. NOTE: You will have another menses after stopping your oral contraceptive pills. 

11/22/16- 8:30 am Suppression ultrasound and blood tests. You will be instructed on self injection of medication on this date. Down payment and signed consent forms required today. These forms can be notarized here or elsewhere. If done here, patient and partner are required to be present at the time of signature. 

With the start of my period, the IVF ball officially got rolling!  And it didn't seem to stop once it started. Looking back, it really did go by pretty quickly (with the exception of the 8 days we had to wait to find out if we were pregnant!).  

One of the hoops we had to jump through was meeting with a Perinatologist, aka Maternal Fetal Medicine Specialist.  I'm greatly simplifying their jobs, but basically they know how to deal with high risk pregnancies.  I think it's pretty standard to be required to meet with one before embarking on IVF.  They want to make sure you understand the possible risk factors you or your baby might encounter.  Adam and I felt like this was pretty redundant since we've had all kinds of genetic testing.  We even did the Counsyl Family Prep Screen.  This was a blood test that Adam and I both did.  The results share the likelihood of your offspring inheriting all kinds of different genetic disorders.  There was nothing concerning that came from the results and we felt pretty knowledgeable about what the results were telling us.  

Despite all this, we still had to schedule an appointment with a Perinatologist.  So we did and showed up for our appointment, which was a couple days before I was supposed to start my injections.  When we showed up, the nurse told us there was a mix-up with the scheduling and that we would need to meet with a genetic counselor.  Of course the genetic counselor wasn't there that day.  I think steam started to come out of both Adam and my ears.  Without yelling, we tried to explain that we were on a strict timeline, had both already taken off work to be here and simply needed this appointment to happen today so we could move on with IVF.  We must have been pretty convincing, because a very flustered Perinatologist came right back to speak with us.  I think we did more talking than she did.  We explained all the testing we'd done and were able to coherently speak about the results.  She said she would send our fertility clinic a note saying we spoke and we could move forward with IVF.  Thank goodness!  

The other thing we needed to take care of right away was ordering our medication.  We were responsible for contacting the pharmacy, ordering our medication, paying for it all out of pocket (unfortunately my insurance didn't cover any fertility medication) and scheduling it to be delivered.  I'm not going to lie. This part stressed me out.  I think Adam could tell and he kindly said he would take over the responsibility of getting the medications ordered.  Even though our fertility clinic had a contract with one pharmacy, you can get your medications ordered through any pharmacy.  Adam called several different pharmacies and ended up ordering medications from two different pharmacies, which ended up saving us money.  This was definitely a lot of work on his part and took a lot of phone calls, but IVF is expensive and saving every dollar you can helps.  

While this was going on, I started taking birth control bills.  This sounds very counter-intuitive, I know.  But the birth control pills actually help prevent any cysts from forming on your ovaries and helps give doctors control of the timeline.  I ended up taking birth control pills for about a month, until November 20th.  

I also started my first injections during this time period.  I started Lupron injections on November 15th. I'm not going to lie, I was very scared to start the shots.  I am scared of needles and the thought of having to do this myself was even more nerve-wracking.  I could have asked Adam to give me the injections, but I wanted to maintain some sense of control.  So I opted to give them to myself.  

The Lupron shots ended up not being a big deal.  You administer them in your stomach fat and the needles are very skinny and not that long.  It was also pretty simple to prepare the shot.  There was a vial of Lupron that you draw up the medication from and there's no mixing involved.  My mother in law is a nurse and I had asked her if she had any tips for giving shots.  She told me to make sure I stuck it in my stomach as fast as possible, like a dart.  This would make it much less painful and help prevent bruising and bleeding.  Putting pressure on the injection site afterwards also helped prevent bruising and took care of the minimal bleeding that occasionally happened.  

All in all, the Lupron Suppression Phase was pretty straightforward and easy.  The next step in the process was to go to the clinic to have my blood drawn and have an ultrasound to make sure my hormones and ovaries were cooperating.  I'll share more about that appointment in my next post.  I've blabbed on long enough!