the Not So Simple Steps of IVF

I’ve had a lot of people ask me about the process and how you have a baby through IVF. There are many steps you can take, many of them different, and it will range greatly from family to family. There are some basic steps although that everyone has to go through in this process, so I figured I would lay out what our journey is going to look like just to give people an idea.

As soon as you start IVF treatment, your body becomes a total science experiment! They take over your entire cycle, your hormones, and often control of your feelings, HAH.

Over the last 5 years, I’ve dreaded getting my period every month. It’s arrival meant no pregnancy for us again that cycle. For the first time in 5 years, I DID A HAPPY DANCE, high fived everyone at work, AND HAD MY VERY OWN PERIOD PARTY when I got home with my hubby! LOL. We made a yummy dinner and topped it off with cheesecake afterwards. When you start IVF, you take control of your cycle within a day of your period starting. For me, I was to start taking birth control on day 2 of my period, to start manipulating my cycle. Everyones may be different, but my prescription starts with 14 days on the pill. This helps your doctor start to take control of your cycle, and helps synchronize all the egg follicles to start at the same stage and growth. The pill “surpresses” the ovaries.

After the 14 days of the pill, I am to take 6 days off of it before starting my injections. Ooo, ahh, scary injections! That’s what I thought too, until they made me practice on myself at our orientation appt. Easy peasy, but yes, strange to stick yourself with a needle. I got to mix up some saline, practicing the process it will take to mix my medications and inject it into my stomach fat. My nurse is a really sweet, funny lady and she made me feel extra good when she told me I might have to sit down and lean over to be able to get enough of a “roll” to pinch and inject into. Thanks Carly ;)

After 6 days off of the pill, the injections start morning and night. My doctor prescribed specific medications that will most likely differ from clinic to clinic, but all have a similar affect. AM injection is one medication (in my case, Puregon) and PM is (Menopur). Menopur is a combination of the naturally occurring hormones FSH and LH, and stimulates my ovaries to produce eggs. Since egg production is my strong suit (my ovaries are full of them when we do the ultrasounds!) I am on a fairly low dose of this as to not OVERstimulate my ovaries. Puregon is a hormone that is very similar to our natural FSH, and helps these eggs to mature and become ready for release. I am to inject for 5 days before going in for bloodwork and an ultrasound.

The biggest worry or complication that could occur during this ovary stimulation stage for someone like myself is OHSS. Ovary Hyperstimulation syndrome. Because I naturally produce eggs abundantly, my ovaries will become very “full”. This will make me look very bloated, and probably receive the odd question if I am pregnant already or not. They say put the jeans away and pull out your Lulu’s! During this process I am to stay quiet, reduce any strenuous activity, no rigorous exercise, and no riding (sniff sniff) as it all runs risk of my ovaries starting to turn and twist, cutting their circulation off and causing a lot of internal damage. Imagine a water balloon blown up and you pinch the neck of it, the top of it and start twirling. The ends get twisted and pinched off quite easily due to the movement and if this happens to my ovaries it means surgery, ASAP, and destroys the entire plan.

ANYWAYS! If the bloodwork on day 5 shows I am just about, if not already, ready, we will then have an ultrasound the next day to see how my overflowing ovaries look, and in what shape/stage all my eggs are at. If they are mature and ready, I am to start a 3rd daily injection that prevents me from ovulating, in my case I’ll be adding Orgalutran along with my other morning hormones. The LAST thing we want my body to do is dump all these precious eggs it has been forming before we get in there to pull them out! I am then going to hop on the next flight down to Vancouver. If they are NOT ready, we will adjust my medication doses if need be and inject for a few more days before testing again. Once things reach their peak, down south we go.

Once in Vancouver, they will monitor me daily until my eggs are juuuuust right. Once the doctor calls and says I’m ready, I will be instructed to take a trigger shot. The trigger shot is a shot of the hCG hormone, and it stimulates the maturation of the follicles containing the eggs and triggers ovulation. This injection is timed TO THE MINUTE, and is taken late at night. Don’t screw this one up Kylie!

