My husband Daniel and I have been together for 11.5 years in total and have been married for two of those years. We have been trying to conceive for approximately 18 months now. I always had a thought at the back of my mind that we might need assistance with fertility when the time came (you will read more detail about this in my posts). I naively thought that IVF was almost the easy way out – sure it would be a costly and emotional journey, but I had no idea about all the highs and lows faced by so many women going through fertility treatment and IVF. This blog is about our journey from the beginning and the fertility treatments we have endured since trying to conceive. I’ve found comfort in reading blogs and forums and know that I’m in no way alone in this journey. I hope that by sharing our story, I can give others information about what to expect at each stage of fertility treatment, whilst documenting each step in my Road To Mummy.
When undergoing fertility treatment and IVF, you’re juggling life, work, your partner, family and friends while spending hours going back and forth to appointments at the hospital and pathology, picking up medication, having tests, scans and completing endless paperwork. It seems like a never ending cycle. If you’re lucky enough to find some spare time, you generally don’t have the energy or mental and physical capacity to do much else other than watch Netflix and laze on the couch.
Fertility treatment and the anticipation of waiting for each step can totally consume your life. The road is long and tiring and there are so many unknowns. I hold onto hope that one day we will have our miracle.
The wait for our first scan which was to be at 6w3d, was far worse for me than the 2WW. Partly because I actually had to wait the whole two weeks, but mostly because we had now gotten excited after being told I was pregnant. We had already told our families and a couple of close friends about our positive result and had started thinking about the months ahead – my sister’s wedding where I would be 18 weeks pregnant, our due date in early Feb and cleaning out our spare rooms to make space for a nursery. There was no way of knowing if things were ok or not. Up until this stage, I had not experienced morning sickness or any other symptoms apart from tender breasts and tiredness, which had been happening on and off with all of the fertility drugs for a while.
5w came around and still no morning sickness or new ‘sign’ that I was pregnant. Although I hate to admit it, Google was my best friend during these weeks as I began to analyse every little thing I felt or didn’t feel. Blood tests had confirmed that I was indeed pregnant but the first scan would confirm if the pregnancy was: a) viable – pregnancy is visualised in the uterus and a heartbeat is detected b) ectopic – pregnancy is located outside of the uterus ie. Fallopian tube c) blighted ovum – embryo does not develop even though the egg has implanted in the uterus d) biochemical pregnancy – hcG is detected in the blood but fails to rise – embryo fails to develop further
I decided to POAS for piece of mind, to make sure the line was continuing to get darker. The last time I did this was 10dp5dt and it was now 22dp5dt.
Early pregnancy bleeding
6w1d – It was the Sunday of the Queen’s Birthday long weekend and we were in the Yarra Valley catching up with some friends at a winery. I had been urinating frequently the last week or so and after lunch went to the bathroom. As I looked down, I saw blood in the bowl. My heart stopped. As I wiped there was bright red blood – and what seemed like a lot of it at the time. I felt instantly sick in my gut. We left in a rush and headed straight to emergency as the clinic was closed for the long weekend and we weren’t going to wait until the Tuesday scan to know what was going on. At this stage we didn’t think to page my FS.
I tried to remain calm but the drive felt like an eternity. We were driving from the Yarra Valley to the other side of Melbourne with the thought of a miscarriage at the back of our minds. Once we arrived at the hospital, I was taken through emergency pretty quickly but waited a little while for tests to be conducted. A blood test would verify my hcG levels. If levels were over 1500 they would be able to do an internal ultrasound to see if they could detect a heartbeat. Over an hour passed as we sat twiddling our thumbs. The doctor came back to do an internal examination which involved checking my cervix and taking a swab. She said there was ‘old blood’ and that I was no longer bleeding. hcG levels came back confirming once again that I was definitely pregnant and they could try the scan to detect a heartbeat. My FS was going to do my first scan in two days time but we were here now and the doctors wanted to check if things were ok.
In all my Googling and YouTubing, I knew how a heartbeat would appear on the ultrasound. The doctor told us not to worry if it couldn’t be detected at this early stage, however as soon as bub appeared on the ultrasound, I saw the heartbeat before the doctor had a chance to announce it!
