The second part of my IVF q&a. For the first part, check here
While I wanted to get this second part up much quicker than I have, it was definitly something that I didn’t want to rush through posting. I know I needed to take my time so I could be as thorough as possible and answer all the questions I was asked, especially the ones that are more personal!
So here goes!
A quick roundup
After our failed IUI rounds, we prepped for our foray into the world of IVF. IVF stands for In Vitro Fertilization, which literally translates to fertilization in glass. Pretty romantic right?!
Essentially the male’s sperm and the woman’s egg are manually put together in hopes of fertilization. Sounds easy. Well it’s not that easy because the woman’s egg has to be retrieved, it has to be of relative good quality and size, it needs to fertilize with the male sperm and then it needs to essentially ‘stay alive’ until the transfer is completed. Lots of steps that are each crucial in their own right. Here’s how ours played out:
HOW DID YOU PREP FOR IVF?
After my last consult with the doctor in which we decided to proceed with the IVF protocol, I met with a nurse to create an IVF schedule, another nurse to go over how to take my meds and Ara and I attended an IVF orientation.
Our nurse gave us our IVF calendar, which had a tentative schedule set up for me. Based on how my IUI’s usually were dated, she let me know roughly what dates I could expect to go in for appointments as well as a full rundown of what shots I needed to take on what days.
My advice? Go in with either your partner or if that is not the case, bring a friend. There’s a lot of information given out and having two sets of ears is really helpful. Because you will forget something!
I was also shown how to put together some of my shots. In IUI I didn’t have to prepare the shots, they were given to me ready to use. With IVF there’s a lot of drugs that are not available yet in a shot form- they are only available in powder form so you have to essentially ‘build’ the shot yourself. That entails filling a syringe with liquid, emptying the liquid into the powder, mixing the powder, and then getting that powder back into the syringe, changing the needle head and finally taking the shot. It’s pretty overwhelming at first but you get used to it and by the end you’re a pro 😉
How many shots did you have to take
Like I’ve mentioned before, everyone has a different protocol dependent on their age, their ovaries, their own egg production and so on. In my case, I started off by taking two shots daily that stimulated egg growth. I took those for about a week or so. On day 8, I added a third shot to the mix. This one would prevent me from ovulating. Because if you ovulate too early, it’s all over for that cycle. There will be no eggs to collect!
Based on my ultrasounds, the doctors told me when to add in the final shot, which was the shot that triggers ovulation. If you look on IVF forums etc people refer to it as the ‘trigger shot’. It’s usually your last one and a moment of excitement because you’ll be collecting your eggs within 36 hours!
IVF procedures are so planned out and it is necessary to take your shots at the exact time your doctor/nurse tells you to. If you don’t, you risk putting the entire cycle in jeopardy. And since most people pay out of pocket for the procedure, you definitely don’t want to do that!!
Do the shots hurt?
The question everyone wants to know! I probably googled this myself about 100 times before 😉 Here’s my two cents: The shots hurt when you hesitate to take them. So when you are quick and fast, and don’t think twice about it, no- it doesn’t hurt at all. Once again, I’m referring to the ones I took, Gonal-F, Luveris, Ovidrel and Cetrotide. But if you hesitate (which is normal because putting a shot in your leg/stomach is not the most natural thing to do!!), it can sting a bit. Out of all the shots I took in IUI/IVF I’d say there were maybe 4 or 5 that I really did not enjoy. But that means there were dozen and dozens of others that were fine. At the end I recognized that when I hesitated it stung more so I just went for it!
How many eggs did you have/retrieve?
I only had five that we were able to successfully retrieve and even that as a blessing. After my last ultrasound (prior to retrieval) we were told that there might only be three. Which was shocking. Because we were expecting something along the lines of 10-20. I had responded really well to my IUI meds, and so with all of the extra stims I was on for IVF, the doctor was definitely surprised by how things were shaping up. There were quite a few small ones but the chances of them getting to the right size by retrieval day were not looking so good.
I remember this day so well because Ara was in Toronto on a work trip and I had my mom in town to help me out for the week. I came home and she just knew from the look on my face that it didn’t go well. I was heartbroken that the entire month might just get wasted and we would have to start all over again.
Ultimately my doctor felt confident in my chances and we proceeded.
What happened during your egg retrieval? Were you awake? Did it hurt?
The morning of my egg retrieval, Ara and I showed up at the clinic bright and early. I changed into a hospital gown, with the full on slippers, hair cap and everything. The nurses ran a few quick tests to make sure everything was fine that day. Ara had to do his part of course, which entailed procuring a sperm sample. Then an IV was given to me and I was taken to the retrieval room. I was nervous. And even if I tell you not to be nervous, you will be nervous too. It’s only natural and you can’t help it!
