My IVF Journey

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woman giving herself a shot ivy

My IVF Journey was full of waiting, excitement, tears, and learning. It taught me so much about myself, my relationship with my husband, and fears I didn’t even know that I had. When you’re in your 30s you don’t think anything about getting pregnant. It should be simple right? Well for many women, it is not. Not at all. There is so much more planning, preparation, and money that goes along with having a baby.

One thing about IVF is the concept of hurry up, and wait. Each step of IVF relies on dates of your cycle in which you anxiously want to hurry up and come so you can get to the next step to hurry up and wit for the next step. It can be mentally draining for couples.

Luckily, my IVF journey only spanned the course of a year or so. I will say that in being part of many Facebook groups and reading other’s experiences I know this isn’t the case for all women and I am severely lucky, blessed and thankful.

Quick Outline of My IVF
  • January – Initial Consultation with First IVF Clinic
  • Covid Pause
  • April – Initial Consultation with RMA
  • May 6 – Bloodwork and Lab (AMH 1.54)
  • May 14 – Nursing Consultation
  • Mock Transfer
  • June 1 – Baseline Appointment
  • June 26 – Retrieval #1
    • 7 eggs retrieved, 6 mature and fertilized, 2 5 day embryos
  • August 6 – Baseline Appointment
  • August 27 – Second Retrieval
    • 16 eggs retrieved, 10 mature, 5 5 day embryos
  • October 6 – Embryo Transfer
  • October 10 – Positive Test ( I tested wayyyyyy early and was lucky to get a positive)
  • November 20 – The last Appointment with IVF Clinic and graduated to Ob/Gyn
Details of the Journey

My IVF journey started in the Winter of 2020. I began going to a local IVF doctor who did my consultation and shared with me the next steps. MY husband and I took time to think about it and honestly save money for it as well. IVF is not cheap even if you do have insurance coverage, medication can be expensive even if it is just a copay.

Then COVID happened and it was impossible to start a new cycle as a new patient at many clinics. But luckily I was able to get established with RMA in Philadelphia and begin the journey with video consultations. During this time I began learning about egg health and taking supplements to ensure my best chance for IVF I started reading “It Starts with the Egg” which is also where I heard about these supplements. Make sure you talk to your doctor before just deciding to add things to your IVF regimen as it is all about hormone levels and control when it comes to IVF.

My first in-person appointment was for labs and bloodwork. One main lab IVF doctors look for is AMH. According to RMA: “AMH or anti-mullerian hormone is a laboratory test that OBGYN and fertility doctors may use to assess a woman’s ovarian reserve or egg count. AMH is a hormone produced by cells from the small follicles in a woman’s ovaries and is used as a marker of oocyte quantity.” This doesn’t tell you anything about the quality of the eggs. It is important to know this.

My level was 1.54. For my age, this isn’t too low but it isn’t average it was below average. My doctor was a bit disappointed. I was told to expect less than 10 eggs for retrieval. This was scary for me because with each step some eggs don’t make it so with IVF I wanted quantity and quality. That wouldn’t be the case. I’m happy to say the quality was more important.

Mock Transfer

The next step was a mock transfer to check to ensure the doctor had a clear path to get to my cervix when it was time to put the planned embryo inside my womb. At this time we found out I had endometritis, not to be confused with endometriosis. Endometriosis is a condition in which tissue resembling that which grows in the uterus develops in other areas of the body. Endometritis (what I had) is inflammation of the inner lining of the uterus (endometrium).

Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. I didn’t have those symptoms. But what cleared up after being put on antibiotics was my constant urge to use the restroom. For the last few months, I would wake up in the middle of the night to use the restroom. I had seen doctors to see if I had a UTI but nothing ever showed up. I don’t know if the two were related. I’m happy I could sleep through the night again at that point.

