IVF Process - April 11, 2012

After approximately 16 months of…waiting…we have officially started the IVF process. 

To me, it seems like we waited forever and now we are in a huge hurry.  So, why the wait forever then hurry up? Well, as Bob put it on Sunday night when I was having a minor meltdown about how quick this is all happening…it’s not happening quick at all.  We have known this was going to happen since January 17, 2011.  We’ve also known since then that once we were ready to start, it happens at a predetermined pace, and once you decide to move forward, you have to be committed.  So, about 2 weeks ago, we realized that everything we needed to be in place before we could start was in place.

I called our Fertility Doctor and talked to the nurse about timing coming up.  It’s basically all based on where I am in my birth control (yes, I take birth control for this process, it seems backwards, but it happens).  Based on where I was, I needed to go in for a sonohysterogram and mock transfereither the following week (April 11) or not until May.  Since May seemed like FOREVER; we scheduled the appointment for April 11. Bob talked to his boss and was able to rearrange some things, so we were officially moving forward.

That quick recap brings us to April 11. The doctor told us he had three goals of the sonohysterogram/mocktransfer.
1.      Look for any abnormalities in my uterus that mayprevent IVF from working
2.      Look for any abnormalities in my cervix that mayprevent IVF from working
3.      Using water instead of embryos, do a practicetransfer to make sure it will work on the day I get implanted with our embryos

To say it was painful would be an understatement.  I’ll spare you the details, but I am thinking this is something I need to get used to for this process.  The reason it was painful was because  Ibasically failed goals 1 and 2.  My cervix is extremely small (Bob says Cervex and it makes me laugh), and he wasn’t able to get a great look at my uterus. He did do the mock transfer, but wasn’t confident that my cervix would allow for safe retrieval of the eggs and safe implantation of the embryos in the future and he wants to look at my uterus with a scope. 

We were told that I would now have to undergo a surgery next week to get the issues resolved and move forward. They said I should plan on coming back in the afternoon, as I was already scheduled, o do a lecture with the nurse about the entire process, paperwork, prescriptions and now to talk about the surgery.

The next 2.5 hours between appointments was stressful and unsettling.  IVF wasn’t off the table,but it wasn’t as simple as we hoped it would be. We were both confused aboutt he surgery and thought that if what he saw was bad, then IVF was no longer anoption.

We got back at 1:30 and ended up being with the nurse for about 2 hours.  She answered every single question.  She went over every single step.  She said to call any time another question arises and she said that if we have questions for the doctor, I should write them down and bring them with me to my next appointment.

So here’s what we learned.  The results of the sonohysterogram/mock transfer don’t mean that I’m not a good candidate for IVF anymore.  They don’t mean that our chances of a successful IVF round go down at all.  It's just that I need to have this surgery to ensure that I remain a good candidate and that our chances of success stay where they are now (which is pretty good).

This means that I have to go to the Doctor next week for a hysteroscopyand a cervical dilation.  This is a surgery that I will be under anesthesia for. And to be clear, this was no part of the original IVF plan we had, but it’s common that the plan changes.  The surgery will allow the Doctor to get a better look at my uterus and remove any polyps or interferences he sees.  As forthe cervical dilation – the way I think of it is when people gauge their ears (like Bob used to, by the way!) and they keep increasing the size of the hole,they’re going to do that with my cervix, but over the course of one surgery.  It will be painful – I will be under anesthesia and I will also be off work Tuesday and Wednesday.

After we made plans and got all the details of the meds and things I need to do to prepare for and recover from the surgery on Tuesday, we started talking about the IVF process itself. Here’s a quick outline of the next 6 weeks for us:

April 11 – sonohysterogram/mock transfer and the nurse gave me my firstshot, basically to give my body a clean slate
April 17 – hysteroscopy and cervical dilation
April 18 – recovery
April 23 – baseline ultrasound and blood work – meaning they will checkto see what my ovaries and hormone levels look like at the very beginning of my cycle so they know what to measure against once the medicine starts changing things.
April 25 – start shots – the good news here is that it’s only 1 shot aday, at night.  It’s common for people to have to do up to 4 or 5 shots a day, so I’m feeling pretty lucky about this.
Every other day from April 25 – May 9ish – I will be going in for ultrasounds and blood work to monitor the growth of the follicles (eggs).
Somewhere between May 9 and May 12 – Bob and I will both have an appointmentin the same day – mine will be to remove all the eggs that I produced (goal number here is above 5 at minimum, but above 10 would be better).  Bob will be in another room...making his...contribution.  They will tell us before we leave the office how many eggs were successfully retrieved.
5 days later – we will go back for the embryos to be implanted.
14 days after the retrieval – I will go back to the Doctor for a bloodtest to determine if I am pregnant or not. For multiple reasons, a blood test will be the only accurate way to know if I am pregnant. 
Even if the test is positive, we have to be cautiously optimistic. I will be monitored very frequently to ensure that my hormone levels continue to double.  I will stay in the care of the Fertility Doctor basically through the first trimester.  At that point, he will refer me back to my OB, where I will be treated like any other pregnancy.  If the IVF does not work, we would have a meeting with the Fertility Doctor to determine why he thinks it didn’t work,and what the best next steps are.

The nurse warned Bob about some fun things we can look forward to during all of this – forgetfulness, hot flashes, night sweats, moodiness, and discomfort in injection areas…  Funtimes.

If nothing else, the curveball we were thrown today just assures methat Bob is the person I want to face the good and the bad with.  When I was in pain during the test, the only part of me he could reach was my toes, but he held them the entire time to support me.  He knows how to talk things through with me.  And, when we get home, he goes into take charge/ schedule appointments/ ordering prescriptions/ updatingthe budget mode and lets me just relax. 
So it's official - here we go!