Once the trigger shot is administered, it’s a game of time. 36 hours after I give myself the shot we go in for the egg retrieval. Timing is very important with this phase because the egg retrieval must be preformed prior to the expected time of ovulation. Once the eggs are ovulated (as in the follicles they grow in burst and release them) they are no longer able to be retrieved. The day after the trigger shot I don’t inject anything (YAY!) and then the following day is egg retrieval.

The egg retrieval doesn’t sound very fun, but it’s a very exciting day for anyone going through this process. I will go in, hubby will do his thing so they have his sample, and I am sedated via IV and go in for my harvest. They stick a fun probe up you know where, and a tiny needle protrudes out the end, piercing through the side of my hoohaw and up into my ovaries. They watch on the screen as they pierce my ovary and poke into each follicle that is ready and waiting, sucking the egg out of each one. The goal is to have as many healthy, fully matured eggs retrieved as possible.

Next is the magic. They grade my eggs from A-C, grade his sperm in the same way, and place all the highest quality specimens into a petri dish together, and let them do their thing. In our case, my eggs and his sperm are not what was causing our infertility. I have lots of healthy eggs and his swimmers are fast and agile, so they should be able to do their thing on their own. In some fertility cases, it is due to slow or deformed swimmers (medications can cause deformed tails which prevents them from swimming well) so they end up needing a little help. If this is the case, eggs are fertilized using the ICSI method (don't know what that stands for, I’ll have to google it) and this is where they take one sperm and physically inject it into an egg. For us, they will allow our little ones to manage on their own.

The day after retrieval they will call us and let us know how many eggs were fertilized, and how many embryo’s we have. There’s a bit of a myth with IVF that they always place 2 embryo’s into the womb. Technology in this field is growing exponentially, and they consider twins high risk pregnancies, and my clinic specifically will only place 2 embryo’s in for special circumstances. For us, since we are young and healthy and could easily go through IVF again with high rate of success if we wanted more, we will only be placing one embryo inside, to reduce risk of a strenuous pregnancy on myself and baby. Once we are told how many we have, they will then grade them once again. A, B, C, and so on. They will always take the Grade A eggs (HAHA, makes me think of breakfast) and start with one of those for the first try (crossing my fingers we will only need one try!).

These embryo’s grow in their lab for approx 5 days, and on day 5 or 6 they do the fresh embryo transfer. After the egg retrieval day I start taking different medications to help prepare my uterus and body for the transfer and pregnancy. These are oral and, uh, hoohaw pills that help prepare. The hoohaw pills are progesterone pills that help you get, and stay, pregnant. This helps prepare and thicken my uterine lining for the day of the transfer, so that the embryo will attach and my body can maintain the pregnancy. Since the embryo’s are outside my body, I am not getting the natural hormone fluctuations to tell my body to prepare, hence the need for medication. The oral pills are estrogen tablets that help placental function, boosts blood flow to my uterus and primes my body for breastfeeding. In my case, I will be taking these for 8 weeks, so up to 2 months, after the embryo implantation.

After the embryo transfer day, we wait 2-3 weeks before going in for a pregnancy test! Crossing all fingers and toes things go as planned!

Throughout this process, it is a very emotional rollercoaster ride. Filling my body with prime amounts of hormones often turns on the crazy. Our nurse laughed and told Jesse to hide the knives, HAHA! Everyones experiences are different and our reactions to the medications vary, I’m thankful my doses are on the lower end, because A - our overall cost is less as you pay by dose and B- hopefully I won’t be too cray-cray (I HATE that term but thought it suited this sentence well, baha).

I am on day 2 of my birth control pill as I write this, so the ball is rolling and the excitement is building! I CAN’T WAIT!

Thanks for following along friends :)

Kylie