Then we wait for my period to start. (this is the only time in my life I have been counting down the days until my cycle started with anticipation)

Egg Retrieval – Round One

To prepare for egg retrieval, you take shots. Lots of shots. I have never liked shots. So this was a mental struggle for me, but I was actually excited about this as well. It meant progress! Once my period started, I began birth control for about 10 days then I went back for an ultrasound and bloodwork to make sure everything was quiet in my ovaries. Then it was time for shots, shots, shots (in my Lil Jon voice). I had to take two shots daily: Follistim, menopur, and then an HCG trigger shot prior to my retrieval.

Here’s how my numbers looked through this cycle. Each day is a doctor’s appointment with blood work and usually an ultrasound to check on follicles.  At this point, we were looking for my follicles to grow slowly but surely eventually to become mature. Follicles are mature if they are 16-20mm in average diameter on the day of human chorionic gonadotropin (HCG) trigger shot to prepare for retrieval. It is important to note all follicles may not contain an egg so there is no exact count but the hope is that for each mature follicle, the doctor will get one egg. They monitor your estradiol or estrogen to ensure it doesn’t get too high as that can cancel a cycle as well.

Day 1 Estradiol 55 Progesterone 0.7 HCG <2  FSH 8.5 LH  7.2 Baseline 11

Day 4 4 follicles that are less than 10mm, 1 that is 13mm and 1 that is 15mm.  On the Left, there are 3 that are less than 10mm. 

Day 6 Right side: 2 follicles less than 10mm 3 follicles in the 13mm range 2 follicles in the 15mm range Left side: 1 follicle less than 10mm, 2 follicles in the 13mm range.

Day 8 9 follicles  E2: 1407 P4: 0.9 LH: 2.6  18 mm biggest follicle 

Day 9 Right 6 follicules 12-19 mm Left 3 15-16mm

Day 10 Estrogen: 2243 Progesterone:1.6 LH: 0.7 Right ovary: 11 10mm-20mm Left ovary: 5 folliculres 10mm-17mm

Day 11  (10 days stimming) Trigger Day(HCG Shot)  Estrogen: 2305 Progesterone: 1.9 LH:0.2 Right ovary: 11 13-20mm Left ovary: 3 follicules 17-20mm

Outcome

7 eggs retrieved, 6 fertilized via ICSI, 2 5 day blasts

We sent those two 5 day blasts for PGD testing and the outcome was two female embryos but we’d have nothing to transfer. I was crushed. I cried for two days. It was $12,000 wasted in my mind. I didn’t know if we wanted to try again. It was such a trying time for us as a couple. I monitored my husbands’ food, I was taking so many supplements and prenatal. The hormone shots had me severely emotional and the pain after egg retrieval was not fun. It hurt, I was sore, tired, and sick. I was so optimistic that round and it failed. But we decided to try again.

Egg Retrieval – Round Two

This next time my doctor changed my protocol a bit. He decided to increase my dose slightly of Follistim. My husband’s doctor decided we shouldn’t use frozen sperm the second time, so his procedure to remove his sperm would happen the same day as my egg retrieval. I also added acupuncture to my routine. We had to skip a cycle due to a cyst on my ovary which is common plus COVID limited the number of egg retrievals that could be done each month. The waiting this time around was brutal. However, we finally were able to begin after my August period and 10 days of birth control. Here’s how that cycle played out.

Day 1 19 baseline follicles (already more than before) 

Day 3 2 measurable follicles 

Day 5  6 measurable 14 total on both sides,  Estrogen was 859, Progesterone 0.7, LH 3.0

Day 6 15.6mm biggest follicle Estradiol: 1106 Progesterone: 1.0 LH: 3.3

Day 7  20mm biggest follicle, 16 was the next biggest (I didn’t get a full count)

Day 8 Right Side: 1 follicle 20mm and 3 follicles 15mm, Left Side:  follicles 15mm and 2 follicles 17mm and 1 follicle 20mm

Outcome 

16 eggs were retrieved. More than double the first cycle! 10 mature, four fertilized but then good news for this cycle, we got five 5-day old blastocysts! Yes, five! I was crushed when I heard only four were fertilized out of ten but it turns out three more actually fertilized after the initial call! We sent those five (well some of their cells, not the actual embryos) off for PGD testing and all five came back perfectly healthy embryos.  We could move to the next step. And get this all five were male embryos.

