We had out IVF consultation visit with Dr. Osheroff. He went over a lot of things including the whole IVF process from beginning to end. He explained the success rates and the complications that may be involved. Basically it goes like this:
1. First we will have to get our blood work done for our referral through Kaiser. I will need to get basic hormone tests done as well as an infectious disease test. Shawn will also need to get an infectious disease test. Once we get our blood work results Kaiser will issue the referral for the IVF. The blood work that will be done will include Hepatitis B, HIV, Blood type, and Rubella Status, and likely others.
2. Once the referral is in order and the fee is paid to Shady Grove I will begin oral contraceptive pills, this will help prepare my ovaries to be cyst free. I will take the pills for approximately three weeks. Honestly, I find it highly amusing that I need to take birth control pills to HELP me get pregnant!
3. Then we will do a mock embryo transfer. The doctor explained that this is to help our doctor determine what size catheter to use when doing the actual embryo transfer and to get an idea of the shape and size of my uterus.
4. Then I begin a series of medications:
Lupron: (2 weeks) Lupron will lead to a suppression of the pituitary hormones, with subsequent drop in estrogen production. Lupron will allow the ovaries to produce more eggs without the fear of premature ovulation. We will be doing the Lupron as a subcutaneous injection, once per day, beginning on or about cycle day 21 in the month prior to the egg retrieval. I have done subcutaneous injections before without much trouble, I do them in my belly. The side effects are listed as follows: Headaches, fatigue, mood-swings, hot flashes, delayed onset of your period, bruising or irritation at the injection sites. Basically, from what I have heard from others, it will give me symptoms very similar to menopause. Sounds like fun!!
GONADOTROPINS (Pergonal, Humegon, Repronex, Gonal-F, Follistim, Bravelle) These drugs will act upon the ovaries to cause the eggs to develop and grow. Usually, several eggs develop on each ovary. They contain either pure FSH or FSH and LH. They are administered subcutaneously once or twice per day, according to the particular protocol. They are started when baseline tests (ultrasound and blood tests) indicate that the ovaries are in a resting, non-productive state. Like they already havent been non-productive!Side effects: Mood-swings, discomfort around the ovaries, abdominal fullness, soreness at the Injection sites.
HCG (Profasi, Pregnyl, Novarel) This hormone is taken once testing indicates the eggs on the ovaries are ready to be released. It performs two functions: structural changes inside the eggs to make them able to be fertilized and expansion of the fluid inside the follicles (egg sacs) that would eventually lead to rupture and ovulation. This must be taken as an intramuscular injection (which is odd because I have taken this before as a subcutaneous injection??) This will be taken approximately 36 hours before the scheduled time for egg retrieval Side effects: Discomfort around the ovaries, soreness at the injection site.
ANTIBIOTIC (Doxycycline, Tetracycline, Keflex)I believe we were informed that both Shawn and I have to take antibiotics. When performing the procedure to retrieve the eggs, a needle is placed through the vaginal wall and into the abdominal space. The antibiotics is to minimize the risk of an infection due to this puncture, as fevers are not good for developing embryos. I am not sure of the dosage of this medication yet. Side effects: stomach upset, allergic reactions (hives, itching, swelling) vaginal yeast infections in women.
PROGESTERONEThis hormone make the lining of the uterus (the endometrium) receptive for embryo implantation. This hormone is so important for women like me with PCOS because many women with PCOS have a lower level of progesterone which can cause a miscarriage. This is an intramuscular injection begun one day after retrieval and continue (daily) through 10 weeks of pregnancy. I have heard that this injection is VERY painful, but I will let you know. Side effects: Breast tenderness, soreness at the injection sites.
PRE-NATAL VITAMINSThey already gave me these to start taking but I have to admit I have not done a good job. I have to take so many pills during each day that I really have to force myself to swallow them! But I really need to take these.
LOW-DOSE ASPIRIN (1 (80mg) tablet, by mouth, per day.)I really dont know why I have to take this but I am sure there is a good reason.
5. The next step will be the egg retrieval. They told me that I will have to be put under IV sedation while they do this. Shawn will provide a "sample" at this time. They then combine the eggs and the sperm into a Petri dish and hopefully they fertilize. The center will call me with updates every day on how our little embryos are doing. We will be told how many eggs have fertilized (the more the better) and when the transfer will be.
6. Embryo Transfer: This is the procedure where they put the embryos back into the uterus. I will be awake during this procedure and Shawn can be in the room with me. I have to have a full bladder for this as they use an abdominal ultrasound. That should be fun! I will have to lay flat for about an hour after the transfer. Believe me when I say that there will be a lot of praying during this time!
7. Last Step-Pregnancy Test 14 days after transfer! That is going to be a long two weeks!!
Well, that's it for now. If you actually read all this good for you!!