This is my latest blog post on Center for Human Reproduction’s website. Check out my perspective on the process of IVF with Part II on the series IVF 101.
In my last post I described the early stages of the process of an IVF cycle. Now it’s time to move on to Part II – the midst of an IVF cycle.
By this point, I had mastered the art of injections and had my medication administration down to a science. I was super organized, with a gigantic to-go pillbox filled and ready, and a bathroom that looked like a hospital with injections and the medical waste container on proud display on the vanity.
At this point, my morning monitoring appointments with the medical staff were also beginning to pick up speed. That is, I started to get poked and prodded every few days, which soon thereafter increased to every other day. It was during this ovarian stimulation period that my blood levels were closely monitored and the doctors were observing the growth of my egg follicles via ultrasounds. The doctors were checking that I was reacting positively to the hormones, which were designed to ensure that my follicles (which are ultimately where the eggs live) were maturing. They told me that regular monitoring was important because there was a chance that my body might not respond well to this hormone dosage and the doctors would need to adjust my prescriptions.
As the cycle progressed, my doctors worked to determine the right day for the retrieval procedure that would produce the optimal amount of mature follicles. From a layperson’s understanding, the doctors look to delicately balance waiting to retrieve until you have enough mature follicles without sacrificing slow and/or speedy growers. For example, you could have one ovary that has only a few follicles but they are growing at a much faster rate than the other follicles so the doctors might feel the need to hedge the bets in one direction versus another. I could tell that my retrieval day was quickly approaching when my monitoring increased from every few days to every other day. Of course, having the medical staffer tell me “It’s time!” was also a sure-fire signal.
Once the doctors decided I was ready for the follicle retrieval, I next had to give myself an HCG shot, otherwise known as the trigger shot, 34 hours before the procedure. For an overly simplified explanation, the HCG is a hormone called human chorionic gonadotropin, which, in IVF, pushes the eggs through the last stage of maturation process and triggers ovulation. (HCG would also come into play later on, as a hormonal indicator of successful implantation in a series of pregnancy tests.)The HCG shot was unlike any of the other injections I had administered so far. As one of the clinical coordinators told me, it was my turn to be Cinderella. No, I didn’t get all dressed up in a gown and sparkly tiara; but I did have to wait until about midnight (give or take 30 minutes) to receive the HCG shot. In actuality, the timing of the shot directly correlated with the time of the retrieval procedure. To be ready for a retrieval scheduled for Thursday morning, I had to have the shot at midnight on Tuesday.
Knowing the importance of the HCG injection, unfortunately, brought yet another level of stress: I only got one “shot” at it. It wasn’t like some of the other injections where if I made an error in drawing, mixing, etc., I could just pull out a new dose from the box and start over. (Then again, based on the exorbitant cost of these medications, this same stress was actually present with all of my injections). The HCG needs to be administered intramuscularly, i.e., in your buttocks. Luckily, I was already familiar with this process since my hormone stimulation meds were administered the same way. So, once again, my husband and I mixed up the meds and then I got ready to bend over and inject. One, two, three, and it’s over. There is one positive aspect to the HCG shot: for the next 24 hours I got a reprieve from constantly poking myself and was able to focus on waiting for the big retrieval day!
Check back soon for Part III of my IVF story, where I’ll discuss the day this has all led up to: retrieval!