Tuesday, January 15, 2013


That is how I feel after our appointment...overwhelmed.  Here is the down low.  We spoke with the doctor and she said we have a unique plan set up based on all the testing that has been done so far.  Since my AMH came back off the charts (in a good way) we are going to start with a low dose of stimulation to get started and make changes as we go if needed.  Here is how it will go:

1. Cycle Day 1 - call to set up baseline appointment (most likely this will be next week)- that day or day after where they will do a blood test, and U/S if everything looks good there they will do a trial transfer.  This is also the day we write the big check out.

2. I will then start on meds. Follistim and Menopur daily and have frequent U/S appointments to see how I am progressing.  Once I have a lead follicle at 14mm I will start on Gonal? which will prevent me from ovulating so the rest of the follicles can catch up.

3.  The hope is to have 20 ripe follicles to be ready for retrieval which I will take Lupron to have me ovulate and then back to the doctor for the actual procedure which is done under sedation 36 hours after I take the shot.

4.  After retrieval they will perform ICSI:

ICSI is a technique of gamete micromanipulation in which a single sperm is captured in a microscopic glass pipette and meticulously injected into the cytoplasm of a single egg. Harvested, mature eggs are selected to undergo this delicate procedure. 

5.  Then we wait for either a 3 day or 5 day transfer (they call and update us daily) where they will "grade" our embryos (this is what the united egg and sperm are now called).

6.  Hopefully day 5 we will come in for transfer which they will place two of the embryos back into my uterus.  

7.  I then begin PIO (progesterone in oil) shots 2x per day until the cycle is ended or until I am 11 weeks pregnant.

This is from memory and I know I am missing a few things but you get the idea.  Somewhere in there I will take estrace, low HCG and baby aspirin.  After we spoke with the doctor we spoke with the IVF coordinator who gave us our prescriptions and a few more details.  Finally we did the injections class and the nurse was watching Dick practicing and said, "you have done this before?" talking about injections and he said, "Yup, I was a farm kid."  She laughed and told him he needed to be more gentle with me than with the cattle.  

The main concern my doctor had was hyper ovarian stimulation because of my AMH number.  Through careful monitoring and using the Lupron instead of the Ovidrel it will hopefully reduce the risk of that happening.  There was a lot more information, but I can't remember it and you don't need all those extra details :).  That is all for now.  Ready or not...here we go!



Amber said...

This sounds oh so familiar!! Ugh, twice a day progesterone? Not to scare you, but that will be horrible. I had it once a day And I was so incredibly sore ...just be prepared. Heat and ice!! I reallllly hope you can avoid OHSS. I had a severe case of it and I felt like death. Worse than having a c section for twins. I'm so excited for you!! It is so much to take on... One day at a time!! Oif your shopping for a specialty pharmacy the one we used was awesome. I can get you the number if you need it. It's so much info... Let me know if I can help!!!

Nikki Kueffer said...

Thinking of you and praying everyday for successful IVF. Because of your strength you've inspired me to make an appointment with my doctor and start the next phase of our infertility journey (couldn't get in until March, but the first step-accepting and owning my infertility-was the hardest for me). I will keep you posted on our journey :)

Julie said...

Thank you ladies!

Amber, Yes twice a day :( that is really the only one that scares me, especially being an IM shot. I'm so lucky to have a high pain threshold which I am sure will be tested to the max over the next month. My clinic does have a pharmacy that they use and told me the IVF Coordinator does extensive research to get the best pricing so I am going to place my trust in them. They do have me on a special plan because I am such high risk for OHSS and agreed, hopefully we can avoid it!

Nikki - that is just so awesome. It really is the first step is accepting and like you said owning it! I waited a long time to make our first appointment with just the OB and almost another year before I saw the RE. One of the best places I found to connect with other people going through infertility is on the Resolve website. I have learned so much through other women on questions to ask, what is "normal" to expect, etc. I would definitely check it out! http://www.resolve.org/resources/online-support-communities.html Best of luck to you and I would LOVE to stay posted on your journey!