Now here’s the part of my story that kind of sucks. Everyone I had spoken to, and everyone online who had shared their story had mentioned how relatively painfree the procedure was. Most people are so drugged up that they don’t really feel anything or remember anything. I’ve seen countless videos of woman coming out of their procedures and having to ask their partners how many eggs were retrieved, mainly because they weren’t coherent enough at the time of to realize.
NOT THE CASE WITH ME. Cap locks necessary! Not to scare anyone because I really feel like I was that 1 percent exception, but my anesthesia didn’t really kick in. And I felt it all. Was it bearable? Somewhat. But what is essentially happening is that a needle is being stuck in through your vaginal canal (never thought I’d write those words in a blog post) and your eggs are literally being sucked out with the needle head. If your anesthesia is not working- it can be a little painful. While it felt like it was going on for 30 plus minutes, it was just really just ten. I alerted the nurses that I was feeling everything, but because we weren’t collecting that many eggs, I think they just thought I could hack it out? Or maybe as most woman are, I didn’t let them now how painful it was for me. I thought I could be brave and deal with it. It hurt- I cried the entire time. But when it was over the pain immediately subsided and it’s now become a distant memory.
I wasn’t sure if I should include this because I definitely don’t want to scare anyone. In hindsight I should have just asked for more meds immediately. But like I said, my experience is not common. Most women barely feel a thing. And everyone whom I’ve shared this with is pretty surprised that mine was so painful- so this is the exception and not the rule!!
What happens after?
At this point I was just given quite a few oral meds to take in the following weeks, as well as a vaginal suppository called Endometrin, which aides in the production of progesterone. The procedure of IVF naturally removes the cells that are needed to produce progesterone- you need progesterone to help aid in the development of early pregnancy so it’s a must when you do IVF. I was lucky and did not have to take progesterone shots- I believe those can be a touch painful. I took mine via a suppository and took it through my tenth week of pregnancy.
And then we waited! For the next five days, I was to receive a phone call from the embryologist everyday. The embryologist is the person assessing how your embryos are doing everyday, and communicates that to you as well as to your doctor. It’s a nerve wracking phone call to receive because he’s either going to give you bad news, or good news!
Day 1 he called us with the great news that out of the five eggs we retrieved, all five fertilized. Meaning the sperm and the egg paired up together! This was a huge relief. As I mentioned, most women retrieve upwards of 15-20 eggs, so if even half of them don’t fertilize, you’re still left with good odds. I was so scared having only five. There was a chance none of them would fertilize and we would have to start all over.
Each subsequent day he called me and updated me on the status of our embryos. My clinic prefers to do 5 day transfers, meaning the embryo has cultivated for five days. 5 days blastocyst transfers have a higher chance of pregnancy rates than 3 days transfers. Some doctors prefer not to take the risk of waiting for an embryo to make it to day 5. If the embryos weren’t looking so strong, we might do a day 3 but in an ideal situation we were going to wait till day 5.
By day 5, three of our embryos were looking great, with two kind of lagging behind in development. This was still great news given that we only started with five.
I went in for my transfer exactly five days after my retrieval. (which is so so easy- very similar to an IUI transfer and completely painless!) On that day we were told that two of the embryos didn’t make it, but we still had two great ones that we would decide to freeze.
And then we waited. This two week wait is so nerve wracking! They say it’s best to just go on living your life, but what do they know 😉 I spent most of it researching IVF success rates in hopes of making myself feel better. That’s the truth! At my clinic they do suggest you take time off of work if you work in a stressful environment, and they also recommend not over exerting yourself through exercise. Whether these thing contribute to IVF success rates or not is left to be determined. However we weren’t going to risk that entire month of shots and money on stress or me trying to run a quicker 5k. Rest and relaxation took precedence!
What’s one piece of advice you can give
That it really only takes one embryo to make it work. I was nervous after our retrieval. I was devastated that I only had 5 eggs and I felt like if this cycle didn’t work- it was my body that let us down. But it worked! And it really only took that one.
Are you having twins?
Firm no on that one! While back in the day IVF meant transferring multiple embryos, these days a lot of woman only have one transferred. Some definitely still do two, but the days of 6 or 7 are long gone. Because of my age and relative good reproductive health, we only did one.
I think that about wraps it up- I could go on even more but I feel like this post is getting way too long!! If you have any specific questions that I didn’t answer, feel free to just send me an email at firstname.lastname@example.org. I will definitely get back to you asap! Thanks for reading and good luck on your IVF journey if you are about to embark on one!