As I didn’t go to my clinic and didn’t see my FS, any hospital you end up at, is meant to contact your FS with details of your stay. My FS just happened to call me the next day, on the public holiday, to see if we could change the time of my ultrasound the following day. As we started talking, I mentioned my hospital visit and realised he had not been notified. I told him about the bleeding scare (I wasn’t home at the time) and he told me to go straight home and insert a pessary immediately, another three hours later and another before bed. I couldn’t believe that the hospital didn’t pick up on this. They had not checked my progesterone and other hormone levels. I had just had a threatened miscarriage and their explanation was ‘bleeding is common in early pregnancy. You’ll be fine.’ My FS explained that I should not have any trace of blood on the medication I was on. It turned out my progesterone levels had dropped and I needed to increase my dose of pessaries to four a day until 13 weeks. Luckily I was able to take two at a time – first thing in the morning, and at night before bed.
All is now going well and this is our first ultrasound photo from 6w3d measuring 0.77cm. It’s hard to believe how clear the heartbeat was at this very early stage, 125bpm!
The dreaded 2WW follows the embryo transfer. This is the time when you’re advised not to do a HPT before the BETA as you could face a false BFP or BPN. It’s the time where you literally can’t do anything to make time pass quicker, you question every little symptom you feel and it can be very nerve racking because you won’t know the outcome of your transfer until BETA confirms it. The nurses will tell you to keep a neutral mindset about your result in hoping for the best but being prepared for the worst.
I read this on a forum during my 2WW and had a giggle to myself. It couldn’t be more true!
“The degree of insanity a woman TTC experiences is inversely proportional to the number of days remaining in her 2WW.”
Of all the cycles we had done previously, I truly felt like I wasn’t pregnant this time round. There had been many occasions before where I had convinced myself I was pregnant from all of the symptoms but it wasn’t meant to be, being negative every time. This time I didn’t feel pregnant and just had a gut feeling that it wasn’t going to be a successful transfer. I caved in and tested at 5dp5dt. I knew that because I was doing a FET I didn’t have any trigger medication in my system that could give a false positive.
I thought testing at home would be the easy part. But it wasn’t. Because deep down I knew that this would be the first time I would POAS knowing it would be our best ever chance of having a positive result. Seeing the two lines that I’ve never legitimately seen before. A simple 3 minute test. I leave the test and set the countdown timer on my phone. 180 seconds.
My mind starts thinking…what am I doing? The clinic told me to wait 11 days before the official pregnancy blood test. To resist the urge to test at home for a false result could appear. Who am I kidding!? I’d rather know in the comfort of my own home if the result was going to be negative. It would be easier to face now then to receive a call when I’m at work breaking the bad news to me.
I’m interrupted by the alarm on my phone. I look down at the test. The tiniest, faintest, thinnest line, barely visible to the eye – a ‘squinter’ in IVF forum terms. At this stage I wonder if my mind is playing tricks and I’m just seeing what I want to believe is there. I call DH into the bathroom and ask him to look at the result. “There’s no line. I can’t see anything.” I tell him to look again and he squints firmly, his eyes still adjusting to the light at 4.30am. “I think I see it but I don’t know.” We felt a glimmer of hope but convinced ourselves that for some reason it could be false and we could just be ‘seeing things’. If I really was pregnant and this was a positive result, the level of hcG in my system would increase each day, producing a darker line. That’s when I decided to test every day until BETA.
6dp5dt: The line was so so faint but slightly more visible than the previous day. DH could see it at first glance. I could definitely see it now but still didn’t believe it deep down. 7dp5dt: There’s no denying what we can see. We get a little excited but DH keeps his cool and says we should just wait for the blood test before we start celebrating. Days felt like weeks and trying to fall asleep at night felt like an eternity. It was difficult to sleep in the days leading up to the blood test. I was still doubting myself because the symptoms I was feeling could have been as a result of the transfer or AF. I honestly believed it was AF as I had experienced the exact same symptoms prior to my failed cycles.
