IVF – What Happens?
In the second of my IVF posts I thought it might be helpful to set the scene and shed light on what’s in store for me over the next few months. Most importantly though, I want to thank you all for being so welcoming after my first post. I cried a few tears that day and I can’t tell you how much support I gained from all your comments.
At the beginning of the year I was familiar with the term IVF and I knew couples who had undertaken the procedure. I’d heard it was hugely expensive, stressful, invasive and painful. However it wasn’t until an appointment with our urologist during our fertility exploration period that it finally dawned on me what REALLY was involved.
I may well be making a generalised statement here but I have been hit by the realisation that a lot of people know very little about the details of the IVF procedure. I suppose you don’t necessarily know much about any medical intervention until you’re faced with it yourself, but I would say within my own family and friends only 1 or 2 of them had any knowledge of what’s involved.
I am not a medical professional but reassuringly I have now been given an outline of my own treatment plan and I feel much more confident in explaining what’s involved for me. I hope this is useful information for anyone who might have found out they’ll need assisted conception or for family and friends who might want to support couples during infertility treatment.
Step 1: Suppression
The first step in long-protocol IVF is to also known as ‘down-regging’ and this is the administering of medication to suppress your natural cycle. Some take birth control pills, others a nasal spray but in my case it will be a nightly injection of Buserelin injected into my thigh. Sounds fun doesn’t it?! This will happen from day 21 of my cycle and continues for several days after my period. It seems as though this first stage will take around two to three weeks. However down-regging can alter your cycle and I’ve read lots of women who found their bleed was delayed which meant the first stage took longer.
I’ve been told to expect headaches, fatigue, ability to cry at anyone and anything and hot flushes as the body is being put into a medically induced menopausal state.
Step 2: Stimulation and Monitoring
Each cycle we produce multiple egg follicles but only one follicle becomes dominant and releases a mature egg. During stimulation the medication results in multiple eggs maturing and this means the size of the ovaries can increase from the size of an almond to the size of an orange!
After a baseline scan to confirm my ovaries are ‘sleeping’ stimulation begins by injecting another drug, Menapur alongside the Buserelin.
I will inject both drugs for around a fortnight and during the second week I’ll visit the clinic every other day for scans (which unfortunately means getting well acquainted with a certain ‘dildo cam’) to check on the progress. When I’m ready I’ll administer a ‘trigger shot’ to tell my body to release the eggs. 36 hours later I’ll be in theatre.
Unsurprisingly common side effects around this time include bloating and abdominal discomfort as well as nausea, cramping, headaches and mood-swings.
Step 3: Egg Collection
Under sedation a needle will be be inserted vaginally into my ovaries and the eggs will be removed. Hopefully as a result of all that medication there will be multiple eggs to take off to the lab. On the same day my husband will also provide a sample and due to our condition may also need to undergo a procedure too – Surgical Sperm Retrieval. I’m sure I don’t really need to explain but it makes him wince every time we talk about it!
Step 4: Fertilisation
In IVF the egg and sperm are put together in a petri dish to fertilise. In our case we will be using the ICSI (intracytoplasmic sperm injection) procedure where one sperm is injected directly into the egg. They are then left to fertilise.
Step 5: Embryo Transfer
Dependent on the development of the embryos, around two to five days later I’ll be back in theatre to have one high quality embryo inserted into the uterus via a catheter. As our treatment is NHS funded we’re only allowed one embryo.
The injections stop and instead it’s time for the pessaries. Progesterone facilitates implantation and so I’ll be inserting capsules three times a day. Thank goodness for the iPhone alarm.
The Two Week Wait
Providing all goes to plan above we’ll then have a two week wait after fertilisation before we can take a pregnancy test.
Unsurprisingly I feel overwhelmed and nervous but I’ve also found I’m a little bit excited. I’m not looking forward to the potential side effects but can’t believe we’re one step closer to becoming parents. Although the procedure will be intense and very invasive I’m forever grateful for medical science – what can be done in a lab now is just incredible. By the time I write my next post we’ll have started the first cycle so for now all I can say is please wish me luck and see you on the other side! Thank you very much for all your support.
Image by Little Beanies.