Sunday, February 25, 2007

IVF Questions and Answers

Admittedly, today was a "tough" day for me.

With my emotions all over the map, I decided today was a good day to start looking for answers as to why I felt like this. I found all of the following information at

"What side effects can I expect from the suppression medication?"
"The side effects of the suppression medication are similar to that of going into menopause. Some women are very sensitive to the effects of the medication while others experience hardly any changes. You may experience some of the following side effects below. Always contact your doctor if you have any concerns or questions about your side effects or the medications you are taking.

*mood swings
*breast tenderness
*hot flashes
*changes in sex drive"

I begin my egg stimulation stage on Thursday, March 1st. I'm very excited to get this stage underway. Although, after today, I decided it was time to learn more about this stage.

"Why do I have to continue to take the suppression drugs, when I start my stimulation drugs?"

"With most IVF drug protocols, you will continue to take suppression drugs while you are taking the stimulation drugs. If you do not take the suppression drugs you may ovulate on your own before the clinic has a chance to retrieve your eggs. The clinic wants to keep you on suppression drugs, so that they can time the retrieval of the eggs when the follicles are at their optimum size for their number."

"What kind of side effects can I expect from this round of medications?"

"You may experience some of the following side effects below. Some women are very sensitive to the effects of the medication while others experience hardly any changes. Always contact your doctor if you have any concerns or questions about your side effects or the medications you are taking.

*Abdominal bloating
*Weight gain

I've already experienced some bloating, which was somewhat relieved when my cycle began today. I'm not looking forward to the nausea, I'm a real wimp when it comes to being sick.

Weight gain??? Uggg....I'm not ready for that. I'm perfectly ok with gaining weight while I'm pregnant. I guess I'll just avoid the scale over the next two to four weeks. :)

And fun fatigue...I had read somewhere else that fatigue is common during the egg retrieval stage. Good thing I don't mind taking naps!

Helpful tips I found on giving yourself these injections:

"To reduce stinging:
Try putting ice OR a product called EMLA (available at pharmacies) on the injection site to numb the skin before injecting
Before injecting, make sure you let the injection site dry after you clean your skin with the alcohol wipe
Some women find that injections sting less given in the abdomen and others find they sting less in the thigh. You might want to try switching locations to see which one works best for you
Some medications sting less than others. If your clinic gives you a choice, Gonal-F seems to sting less than Puregon or Follistim."

"For better absorption:
Try giving yourself injections in the abdomen instead of the thigh. The abdomen is actually the best site for injections for most people because the blood flow to the tissue remains the same and generally speaking there is more fatty tissue there. However, you must stay away from your bellybutton by at least 1 inch in diameter. The more blood flow to the injection site the quicker the medication is absorbed.

"Progesterone in Oil Injection Tips
Try warming the progesterone in oil vial next to your skin (slipping the vial in your bra is ideal) for half an hour before the injection.
Change the needle after drawing up the Progesterone to avoid injecting yourself with a dull, oil-covered needle
To lessen the pain of the progesterone IM injections, place warm compresses on the injection site after the injection is given and rub the area really well so the oil gets disbursed more quickly."

"How does the clinic know when my eggs are ready to retrieve?"

"The clinic will monitor you closely, once you begin the stimulation stage of your IVF cycle. The clinic can monitor you in 2 ways: through ultrasounds and through blood work. Some clinics only use the ultrasound method. The number of days that you will be on stimulation drugs varies greatly depending on your drug protocol and how well you stimulate. In the US most clinics are looking for 150-300 units of Estradiol for every mature follicle. In Canada, clinics like to see between 750 and 1,000 units of Estradiol for every mature follicle. A mature follicle is usually between 18 and 23 mm. The clinic tries to do the retrieval when the most number of mature follicles fall within range. This may mean that some eggs may be too mature and some too immature to fertilize."

At this point, I know our Dr. will be doing a procedure called Intracytoplasmic sperm injection or ICSI for short, it's where the sperm is injected into the egg. It can help to improve fertilization rates when the sperm can't penetrate the eggs on their own.

Next is the transfer stage, the most exciting part of the process, the reason the "pain" didn't hurt...the reason the emotional roller coaster was worth every tear.

"What will the transfer process be like?"

"The transfer process is usually uneventful and pain-free compared to the retrieval process. Your embryos are loaded into a thin flexible catheter, which is inserted into your uterus. The embryos are placed as far into the uterus as possible without touching the back wall of your uterus. Some clinics measure how long your uterus is and map out your uterus before the actual transfer date. The doctor doing the transfer tries to place the embryos 0.5-1.0 cm from the back wall of your uterus. Some clinics use an abdominal u/s to help guide embryos in place. Once the embryos are inserted into the uterus, the catheter is slowly removed. The catheter is then sent back to the lab to confirm that there are no embryos sticking to it. The embryos don't often stick to the catheter, but if this happens the stray embryo is reloaded into the catheter and the transfer is tried again. Some clinics will recommend that you rest on the transfer table for about an hour, while other clinics may allow you to leave right away."