BETA – the moment of truth 11dp5dt: The clinic opened at 7am and I arrived as the doors were opening. I was fifth in line of all the eager ladies I assume were waiting for the same test. I was told I would receive a call from the nurse with my result at around lunch time so off to work I go. I hoped for the busiest day I could possibly imagine and got stuck into work to distract myself from the long wait until lunch time.
I left my phone on vibrate so I wouldn’t miss the call and took my phone with me any time I left my desk. At 10.39am ‘MIVF’ flashed on my phone as it began ringing. I’m caught by surprise as they’re calling so much earlier than I expect. I power walk away from my desk and get outside as quickly as I can, answer my phone and rush through the identification questions. I couldn’t believe my ears.
“We’re so so thrilled to say you’ve had a positive result! Congratulations, you’re pregnant!”
Although we had already seen the two very clear lines over a number of days, I was still in total shock and disbelief. The nurse said my hcG levels were very convincing at 386 and that I was 4 weeks and 2 days pregnant. She told me that my progesterone levels were still looking good and just to be safe, they would repeat the blood test in two days time to check hcG levels are continuing to increase. At 13dp5dt my levels increased to over 1000. Your hcG levels should double every couple of days, but don’t go crazy analysing these figures and comparing them to the results of other women. Everyone’s results are just so, so different.
It’s now official! After six failed rounds of ovulation induction, 193 needles, 25 eggs collected and 1 embryo transfer, our bub is due in February 2018!
Embryo transfer day finally arrived. I was told there would be a 90% chance of a successful thaw.
I received a call from the nurse the day before the transfer. She instructed me to empty my bladder one hour before the transfer and that I would need to have bloods to check my progesterone levels. If levels were too low, daily dosage of pessaries would need to be increased.
We saw the nurse upon arrival. She told me to continue the medication I was on – progynova, pessaries and folic acid (pregnancy vitamins) and advised me that if any bleeding occurred in the next couple of weeks I would need to contact the nurses as soon as possible. I’m told panadol is safe to take, no alcohol, no hot bath. She explained listeria – foods to avoid, food storage and rules around reheating food. You can find detailed information about this online.
I was advised that my pregnancy blood test would be in 11 days time. A positive pregnancy test is confirmed by a level of hCG 150iu/L or greater. A negative test is a result under 5iu/L. If the result is somewhere in between, the blood test will need to be repeated in two days time to see whether hCG is increasing or decreasing. If a negative result and no bleeding occurs within 7 days, the blood test will also need to be repeated.
The procedure We made our way to the waiting room where I signed some paperwork and did all the identification checks. You will soon come to realise that anyone you come into contact with during any appointment or med pick up will ask you for three points of identification – name, address, DOB or for your patient identification number. A nurse then took my blood pressure and temperature before we were to wait for my FS. Once called in, it was bottoms off, gown on and onto the reclining bed. The procedure was so quick – under 10 minutes in total. It all seemed too good to be true considering the long haul it took to get to this day. The procedure was painless, just a little uncomfortable like a pap smear.
During the procedure an abdominal ultrasound is used to guide a catheter into the uterus. A moderately full bladder is required to ensure good ultrasound visualisation of the catheter. The embryologist and FS go through identification checks again and showed us our embie on a screen before loading it into the catheter. The catheter is then passed through the cervix and once in place, the embryo is released. The embryologist then checks the catheter under a microscope to ensure it has been released successfully.
Image: Reproductive Medicine Wagga
That was it – straight in and out! It was a little strange getting up and leaving so quickly. I felt like I was walking a little funny and didn’t want to empty my bladder – I know this seems silly but you just think it could fall out! I was told I could continue with normal day to day activities. I took the day off work and DH treated me to a nice lunch and new perfume 🙂
I received a call a few hours later with my blood test results. My progesterone level was 54.8 so I could continue my two daily doses of pessaries for now.
