In Vitro Fertilization… IVF
Here we are my friend. It’s been a long, long road and I am both terrified and exhilarated to see you. Petrified that you will also fail me, but rejuvenated by the hope that you will not. To read more about how I ended up here, click HERE.
As I mentioned in my last post, IVF was always on the horizon, but I was never pressured by my RE to take that step. I CHOSE to take that step. I was ready. I simply could not continue as I had been. So, my husband and I found ourselves sitting around a conference room table with other hopeful parents, learning about all kind of injections – some of which I had done already and some I had not. We reviewed the expectations, the process, the demands, the risks and then we were handed our individual plans.
It was at this time that we realized that in addition to my own PCOS diagnosis, that there were also concerns on my husband’s end. Part of our IVF plan recommended ICSI, which is when they take eggs from the mother and sperm from the father and manually complete the fertilization process in the lab with a needle. My husband’s sperm count was plentiful, but there were some concerns about the shape of the heads which would make natural fertilization (even in a petri dish) less likely. This was news to us. Would it have made a difference if we had known this earlier? Maybe. But, it was kind of a moot point at this juncture.
Let me summarize IVF for you in a way that makes it seem so overtly simple.
- Start birth control – no, this is not a typo (the key to IVF is controlling your cycle)
- Order IVF medications
- Do some blood tests, including getting tested for HIV (husband does this too)
- Gasp as an insane amount of needles and medications arrive on your doorstep
- Begin the injections designed to suppress ovulation
- Do more blood work
- Begin the injections designed to stimulate follicle development
- Do more blood work
- Enjoy a thrilling vaginal ultrasound
- Begin looking like you have gained 10 pounds overnight
- Rinse and repeat until you are determined to be ready to ovulate
- At the EXACT time you are told, take the injection of to induce ovulation. You must set about 8 alarms to make sure you don’t mess this up, as this injection is perfectly timed so your follicles will be ready for fertilization when the RE needs you to be.
- Begin Progesterone in Oil (PIO) injections (OUCH.)
- Show up to the RE’s office at the time you are told. Your husband drinks an energy drink on the way there, as instructed, to wake up the swimmers.
- Nervously get ready and wait as you listen to your RE excitedly tell a med student all about ICSI and how cool it is. You think to yourself that it is really cool how much he loves his work. You love this about him.
- Briefly think about how awkward it feels to be going under anesthesia knowing the people in the room will be getting up close and personal with you while you are under.
- Wake up and immediately ask how many follicles they got. They tell you 22. You want to cry you are so happy.
The next day, I ended up calling the emergency number for my RE because of severe pain. I have never felt pain this intense in my life. As a PCOSer, I knew going in I was at risk for Ovarian Hyper Stimulation Syndrome (OHSS) and sure enough… that is what I had. Some bed rest and Tylenol with codeine got me through the worst of it, but when I did finally go in for transfer, my RE couldn’t even really see my bladder because my ovaries were the size of softballs. Softballs. Two of them. No wonder it hurt.
Over the next couple days, I waited for news on how many of the follicles were able to be fertilized (11) and then how many of those made it to day three (7) – the earliest they would transfer; day five (6) – the last day for embryo transfer and eventually day six (still 6) – which was my RE’s preferred transfer date because at this point they are no longer embryos, but something called blastocysts.
Here is your over-simplified process for IVF transfer.
- Drink a TON of water. Then drink a TON more.
- Sit in the waiting room wondering if anyone has actually peed on themselves while waiting for IVF.
- Say hi to your RE who comes in completely giddy over the way your blasts are looking that morning.
- Do a mental celebration, then remember how bad you have to pee.
- Get gowned up, and go into the sterile room with your husband where they tell you that your bladder isn’t full enough and you need to drink more water (WHAT?!?!)
- Get your first baby picture (a lab photo of blastocyst cells) and secretly name them.
- The superstitious RE comes in and hands you his keychain with a genie lamp on it to hold.
- Your babies (two in my case) are brought in and you can actually see them being deposited into your uterus.
- Your RE is happy, so you are happy. He kisses your hand as he takes his keychain back and tells you to “be pregnant.”
- You lay inverted on the bed for a few minutes more.
- They let you pee. It feels amazing.
- You go home and wait.
In the world of infertility this time period is known as the Two Week Wait (TWW) and it is torture. Your RE will tell you not to test at home, but instead, wait for the blood test. Home tests (positive or negative) can be a huge mental battle and not as accurate. Some people have self-control. I did not. I tested on day 11. My husband couldn’t see the line, but I could. I had seen enough negatives to know what a positive looked like. I was pregnant. And the blood test confirmed it.
And this time, I stayed pregnant. More on that to come.