Ovulation induction with FSH injections

The first step for us was timed intercourse with follicle stimulating hormone (FSH) injections. The aim of the injections is to develop follicle/s, stimulating the ovaries to ovulate and allow fertilisation to occur naturally by timed intercourse. I was under the impression that if I can produce an egg there shouldn’t be any reason why it can’t be fertilised naturally. Well, it sure wasn’t as easy as that and we faced six failed cycles.

The aim of this cycle was to produce one or two dominant follicles. We started at a very low dose of Puregon because with PCOS there’s a higher chance of overstimulating (producing too many follicles) which could result in multiple pregnancy and in two of my cycles ‘octomum’ where we had to cancel the cycle. Due to the low dose medication, most of the stimming continued for over 20 days (one cycle was over 40 days so you can imagine my disbelief when my period arrived after being absent for years). It was all very slow and steady with 20+ days of having internal ultrasounds every three days and frequent blood tests to check hormone levels. Regular ultrasounds are necessary to check the number of follicles and their development. Each appointment cost $100 – $130 in addition to the cost of medication. We were lucky enough that our FS only charged us for the first five appointments per cycle. To this day we have spent thousands and thousands of dollars on tests, scans, appointments, medication, IVF – we have a folder of receipts but we have no idea of what we have spent up until now. We just know that one day it will all be worth it.

We were to have sex every second day during the stimming then at a specific window of time once a trigger injection is given for ovulation. There’s nothing more romantic about being told when to and when not to have sex!

Injections are administered in the stomach through an epipen looking device. I’ve never really been fussed about needles but did get nervous about injecting myself for the first time. Daniel is definitely not a needle person and I knew there was no way he would be able to inject me. We watched YouTube videos about loading the pen and injecting the needle. They made it look so quick and easy. To be honest I couldn’t feel a thing when injecting Puregon. It was definitely the easiest and pain free needle with little side effects. After the first failed cycle my FS prescribed Ovidrel as an extra support to stimulate follicle growth. I was taking Puregon every night plus the Ovidrel injection every second night. My fridge was beginning to look like a drug lab.

 

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Puregon and Ovidrel pens
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mixing the powder and liquid for the trigger

I administered injections at 6pm each night. I knew that at this time I would usually be home from work, and if it was on a weekend I could do it at home before we went out. On one occasion we went to see a show in the city and had dinner at a nice restaurant beforehand. I had taken my meds to work with me and left them in the fridge along with an ice pack in the freezer. We had a 5.30pm dinner booked so we could make the show and I knew I’d need to do the injections in the bathroom. As it got close to 6pm I got up with my freezer bag and went into the bathroom. I went in the toilet and locked the door. There was only one unisex toilet and I was freaked out at the thought of people waiting outside. I was nervous and shaky. I quickly did the Puregon injection but in a panic dropped the needle tip for the Ovidrel injection in the bin. I desperately tried to ruffle through the bin (ewww) but had no luck. I quickly left the bathroom to tell Daniel what had happened. He tried to reassure me in his calmest tone that it would be ok and we could just inject the second needle when we got home. I was distracted for the rest of the evening until we walked through the door at home.

Failed cycles
#1 – poor follicle response
#2 – bleeding
#3 – overstimulation
#4 – BFN (big fat negative)
#5 – bleeding
#6 – overstimulation

Our last failed cycle was in December 2016 and we decided to take a break over Christmas before commencing IVF.

 

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