We had our meeting with Ashley, the nurse who will be handling our IVF cycle, on Tuesday. She was very knowledgeable and informative. We left the meeting feeling pretty good about the next step of this process.
Ashley went over all of my medications that I will be taking during this process. I was overwhelmed with the amount of medications that they will be prescribing. Overall I will be taking 12 different medications. Not all of them are injections, some of them are just a pill I will take before or after a procedure and I won't be taking them all at the same time. Ashley wrote out a great chart and list so we can keep everything straight.
They are starting me on a new birth control pill that delivers a consistent dose of hormones throughout the month, instead of it changing week to week. It also has an extra low level of estrogen in the pills. Who knew birth control pills could be so different? Ill take only the active pills in this pack and the next so I will not have a period. This is so once RGI lets us know that they are done creating the gene probe, we can start our IVF cycle without waiting for another period.
I will start with injections of a drug called Gonal-F, which is a follicle stimulating hormone, every night between 6PM and 8PM. This will cause an increase in the number of follicles and help with the quality of the eggs. I will also be taking a drug called Menopur at this time. Menopur delivers the hormone human chorionic gonadotropin (hcg), which helps with the growth and maturation of the eggs.
I'll have ultrasounds and bloodwork every 2-3 days while taking the hormone injections. My doctor will adjust my medications and tell me when to move onto the next step based off of my lab work and the ultrasounds of my ovaries. About 6 days after starting the Gonal-F and Menopur, I will begin daily morning injections of a drug called Cetrotide. Cetrotide blocks luteinizing hormone which is released as a result of the Menopur. Basically it prevents me from ovulating so all those health eggs stay right where we want them!
About 6 or 7 days later, based on my test results, I will give myself an ovulation trigger shot called Lupron. This gives the eggs a little extra boost to mature and causes them to break away from the follicle wall. The will stay in the follicle and will be extracted along with the fluid inside the follicle during the egg retrieval. This shot has to be given exactly 35 1/2 hours before egg retrieval. This one looks large and I've heard It's pretty painful! I'll probably have someone do this one for me so I don't hesitate too much and miss my time window. If anyone has ever felt the desire to stab me, let me know and this might be your shot.
36 hours later they will be retrieving the eggs from my ovaries. I have opted to be have an anesthesiologist there so I will not be awake during the procedure. Ashley said some women say they are fine being awake as they give you Fentanyl and Versed to calm you down and make you drowsy. I just know I was nearly hyperventilating before the mock embryo transfer and that was a very negative experience for me. I would rather not be aware that they are stabbing me with a needle the size of my arm and just take a nice nap.
Once they have all of the eggs, they will fertilize them and leave them in the incubator overnight. The next day they will tell us how many have successfully been fertilized. On day 2 they will update us on how many have continued to grow. On day 3 they will leave the embryos alone and let them incubate more and on day 5 the embryologist will come to collect the biopsies. Because so much growth is done in that 5 day window, the embryologist will come late in the day. He may need to come back the next morning to biopsy any embryos that were not ready on day 5. Our embryos will then be frozen until it is time to transfer them back into my uterus.
It takes 2-3 weeks to test all of the embryos and I will need to be on some other medications during this time and even more after the embryo transfer. I'll go over that whole process another time so I won't bore you. Ashley gave me a list of online injection training videos to watch. the small shots in the stomach don't look like they will be too bad, the needles are super tiny! The Trigger shot and Progesterone shots that Ill be on later look extremely painful. Something about the line "inset the entire length of the needle in a quick, dart-like motion" makes me cringe.
We also had to sign paperwork to determine what will happen to our embryos if something were to happen to us. We had to decide who would take custody of them if we were to split up. This would only determine who would be financially responsible for the cryopreservation of the embryos until a court hearing could be held. We also had to designate a guardian for the embryos if we were to die. My mom has agreed to be the guardian and Brian and I will tell her our wishes for if something were to happen. If god forbid something happen to us, we want our embryos to be donated to a couple who cannot have biological children of their own.
It was strange having to make all of these decisions at this point. What once seemed so far away could now be starting in just a few weeks. We have a ton going on the next few weeks, so I am sure it will be here before we know it!
