The Full Guide to IVF

As I mentioned in my last post, there is A LOT of preparation for the IVF journey. You can check out our pre-IVF checklist here! Once we checked all of those boxes, it was time for the real deal! At this point, I've already been taking prenatal vitamins since March and Vitamin D for 3 months (I live in Michigan, so just about all of us are VitD deficient to some extent).

1. Order medications: Seriously, as early as possible! It took us almost 2 1/2 weeks from the time our prescriptions were sent to Freedom Fertility to the time they reached our door. This was partially due to the fact that our insurance would only cover the costs if we went through a different pharmacy. Even though the doctor handled ordering the prescriptions, I was on the phone with both them and the two pharmacies nearly every other day for a status update. I was diligent to say the least but at this point, how could I not be!? You can't start the treatments without them, they're the most important part of all of this.

2. CD2 Blood work and Ultrasound: Not the first time you've gone through this, DEFINITELY not the last. This gives the doctor a baseline to compare your progress to on the stimulant meds (stims).

3. CD3 Begin Stims!: The moment we've all been waiting for. Injections start today. Remember how terrified I am of needles? Yeah that hasn't changed. I can now look at them and draw medication without feeling like I'm about to hit the floor, but no way no how would I ever be able to jab myself with one. This is alllll hubby's job. The nurse made it very clear that everything should be taken at the same time every single night so no matter where we were at 7:30pm, I was getting shot up in the belly. Yay. I decided to keep track of my meds via a bullet journal tracker. I like to visually see progress so this has been awesome for me!

Aside from the prenatal vitamin and Vit D, my doctor ordered the following medications:

Follistim: Stimulates follicles to help develop and mature. This one was easy! You put the cartridge of medicine inside of the reusable pen (where it lives until you've used it all). All you have to do is attach a new .5" needle for each use and dial up the prescribed dose (mine was 150IU daily). This one has to stay refrigerated, all of my other meds were fine to be left out. I took Follistim for 10 days.

Menopur: Does the same as Follistim by providing the follicle stimulating hormone (FSH) and luteinizing hormone (LH). I was on this one for 10 days as well. Menopur comes in a vile as a powder so it involves a bit more prep. We had to draw up 1CC of solution to then inject into the powder which dissolves instantly. After drawing that back up it was ready. If we're being honest, I hated this one. It burned going in and burned for several minutes after the fact. A lot of the tips I read online said to ice before, heat after to help with any pain, but I found putting a cold pack on afterwards worked just fine. I actually used a reusable cooling eye pad to hold right on the injection site, whatever works right?

Ganirelix: Blocks the release of LH. It prevents eggs from being released to early, allowing them enough time to grow properly. This shot didn't start right away. My doctor had me start this one on day 6 of stims and continued it for a total of 6 days. Once they started to see eggs reach a mature stage is when I started this to prevent ovulation until we had enough for go time. This shot was a pre-filled syringe, so no prep necessary. Pretty painless, but my husband hated it. He said he felt like he had to jab it a bit more forcefully than the others to get it through the skin. I didn't really notice that though.

Doxycycline: Hubby and I both started this on day 7 of stims. He took it until the day of the retrieval and I took it until the day of the transfer. It's an antibiotic in pill form that prevents either of us from getting sick. We took it both morning and night, and the nurse warned that we have to take it with food or we WILL throw up. Nobody has to tell me twice to eat something so I never had any problems with it, but Chris isn't much of a breakfast eater so there was once or twice that he said he felt sick.

HCG: Stimulates the release of the eggs! I've had this one before with every round of IUI, but this time Chris gave it to me at home. Luckily this one goes in the butt instead of the belly. The HCG had to be taken exactly at 8:30 so that the timing was just right for retrieval day. No pain, just excitement that this is actually happening!

Medrol: A pill taken the night after the retrieval and 3 days afterwards. It helps to prevent/reduce inflammation of the uterus after the surgery.

