IVF consult & first steps.

Long entry but this was covered over a couple hours of consults & about 50 pages of reading.

Our IVF consult went well. When we sat down with the doctor, she was able to clearly explain how the process works. However, the process is complex and differs a bit from person to person.

I'm doing stimulated IVF, meaning I'll be taking injectable medications to stimulate egg production. At 27 years old, my age works very strongly in our favor. At the practice we go to, less than 20% of the patients who undergo IVF are under the age of 30 but they have significantly higher success rates than their older counterparts. It is estimated that my success rate is between 50-60% per cycle. For anyone who's been through infertility treatments, you know that is extremely, extremely high. The average woman has about a 15-20% chance of conceiving naturally each cycle. During the IUIs, I basically had achieved "normal woman status" and was quoted a 60% chance of success after 4 IUI cycles. After the 3rd IUI cycle, I'm fairly sure the doctors would probably lower that percentage seeing as they realized my body was not properly responding to the medication.

Brian said to the doctor, "Since she doesn't do well at growing eggs why are we assuming she'll grow a lot of eggs now?" The doctor explained to Brian there is a huge difference in the strength of Clomid vs. injectables. They have no reason to believe my body will not do well on injectables.

We learned we will be doing a single embryo transfer. There are ethical guidelines which doctors follow to determine this. The guidelines are based off a patient's age. In the world of IVF, 27 is very young so only 1 egg will be transferred to avoid multiple gestations.

We will be doing a frozen embryo transfer (FET); the doctor choose this route for us. The hot topic in the IVF world is fresh vs. frozen. Different doctors have different beliefs. It's possible we'll do fresh in  the future but frozen is supposed to be easier on the body. They doctor is also giving my a Lupron trigger as opposed to an HCG trigger because it will allow my body to recover more quickly.

Here is a rough step by step of our plan:

1. Administrative/"getting ducks in a row" part.
- Read and sign consent forms (about 36 pages - took roughly 2 hours).
- Call insurance company to see if they will cover my injectables (price range $2.5K - $6.5K)
- Brian's chromosomal blood screening
- Fill birth control prescription
- Attend a "Cycle Review", an hour long class in which a nurse will teach me about my medications and how to use them
- Waiting to find out if I get approved for Money Back Guarantee program (23K) & of course, payment

2. 3 days after getting my period I begin taking a week of birth control. This is in an effort to "normalize" my hormones because of the imbalance I have.

3. After the birth control is finished, I begin injecting myself. I go to monitoring every other day or every few days, just like with IUI. Monitoring is the same: it includes a blood draw and transvaginal ultrasound. This "growing eggs" part takes roughly 2 weeks. I should expect to be in the office more than with the IUI.

4. Once the eggs are ready, no smaller than 17mm - hopefully 20-24 mm, I will be given a Lupron trigger injection.

5. Right before my body would ovulate them on my own (like with IUI), I will have a retrieval. This is done under anesthesia and most patients have zero recollection of it taking place. At the same time, Brian will be giving them his sperm. They will immediately mix his sperm with my egg.

-There are two methods that can be done: ISCI (where 1 sperm is injected into the egg, good for low motility) or conventional (his sperm will fight for the egg). We'd like to do conventional. It has a lower rate of congenital abnormalities because the strongest sperm has found the egg.

-The egg and sperm are grown for about 5 days, bringing it to "embryo" stage. Then it will be frozen.

- Remaining healthy embryos will be frozen for future use.

6. Following the procedure, I will be on bed rest for 24 hours. And after that, I will need to not over exert myself or do any heavy lifting. I will get a period about 2 weeks after retrieval.

7. Once I begin my period I begin a new round of injections. This will thicken my uterine lining to get it ready for implantation. I am routinely monitored during this stage, just as with the egg growing stage. It should take about 3 weeks to get the uterus ready.

8. Transfer. It is done much like the IUI and should be fairly easy.

We wait for 2 weeks and see if we've made a baby.

Clearly, that was probably boring to read but that is how it works in pretty easy to understand steps. Today I will continue to work on the "getting ducks in a row" portion.

My to-do list:

- get birth control
- call insurance company
- schedule cycle review
- exercise (this is my new job as this process is going to be very stressful and tough physically)

We read that some women find it helpful to talk to a mental health professional while undergoing treatment because of the depression and anxiety associated with IVF. Whelp, this blog is my mental health professional. It helps me greatly to talk about what I'm going through. At this point, I am overwhelmed and a little scared. But I am also very excited and optimistic. Please realize that this process is not all rainbows and butterflies and at times, my blog will reflect that.