That evening, I felt crampy and bloated – both side effects of the transfer. I also had mild waves of nausea in the next couple of days, mainly at night when I went to bed, a little bloating, pelvic pain on my left side and cramps that came and went on the same left side. I know these could be side effects from the transfer but also a sign that our embie could be implanting. I’m not going to think too much of it because these are also symptoms I can get before AF, and usually did get before a failed cycle. In IVF/fertility terms I’m currently PUPO which is pregnant until proven otherwise. The waiting continues…
I’m baffled, yet not surprised by how many people in this day and age make judgement towards the choices made by new parents and those TTC. It seems like EVERYTHING has to be up for debate. Obviously I’m yet to face most of this but I can tell you of many friends who have.
Assisted reproductive technology (ART) vs ‘natural’ conception, public vs private care, caesarean vs vaginal birth, breast vs bottle fed.
Strong opinions left, right and centre. Sometimes I wonder if I’ll ever be on the receiving end of this. But for now, instead of engaging in these debates, we’re confronted by something that 1 in 6 couples will understand.
The thoughts of going to places that are buzzing with families – breakfast at our local café, walking through the park, doing our weekly grocery shop, going to the beach for a day in the sun. Baby boosters are out, monkey bars are in use, prams are being pushed and children are playing in the bay.
And there we see them. The couples just like us who could fit into the statistic of 1 in 6.
The mother who is feeding eggs and soldiers to her fussy toddler while being sure to pay attention to her five year old could have had secondary infertility, the mum with her baby in one arm and pushing the trolley with the other could have gone down the path of surrogacy, the family kicking the footy at the park and cheering as the little ones kick the winning goal could have adopted their children, the parents in competition as to who can build the best sandcastle could be foster parents. And you can’t forget the couple who are sitting quietly at a family gathering coming to terms with their recent miscarriage.
The reality is this. 1 in 6 Australian couples are struggling with infertility.You don’t know someone’s story until you’ve stepped in their shoes. Please don’t make judgement and assumptions based on face value – you just never know what’s going on behind closed doors and how someone got to where they are today.
Be happy for first time parents and the fourth time parents. Be happy for the couple who are finally pregnant after years of TTC. Be happy that in this day and age we are all free to make our own choices. So let them make theirs…
ICSI (Intracytoplasmic Sperm Injection) was incorporated into our IVF treatment cycle to enhance fertilisation due to low end sperm count.
IVF has long been used to treat infertility and involves eggs and many sperm placed together in a petri dish, left to ‘naturally’ do their thing. ICSI is a more recent development and involves injecting one single sperm directly into the mature egg under microscopic vision. The embryologist prepares the sperm by washing and sorting them so that only the healthiest, most optimal sperm is used. Pregnancy rates achieved by this method are very similar (if not better if severe male infertility is a factor) to that of IVF.
Just when I thought it couldn’t get much worse than daily injections, I’m introduced to Synarel (a nasal spray) and Progesterone Pessaries, tampon looking ‘tablets’ which are not injected or ingested orally! Cue the self-doubt here – it’s difficult to know whether or not you’re doing any of this correctly. Thank you Dr Google!
Progynova Here’s where it began. I started taking Progynova on CD5. Progynova is a tablet that’s ingested orally and contains estrogen to thicken the lining of the uterus (endometrium) before FET can take place. I started by taking 1 x 2mg tablet twice a day.
Side effects include but are not limited to: mood changes/depression, spotting, premenstrual like symptoms, nausea, stomach pain, headaches, feeling tired, acne, weight gain.
I was feeling quite bloated and nauseous for a few days and my CD14 scan revealed I still had some fluid. My lining was only 5mm and needed to reach 8mm before moving to the next step so my FS increased Progynova to 2 x 2mg tablets twice a day. I had a blood test to check progesterone levels and also commenced taking Synarel.
Synarel is used to suppress the growth of follicles and is absorbed in the bloodstream. I had one spray twice a day, 12 hours apart (one nostril in the morning and the other at night).
Side effects include: headaches, hot flushes, nasal irritation, muscle pain/weakness, acne, mood changes/depression, increase in hair growth.
