IVF Part 1: Waiting, Miscarriage, IUI, and Finally IVF

Alisha says: Dave and I have wanted to have a baby for several years now. After we didn’t become pregnant after a while I started using clomid to see if that would help. I did get pregnant on clomid but had a blighted ovum and miscarried at eight weeks.  I thought that I would get pregnant soon after the miscarriage but as the months passed, even on increasing doses of clomid and nothing I knew it was time to see someone. When moving to Seattle we knew it was time to see a specialist to get some help. I am so glad that I found the clinic that I did. I choose to go to Overlake Reproductive Health. They have been great, a bit expensive, but great. I have been there so many times that I basically know the name of everyone who works there. My doctor, Dr. Rehman, is really knowledgeable and good at taking his time to get to know you and explain things. The receptionists Melissa and Teesha are awesome; they are always good for a laugh. The medical assistants are great and the two nurses who you actually see the most, Jo and Julie are exceptional.

Overlake Reproductive Health Staff

I had to do a bunch of baseline blood tests, diagnostic blood tests, ultrasounds, HSG, SGH before having a re conference with Dr. Rehman. Basically all of the tests confirmed what I had suspected and that was that I had Poly Cystic Ovarian Syndrome or PCOS. PCOS makes it hard to get pregnant because your hormones are out of balance resulting in many small cysts on the ovaries and not ovulating on a regular basis. Because I had already done many months of clomid cycles and still nothing, we decided to move forward to the next step and try a few rounds of intrauterine insemination or IUI. I was hopeful that this would work for us but after two rounds we were still not pregnant. We actually could have done one more round of IUI but around early December Dave accepted a position at the University of Arizona and we knew that we would then be moving in June. We were anxious to be pregnant before moving and I wanted to hopefully finish the process at Overlake because I had been going there since we moved to Seattle, they had done all my testing, I knew everyone and was comfortable and I didn’t want to have to search for a new fertility clinic in Phoenix and was afraid of the delay that there would be in finding a new clinic and then how long it would take before things got rolling at a new clinic so we made a huge decision and decided to move forward with in vitro fertilization or IVF in January. IVF is an extremely expensive procedure (on top of all that we had already spent) but we both felt good about it. The way that they do it at this clinic it is a three month process from the start to embryo transfer. At this clinic they freeze all of the embryos after egg retrieval and then wait until the next cycle before transferring them back. They are finding that this is safer for both the mom and the baby because they aren’t transferring the embryos directly back after you have used all of the stimulating medications.

Getting ready for IVF is a bit overwhelming. I received a giant box of medication that made me almost cry when I opened it. However my clinic is awesome and they do an injection training where they go through each medication and show you how to use it. They also provide very detailed instructions so that you are giving the right meds in the right dose at the right time.  Friday, January 9^th I gave myself my first injection. Luckily the needles are tiny and it really wasn’t too bad. I did get a few bruises and my stomach was tender around the injection sites.  A typical day was follistim injection in the morning followed in the evening by a menopur injection. After a few days another injection called ganerelix was also given in the evening. The menopur left a stinging/burning sensation that I found was almost eliminated if I iced the area for a few minutes before giving the injection.

Lots of expensive medication

After a few days of injections I began going to the clinic daily for a blood draw/ultrasound so that they could monitor my response to the meds and monitor the development of the eggs. After my second blood draw/ultrasound my estrogen was extremely high and I was responding a little too well to the meds so they cut my already low dose of follistim down even more.  I already know almost everyone at the clinic really well but after going there every day that week I took some cookies to those who had to work on Saturday. At my appointment on Sunday Jo, my nurse/ivf coordinator, said that I was ready to do the ovulation trigger medication and that my retrieval would be scheduled for Tuesday. Because I stimulated so well I was at risk for OHSS so they triggered me for ovulation with a medication called Lupron. It is given in two doses exactly 36 and 24 hours prior to retrieval so my first dose I had to get up and inject at 1:15 am in the morning. Monday I had to go in just for some blood work and then Dave and I went to Snoqualmie to ride our hardtail mountain bikes on a path. We planned to be back to the car in time for me to give my 2^nd trigger injection but I took it with me just in case which turned out to be a good thing. First of all we got rained on really hard for a little bit but then it stopped and we had a nice ride for a while. On the way back to the car I got a flat tire and so there we were on the side of the path with Dave fixing my tire and me giving myself my injection.  I felt pretty good through the stimulation phase, I was worried that all the hormones would make me a crazy person but emotionally I felt fine. Physically, as time went on I began to feel a bit different but generally okay. I still stayed active but just toned it down and listened to my body, I ran the first few days but stopped when the jarring of running became uncomfortable then we did a few bike rides and some walks. In total I gave myself 37 injections, had 11 blood draws (19 vials), 6 ultrasounds and 1 egg retrieval.