After reading about IVF or the past couple of months, I wondered, what is the difference was between an embryo, morula, and a blastocyst transfer?

"Embryo Transfer: An embryo transfer is done 2 or 3 days after retrieval. A day 2 embryo usually contains anywhere from 2-4 cells. A day 3 embryo is usually around 8-10 cells in size. Morula Transfer: A morula transfer is done 4 days after retrieval. Morula transfers are not as common as embryo or blastocyst transfers. A Morula usually contains at least 30 cells, but as the cell numbers increase the morula compacts and the cell borders become less distinguishable.
Blastocyst Transfer: A blastocyst transfer is done 5-6 days after retrieval. A blastocyst has so many cells that individual cells are no longer recognizable."

My Dr has told me that I will be on complete bed rest for 3 days following my transfer. I've already got a few things I will be able to do while lying down. I've decided to take a few extra days off from my part-time baby-sitting job to prevent any unexpected accidents that could happen.

"What else should I avoid following my transfer?"

"I have compiled this list of precautions from the women who have passed along their clinic's guidelines to me. Please always seek the advice of your doctor on what precautions you should take for your situation. If you are in the 2 week wait and have already done something which the list says to avoid, please do not worry. I have known women who have done some of the things on the list and still have gone on to become pregnant.

AVOID caffeine, smoking, alcohol, and drugs
AVOID heavy lifting
AVOID strenuous exercising and housework (this includes vacuuming)
AVOID bouncing activities (horseback riding, aerobics)
AVOID sunbathing, hot saunas, hot tubs and Jacuzzis
AVOID swimming and baths
AVOID sexual intercourse and orgasms"

"Will I experience pregnancy symptoms?"

"From having talked to women who have gone through IVF, I have come to realize that there is not a standard set of symptoms that you will feel if you are pregnant. The range of symptoms differs so widely that it is hard to even begin to answer this question. Symptoms during the 2-week wait can be caused by a number of different sources: the medications you are taking, your body recuperating from the IVF cycle, an impending period or an impending pregnancy. Below are some of the symptoms that women have reported to me before getting a positive result. You may experience some of these symptoms before your pregnancy test, but the only way to verify what you are feeling is a pregnancy test done by your clinic.

*absolutely no symptoms
*pre-menstrual-like symptoms
*breast tenderness
*food aversions"

"I tend to be pretty impatient, can I take a home pregnancy test?"

"It is very tempting to do a home pregnancy test before the one scheduled by your clinic. However if you had an hCG injection (the one 2 days before your retrieval) it could take up to 2 weeks for the hCG to leave your system. If you have received hCG boosters it could take even longer. If you test while the hCG from the injection is still in your system you could get a false positive. You could also get a false negative if the hCG from the injection has left your system and the hCG produced by the implanted embryo isn't strong enough yet. If you do decide to do an HPT, please realize that it is not a conclusive result and that you should always have your cycle results confirmed by your clinic."

I guess I'll just have to wait out the 2-week wait to find out for sure if we'll be expecting a little one in December.

"What if I experience spotting during my 2-week wait?"

"Spotting during your 2 week wait could mean a number of possible things: an embryo is implanting, one embryo is implanting while another is detaching, your period is arriving. Please always call your clinic if spotting occurs. You should always go ahead with your clinic's pregnancy test even if the spotting is heavy. There is really no way to tell what is happening until the pregnancy test gives the clinic some indication."

The night before each of my appointments I make a list of questions to ask my Dr. He is always more than happy to take the time to answer each one of them.

This blog is simply the information I believe to be true, always ask your Dr any and all questions you have regarding your IVF process!

If you are in the process of IVF or AI, I wish you luck!



S said...

Read your blog for the first time and am highly impressed at the detailing of it. You do have a lot of courage lady! However, I'm surprised that nobody left a comment on such a well written blog, and although I usually dont respond more than a thanks, I just couldn't resist writing back to you. I am happy that I found such sincere information on the IVF process in one blog itself. Thank you!

Amy said...

Just seconding the previous comment. I'm going in for my first appointment, to start the whole process, and found your blog incredibly helpful. Thank you!

suchi said...

first of all..thank u soo much for all these valuable infos!!!I am undergoin IVF and I am terribly nervous...ur informns have really given me gud hopes..just pray for me that I get pregnant in my first cycle...this is my 7th yr of my marriage and we both have waited solongg be financiaaly secure bfore undergoin this expensive treatment...

thanking you...and wishing u all the luck and gud wishes...
with love..

ivfmexico said...

Thanks for sharing a idea....Great post and informative
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chrissy1784 said...

I used your list to help me create my own list for my first IVF consult. I found this very helpful. Thank you!

sweet bia said...

Just read your blog or the first time ND I M SO MUcH impressed the way you post so detailed process.M also going in for the ivf really helps me. thankyou and good luck...

sweet bia said...

can anyone tell me that how much success rate in ivf?as me and my husband both are health, its unexplained infertility.i have done bIUI as well 3 attempts but failed...for ivf m so scared and worried!!!help me out

Unknown said...

Thanks for this info! As someone going through IVF soon, it is very helpful. :)