Preparing for Transfer

The next step was putting a baby in me! But there was a lot of preparation prior to this! After two cycles we could move forward. (Once again hurrying up to wait) This gave my body time to heal after the egg retrieval and come off the hormonal roller coaster I was on. This cycle is LONG and in my opinion way more mentally trying than stimulation. I had no sex drive which was not great for my husband. I was also a hormonal angry minion during this cycle.

Then in September, I began birth control again for about ten days. I was told to expect period-type bleeding just like every other time I stopped birth control pills but this time I didn’t have a bleed. I was so freaked out I thought my cycle was ruined. It wasn’t. I went back at the end of September for blood work and an ultrasound to check my lining of the uterus. This is what matters during the transfer cycle. This time around I took: Estrace tablets, progesterone in oil shots, and baby aspirin every day. I attached my calendar the doctor gave me of what to take when. This is not the same for everyone but my specific protocol.

9/21/2020 9/22/2020 9/23/2020 9/24/2020 9/25/2020 9/26/2020 9/27/2020
AM:

Baseline US & BW

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

 

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

 

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

 

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

 

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Office Visit: BW & US

 

Mid-day (after call back): Add Estrace 2mg in afternoon

 

PM:  Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

Mid-Day:

Estrace 2mg

 

PM: Estrace 2mg

Baby aspirin

9/28/2020 9/29/2020 9/30/2020 10/1/2020 10/2/2020 10/3/2020 10/4/2020
AM: Estrace 2mg

 

 

Mid-Day: Estrace 2mg

 

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

 

Mid-Day: Estrace 2mg

 

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

Office Visit: BW & US

Mid-Day: Estrace 2mg

 

 

PM: Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Start Prog in oil 1cc

Take at 7am daily

Decrease Estrace to 2mg twice daily

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

 

Prog in oil 1cc

 

 

 

 

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

 

 

PM:

Estrace 2mg

Baby aspirin

10/5/2020 10/6/2020 10/7/2020 10/8/2020 10/9/2020 10/10/2020 10/11/2020
AM: Estrace 2mg

Prog in oil 1cc

 

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

Thaw Blastocyst(s) & Transfer & BW

 

PM:

E/strace 2mg

/Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

PM:

 

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

PM:

Estrace 2mg

Baby aspirin

10/12/2020 10/13/2020 10/14/2020 10/15/2020
AM: Estrace 2mg

Prog in oil 1cc

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

 

PM:

Estrace 2mg

Baby aspirin

AM: Estrace 2mg

Prog in oil 1cc

 

Office Visit:

Preg test

*If pregnant, continue: Estrace 2mg twice daily

Prog in oil 1cc daily

KEY:  Estrace 2mg = 2 tablets, Estrace 3mg = 3 tablets

Baby aspirin 81mg/day

 

Everything went according to plan this cycle and the transfer took place as it was scheduled. For a frozen transfer, you have to have a full bladder. Funny story, I overdid the full bladder. I was so worried I would mess up transfer by not having a full bladder that I drank too much too fast and I had to use the restroom FIVE times in the two hours leading up to my transfer. I opted to do acupuncture the day of transfer and I had to get up with needles in me to run to the restroom because I had to potty. So don’t overdo your water consumption. Just follow their instructions.

Next, I took pregnancy tests daily. Not a good idea but I have anxiety so it was helpful to me becuase I expected a negative on day one so seeing one in later days was less hurtful. I swear I saw a positive the evening of day 3 after the transfer but my husband wouldn’t let me claim it. Day four was clearly positive. This is not common. Many women do not get positives until 7 days after a 5 day transfer. I went to Lab Corp for my two pregnacy blood tests. My first HCG was 9 days after the transfer it was 270 the next was three days later 2251. As long as it doubles everything looks good… We were pregnant! I cried. I danced. I slept. I was so tired and the progesterone shots and estrogen pills still had me on an emotional roller coaster.

 

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