-Emily
Ashley went over all of my medications that I will be taking during this process. I was overwhelmed with the amount of medications that they will be prescribing. Overall I will be taking 12 different medications. Not all of them are injections, some of them are just a pill I will take before or after a procedure and I won't be taking them all at the same time. Ashley wrote out a great chart and list so we can keep everything straight.
They are starting me on a new birth control pill that delivers a consistent dose of hormones throughout the month, instead of it changing week to week. It also has an extra low level of estrogen in the pills. Who knew birth control pills could be so different? Ill take only the active pills in this pack and the next so I will not have a period. This is so once RGI lets us know that they are done creating the gene probe, we can start our IVF cycle without waiting for another period.
I will start with injections of a drug called Gonal-F, which is a follicle stimulating hormone, every night between 6PM and 8PM. This will cause an increase in the number of follicles and help with the quality of the eggs. I will also be taking a drug called Menopur at this time. Menopur delivers the hormone human chorionic gonadotropin (hcg), which helps with the growth and maturation of the eggs.
I'll have ultrasounds and bloodwork every 2-3 days while taking the hormone injections. My doctor will adjust my medications and tell me when to move onto the next step based off of my lab work and the ultrasounds of my ovaries. About 6 days after starting the Gonal-F and Menopur, I will begin daily morning injections of a drug called Cetrotide. Cetrotide blocks luteinizing hormone which is released as a result of the Menopur. Basically it prevents me from ovulating so all those health eggs stay right where we want them!
About 6 or 7 days later, based on my test results, I will give myself an ovulation trigger shot called Lupron. This gives the eggs a little extra boost to mature and causes them to break away from the follicle wall. The will stay in the follicle and will be extracted along with the fluid inside the follicle during the egg retrieval. This shot has to be given exactly 35 1/2 hours before egg retrieval. This one looks large and I've heard It's pretty painful! I'll probably have someone do this one for me so I don't hesitate too much and miss my time window. If anyone has ever felt the desire to stab me, let me know and this might be your shot.
36 hours later they will be retrieving the eggs from my ovaries. I have opted to be have an anesthesiologist there so I will not be awake during the procedure. Ashley said some women say they are fine being awake as they give you Fentanyl and Versed to calm you down and make you drowsy. I just know I was nearly hyperventilating before the mock embryo transfer and that was a very negative experience for me. I would rather not be aware that they are stabbing me with a needle the size of my arm and just take a nice nap.
Once they have all of the eggs, they will fertilize them and leave them in the incubator overnight. The next day they will tell us how many have successfully been fertilized. On day 2 they will update us on how many have continued to grow. On day 3 they will leave the embryos alone and let them incubate more and on day 5 the embryologist will come to collect the biopsies. Because so much growth is done in that 5 day window, the embryologist will come late in the day. He may need to come back the next morning to biopsy any embryos that were not ready on day 5. Our embryos will then be frozen until it is time to transfer them back into my uterus.
It takes 2-3 weeks to test all of the embryos and I will need to be on some other medications during this time and even more after the embryo transfer. I'll go over that whole process another time so I won't bore you. Ashley gave me a list of online injection training videos to watch. the small shots in the stomach don't look like they will be too bad, the needles are super tiny! The Trigger shot and Progesterone shots that Ill be on later look extremely painful. Something about the line "inset the entire length of the needle in a quick, dart-like motion" makes me cringe.
We also had to sign paperwork to determine what will happen to our embryos if something were to happen to us. We had to decide who would take custody of them if we were to split up. This would only determine who would be financially responsible for the cryopreservation of the embryos until a court hearing could be held. We also had to designate a guardian for the embryos if we were to die. My mom has agreed to be the guardian and Brian and I will tell her our wishes for if something were to happen. If god forbid something happen to us, we want our embryos to be donated to a couple who cannot have biological children of their own.
It was strange having to make all of these decisions at this point. What once seemed so far away could now be starting in just a few weeks. We have a ton going on the next few weeks, so I am sure it will be here before we know it!
-Emily
From our lips to God's ears, may everything go as planned with no trauma.Brian and yourself will make loving, compassionate parents
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