I hated Synarel. Half the time I didn’t know if I sniffed it in deep enough, if the angle of the bottle was ok, if it was too far up my nose, if anything was even being absorbed. It left a disgusting taste at the back of my throat that lingered for a while and made me want to gag. Hold in your sneezes and don’t blow your nose because you don’t want to be taking another dose!
Progesterone Pessaries My next scan was CD18. My lining was looking good but I had a follicle/cyst (damn PCOS) and needed to have another blood test to check that progesterone levels were ok. In the afternoon I received a call from the nurse giving me the all clear to commence Pessaries the following morning – 400mg twice a day, 12 hours apart, while continuing to take Progynova. Progesterone Pessaries are used in the luteal phase (LP) to support the endometrium and ensure that the lining of the uterus is optimal for implanting an embryo. If FET results in a pregnancy, you’ll be lucky enough to continue administering these Pessaries twice a day (sometimes up to four times a day!!!!) for the first 12 weeks of pregnancy. I can only laugh….
Pessaries are stored in the fridge and need to be used immediately as they have a cocoa butter base and start melting pretty quickly. Side effects include: nausea, acne, fluid retention, weight gain, breast tenderness, abdominal pain and discomfort and pretty much every other pregnancy symptom you can think of!!
I have a really sensitive tummy (yes, I’m a decaf drinker for this reason) so usually feel the bloating/fluid retention/gastric upset side effects. It was no different with the Pessaries. I could definitely feel it in my tummy – bubbling, cramping and nauseous.
No more morning gym sessions for me. Instead I lie flat and can’t move for at least 30 minutes after the pessary is inserted. Give me needles any day! How the hell can four doses of these things be taken in one day!?
If you’re the 1 in 6 Australian couples who are confronted with infertility, there’s a good chance you will experience the physical and emotional stress it brings whether you’re months or years into treatment.
There are highs and lows; hope and despair, implications on your mind, body, relationship and finances. There’s sacrifice and heartache and for a considerable amount of time it’s overwhelming.
As I wait to commence a medicated frozen embryo transfer (FET), a number of coping mechanisms have come to mind that I’d like to share. IVF is not only a numbers game; it’s a huge psychological journey. Here are my tips for getting through it:
Connect with others – whether it be talking to a close friend or trusted family member, joining a support group, starting a blog or personal journal, talking to someone or writing is an excellent way to ensure you don’t bottle up your emotions. There are some great online support groups where there’s no such thing as a silly question. No one will understand what you’re going through more than these amazing women.
Spend time with your significant other – go on regular date nights. See a movie, go out for dinner, go for a long drive to wherever the road takes you, be spontaneous and get out and have some fun. Do what you can to take your mind off IVF. Your mind will thank you!
Spend money on something other than treatment – pamper yourself. No one deserves it more than you do!! Go on a holiday or cheap weekend getaway. A change of environment does wonders. We love going away on holidays. It’s like a ‘reset’ button and we always come back feeling refreshed and ready to tackle whatever is thrown our way next. Instead of always buying presents for anniversaries, birthdays and Christmas, we much prefer to get away and have some extra spending money up our sleeve.
Exercise – get outdoors, enjoy the fresh air and go for a walk. Do the kind of exercise you enjoy doing. For me it’s running and boxing. Nothing beats smashing out your anger and frustration or clearing your mind and the many thoughts constantly going on. Exercise has long been known to boost happy chemicals and release endorphins, making it a fantastic stress relief. Of course there will be days when you just don’t feel like exercising (and that’s totally fine) and days when you will actually be advised against it.
Take a break – I know this may seem counterproductive but it’s nice to take a break from the daily race against the clock. We took a break over Christmas. It great not to constantly be on the run planning my day around what time I need to be home for injections.
Control your mind – most of my stress comes from my own mind. If you’re anything like me, your mind rarely takes a break from general day to day things let alone through the process of IVF. How will I respond to meds this month? How many eggs will I produce? Will they fertilise? Will this be it? The journey is not only physically but emotionally draining. Channel your inner thoughts and try to be positive. Have hope and faith. I know for a lot of people this can be easier said than done.
