CHR Post: IVF 10; A Guide To The Process of IVF, Part I

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In a previous post, I described the process of deciding that CHR was the place for my husband and me to battle our infertility issues.  After our medical consultation with Dr. Gleicher, we learned that that IVF was our only option and the best chance we had of having genetically-linked children of our own. So we committed with full force.

Committing to IVF is a big deal – both emotionally and financially. But once you “get there,” you now know that you have a plan. So what can you expect from an IVF cycle?  Here is my personal guide to the process of IVF, Part I.

Chapter 1: Preparing for a cycle

After the initial medical consultations were through, we knew our IVF cycle was upon us in a matter of weeks. In preparation, our first step was to order all the medication I would need for the full cycle (which spans from prepping my body for ovulation through to the pregnancy test). I should note here that everyone’s cycle at CHR is different, and the doctors really tailor it to your own case. In my situation, my medication included an estrogen patch, various oral medications, and injections. The nurse, who also acted as my clinical coordinator, reviewed all the medications that were prescribed for me. It was during this meeting that we reviewed the process of how to inject myself with the stimulation medications, which I was told (and read about later online) work to stimulate the ovaries in an effort to produce multiple eggs.

My first reaction to these instructions was: “What do you mean my husband and I have to administer shots? And where exactly are these shots going? We don’t need medical training? You just trust that we can mix medicine and draw the proper amount into a syringe and voila?” The nurse clearly explained how to mix the meds (there is a process of mixing vials of water solution with a powder to create the right amount of prescribed medication). So after a thorough tutorial, I came to understand the mixing process, but still had more questions: “How do you pull the syringe? Where exactly do you put it?” Well, the nice – and very patient – nurse also covered that, too. In fact, I had such great, attentive care that the nurse drew where to administer the shot. I mean she literally drew on me. She took a pen and made a circle on my buttocks to show us where to inject the intramuscular shots. Needless to say, I tried not to wash that area for a week or so for fear of not knowing what to do when we were home and left to ourselves.

Chapter 2: Getting the green light

Once I was an expert in shots and picked up my medications at the pharmacy, the next step was to monitor my menstrual cycle and prepare for the official kick off of IVF. In my case, I began to use an estrogen patch on day 21 of my cycle. Then my instructions were to wait for my period to begin and come back to the office on day 2 of my new cycle. On that day, my blood was drawn and tested to ensure my body was ready to start the injections.

Blood work and ultrasound monitoring at CHR takes place early in the morning … usually ending by 10 a.m. This is very convenient for just about anyone on a schedule. I felt I had to be the first patient to be seen for monitoring (for fear of running late to work) so I always arrived first to the office – sometimes before the doors were open for business (early bird catches the worm, right?)  Once I walked in and got my paperwork/spot in line, I made myself comfy in the waiting room and enjoyed the daily croissants and bagels, as well as a cup of the coffee from the best and craziest coffee machine I’ve ever seen. What a lovely way to start your day: croissants and cappuccino as preparation for the needle poking and/or ultrasound wands.

After I was fed and caffeinated, my name was called and I went in for my blood work. Just a few minutes later (probably before 8am) I was finished and was told that I’d get a phone call later with the next steps. Sure enough, later that afternoon the nurse called me to give us the “green light” to start the oral medication and one of the injections (microdose lupron). The stimulation injections (Bravelle and Menopur) would begin a few days after that and then I was to return to CHR for blood and ultrasound monitoring.

The nurse had instructed us to administer the injections between 7-10am and 7-10pm. Because I am a huge planner and very detailed oriented, I decided that we were going to do the shots at 7:30am and 7:30pm – on the dot. That meant that sometimes, my husband and I would be sitting there, me getting ready to bend over and watching the clock, 7:28, 7:29 and ah . . . 7:30. I put reminders on my calendar that listed each pill I had to take and which side we administered the shot in the day before as to prevent bruising. I even had a printed calendar that I checked off after we did the shot or I took a pill. It was like crossing out the days on a wall calendar as they pass.  I acknowledge that I may have some compulsive, controlling tendencies.  But to defend my behavior, this was a few years ago before the word “app” was part of our vernacular. Today there are many useful smartphone apps out there to help keep your medication routine organized. To be honest, when you are taking a lot of medications, things can seem overwhelming. For me, being so organized helped me to feel in control of a very uncontrollable situation. It also helped to know that I was doing everything I could physically do to ensure a successful cycle.  So however you keep up with medication process, whether digitally or handwritten, just be organized.

All in all, the first half of an IVF cycle doesn’t require too much of your physical time – obviously mental time is another topic/post all together. You have some morning monitoring, which includes mundane waiting room time, but your actual monitoring should be quick and easy. (If you’re like me, you’ll of course strive to be #1 on the list). Things get a bit more time consuming as you move closer to your ovulation and retrieval days. I’ll go into that part of the cycle in IVF 101, Part II, so be sure to check back soon for the rest of the story.

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