PIO: or Progesterone in Oil. It's essential because nothing about IVF is natural. Your body doesn't know that we're trying to get pregnant, so it's not producing nearly enough on it's own. PIO also helps aid in implantation of the embryo. As I'm sure anyone who's looked into IVF knows, PIO is a doozy. It started the day after the egg retrieval and will continue until the blood test. If the test comes back positive (🤞) I could be taking up to 6 WEEKS. Luckily it's the only shot we have left to worry about. It's intramuscular so there's a 1.5" needle on the end of that syringe. Because the oil is thick, it needs to be drawn up with an 18 gauge needle. It's huge. You do NOT want that going inside of you, it's only to draw up the PIO. After it's drawn up, SWITCH THE NEEDLE to a 22 gauge. This one goes in the butt and takes a bit longer to administer not only because I'm taking 2CCs each night, but it's oil so it's thick and slow going. I use my little cooling pad on the injection site after this one. I've currently got a pretty nice collection of bruises going on on the cheek regions. So cute.

4. Blood work & Ultrasound: It feels like you should have your own special room at the office with how often you're there! I went every other day up until day 8 of stims, then I was there every morning to monitor the growth of the follicles. They do this to ensure that everything is moving along the way it's supposed to, and to prevent any chance of Ovarian Hyperstimulation Syndrome (OHSS). OHSS happens when your body responds too rapidly to the stims and the ovaries become swollen and painful. My nurse said that this only happens to about 1% of women, but they monitor the progress to try to ensure it doesn't happen. Every time I went in, I had both a transvaginal ultrasound and blood taken. The day after the HCG shot, I went in for blood only to make sure that it was good and in my system.

5. Retrieval Day!: This day couldn't have come soon enough. My ovaries were growing and I felt it. I was incredibly bloated (dresses or leggings every day), and just felt gross. For me, retrieval happened on day 13 of stims. We got to the office at 7am for a surgery scheduled at 8:30. While I was being prepped, hubby had to go and give one final sample. Afterwards he joined me while we waited for it to start. The doctor explained that I would be in a light sleep from the anesthesia while the retrieval took place. When they took me into the room my feet were placed into big boot-like stirrups and the next thing I knew I was waking up. The embryologist let us know that they were able to retrieve 20 eggs! Woo hoo! I was given some pain meds for the cramping and discomfort I had post-retrieval and slept most of the rest of the day. I had the following day off as well and I'm glad I did. I just had a surgery after all and I needed those two days to recoup. The next day the nurse called and told us that 10 of the eggs successfully fertilized. This is good! Not all of the eggs will fertilize, so 10 had us excited! 

6. Transfer Day: This happened 5 days after the retrieval. We got to the office at 8am for a 9am transfer. Once we got there, I had to take two Valium. Not only does it relax you, but in turn relaxes the muscles of the uterus to allow for a smooth transfer. Then came the water. By the time I got there I had already drank a bottle of water, but I needed more. The bladder has to be very full at the time of the transfer to help push the uterus downwards. Because of my UU, this was especially important. By the time we went into the procedure room, I had taken 3 Valium and had an OVERLY full bladder. I started panicking because I knew I wasn't going to be able to hold it. The doctor let me use the bathroom enough to where I didn't feel uncomfortable. That was fun. Chris got to be in the room while this happened, and watched the transfer on the ultrasound screen. I didn't, I had my eyes closed and put every one of my efforts on not losing control of my bladder. The transfer only took a couple of minutes and I now had an embryo inside of me. After we went back to the recovery room the doctor gave us a photo of the embryo. 

I saw this and immediately started crying. This is overwhelming! That perfect little embryo could be our perfect little baby! The doctor told us that the embryo is pretty perfect and that I'll be back in the office 10 days later for the blood test. I went home and rested for the day (and the day after that). I'm not taking any chances by doing too much!

10 days is better than a full TWW, but the wait feels harder than any TWW we've been through so far. I've got 4 days left until the blood test and am trying my hardest to keep stress low and positive thoughts high. Here's hoping that my next post brings lots of happy tears. 🤞🤞🤞