Be kind to yourself – take some time out for yourself. Get a massage, catch up with friends, read a book, cook, write. Do whatever you need to do to get through each day as it comes and ensure you take the time to REST.
Be prepared to gain some kg’s – especially if you suffer from PCOS. It’s hard enough to maintain a healthy weight with PCOS and with all the hormones being pumped into your body it’s just another nasty side effect we need to deal with.
Be grateful – Know that there’s someone else who is always worse off than you are. Be grateful that you’re alive and have access to incredible doctors, healthcare and the latest technologies.
Before the procedure We were instructed to arrive at the hospital at 8.40am to complete some paperwork, finalise surgery fees ($500 for the procedure) and prepare for the egg collection. Daniel sat with me for about 10 minutes before he had to go to the IVF clinic down the road to do his part. It’s strange to think that we were in separate hospitals for this whole process!
I was called in by one of the nurses and sat with her in a waiting room. She took me through a few things and I signed a consent form, put hospital tags and hair net on and changed into a gown and robe. I was visited by the anaesthetist, another nurse and then my FS. It was great to see my FS there. He put my mind at ease but also reminded me that I was at risk of Ovarian Syperstimulation Syndrome (OHSS) due to the large number of follicles I had at my last scan. Due to this risk, I knew that it was highly likely we would not be able to proceed with a fresh egg transfer five days later.
OHSS occurs when there has been an over response of the ovaries to the stimulation medications. Women who have PCOS, are aged under 30 years and have 20+ follicles retrieved at egg collection are at higher risk of overstimulating. Symptoms include abdominal pain and distention, severe bloating, nausea, fluid retention, weight gain, vomiting, shortness of breath, reduced urine output and pain not relieved by Panadeine or Panadol.
The nurse then walked me into the theatre and I got onto the bed. My FS was cracking some jokes while we waited for the anaesthetist to arrive which relaxed me but I couldn’t help but notice how many people were in the room. At least I knew I was in good hands. The last thing I remember was my FS holding my hand, telling me everything would be ok and saying “sweet dreams” while the anaesthetist inserted the drip in my arm to put me to sleep.
During the procedure, an ultrasound probe is inserted through the vagina and a needle is passed through the ovary into the follicles. Fluid from each follicle is drained to retrieve the eggs.
Waking up in recovery
20 minutes later I was in recovery with a heat pack on my tummy. They gave me pain relief almost immediately. I felt sharp pain low in my abdomen but it soon spread all over. I was desperate to know how many eggs had been collected and the first thing I did was ask the nurse. She handed me a note from my FS which confirmed he had collected 25 eggs and that they would be frozen for a transfer at a later date. They continued to give me pain medication. The more eggs retrieved, the more invasive and painful the procedure is. You should also expect a longer recovery time.
After a little while I was moved to a recliner chair and given something to eat. I felt quite uncomfortable and it was difficult to move. As time passed I was asked to empty my bladder and get changed when I could. The walk to the bathroom was painful. I’ve always thought I had a pretty good pain threshold, but this pain and bloating was a whole different feeling. Little did I know over the next few days, the pain would get much worse and I would gain 7kg of fluid.
Trip to emergency
The nurses discussed my risk of OHSS with me and said they would be monitoring me closely over the next week with daily calls and weight monitoring. They also told me that if the pain got worse and I developed symptoms of OHSS, to go straight to emergency at the Royal Women’s Hospital as it was the Easter long weekend and the clinic was closed. The following night I ended up at the RWH where they gave me pain medication, took bloods samples, measured how much water I drank and my urine output weighed me and measured my abdominal girth. I spent the night in hospital and Daniel was sent home. I was given a prescription for stronger painkillers and was on bed rest until symptoms started to improve. I was also told the pain and bloating would get worse before it got better and that my weight could continue to increase with fluid.
The following week at home
I lay on my back for the next week, barely able to move. I couldn’t sleep on my side, couldn’t sit up on a chair, couldn’t laugh, cough or sneeze and was in agony when I did. I’m not joking when I say I looked six months pregnant. Each night I cried myself to sleep in pain. I’m not one to take painkillers – I need to have a pretty bad headache to take Panadol. Every four hours on the dot, I was taking the next two pills I could. Each morning I weighed myself and my weight was steadily increasing. 1kg, 1.5kg, 1.3kg, 1.2kg, 1kg…..in total I gained 7kg of fluid. I vomited in the first couple of days and my whole stomach was so tender. At one stage, I had a fluid shift which was pretty scary. The 7kg of fluid in my stomach started moving to my sides and back. Wherever the fluid was, was rock hard to touch. It made it difficult to breathe at times and I would get puffed out just from talking.
Daniel was my saviour during these days. I couldn’t walk up the stairs to our bed, so we slept downstairs in our spare bedroom for the week. I would dread going to bed at night. There would be no TV to distract me, no one to talk to, nothing to keep me busy and all I could think about was the pain I was in. I barely slept for the first few nights and was exhausted during the day. Daniel would heat my heat pack every couple of hours, and cater to my every need. Lucky for him it was a long weekend as he ended up pretty sleep deprived too!
I can assure you that if you face OHSS, it does get better with time, even if you think it will never pass and your ovaries feel like they’re going to explode. I promise you that there is light at the end of the tunnel! Rest and take all the time that you need to recover.
The day after your collection, you will receive a call telling you how many eggs fertilised. Out of the 25 collected, 19 were mature and 16 were fertilised. They keep a close eye on them in the lab for the next few days. At day five, we had six embryos to freeze.
I was really relaxed when we commenced our first IVF cycle, probably because I had been through months of injections and we were really eager to get started.
There are four potential outcomes when it comes to your scan
1. Poor response – need to increase medication
2. Over response – monitoring for overstimulation
3. Not ready for trigger
4. Ready for trigger
Injections started on day 3 of my cycle with the aim of having 10-15 follicles for egg collection. They were different hormones and at a higher dose to ovulation induction. I was on 75iu Luveris and 100iu Bemfola every night beginning Thursday 30th March. On Tuesday 4th April I had my first scan for this cycle showing slow growing follicles that were small in size. My Bemfola dose was increased to 137.5iu, while continuing with Luveris and adding in Orgalutran from then until trigger to prevent ovulation. Orgalutran stops eggs from being released too early and is taken at the exact same time every morning. The syringe is pre-loaded and needs a real push to pierce through the skin. It was a much more controlled injection that had a real sting to it.
My next scan was on Friday 7th April and although there were an increased number of follicles growing, they remained small and insignificant. Bemfola was increase to 162.5iu and I continued taking Luveris and Orgalutran as normal. I was scanned again on Monday 10th April and the scan revealed I had 20 follicles putting me at risk of overstimulating. My medication dosage was reduced (Bemfola 100iu, stopped taking Luveris) for the final two days of injections. I had already planned to have this week off work as I had lots of time in lieu which turned out to be great timing.
I knew on Monday I would find out what day egg collection would be. It was scheduled for the Thursday. By this stage my bloating was quite excessive and I could barely fit in water and food during this week. It was recommended I have small frequent snacks instead of meals in the lead up to egg collection. I could no longer wear jeans and I couldn’t go to the gym. I was just too bloated, tired and uncomfortable.
Monday and Tuesday I continued my medications at the lower dose with the addition of the trigger injection Pregnyl 5000 on the Tuesday night. Pregnyl controls the release of eggs from the ovary, causing ovulation. It comes in two glass ampoules of powder and liquid that need to be drawn up in a syringe and mixed together. I received a call from the hospital with instructions on the Tuesday night about my Thursday procedure and timing for the Pregnyl trigger. I was told to administer the trigger at exactly 8.40pm, 36 hours before my egg collection. I was to fast from midnight to 6am with only sips of water allowed. No water was to be consumed from 6am until after the egg collection. The side effects I had from the triggers I had during the course of my treatment were bloating and night sweats. There were a number of nights I’d wake up soaking wet from head to toe – to the point I would have to change my clothes a couple of times during the night. Of course, I complained at the time, but these side effects were nothing compared to what I faced after egg collection.