The next step in the IVF process is called stimming. Once my body has been sufficiently suppressed, through the use of birth control and lupron, my doctors will then introduce drugs that will cause my ovaries to create multiple eggs. See, every month most women start the first few days of their period with several small follicles on each ovary. During this time one follicle (sometimes 2 or more, hence natural fraternal twins/triplets, etc) will pull ahead of all the rest. This follicle will go on to mature, then around day 14 of your cycle you will ovulate and release an egg. For IVF, we want more then 1 of these follicles to grow and mature, but NOT too many. We also want to control when we ovulate, so that the Dr may retrieve all of the eggs and they are not lost into the abyss.
Needless to say, this is where things get pretty serious. Based on your baseline results, your diagnosis, and your age, your Dr will prescribe you the dosages of these medications. You will then typically start taking the injections daily (stimming takes 8-12 days on average), with your first follow up ultrasound and bloodwork on day 3 or 4, and then every other day, or quite possibly every day up until your retrieval. There are numerous blood draws to watch and make your your estrogen levels don’t get to high too fast (estrogen indicates how many mature growing eggs you have), as well as LH and progesterone to make sure you don’t ovulate on your own. Timing for all of this is very critical. If you produce too many follicles and/or your estrogen gets to high you risk something called ovarian hyperstimulation syndrome. OHSS on the low end is just very uncomfortable, and on the extreme end is life threatening. So, kind of a big deal. You also don’t want to stim too quickly, as this can result in poor quality eggs. So it is a very delicate balance.
At my baseline I had a very high antral follicle count (about 45-ish small follicles on each ovary) and an okay estrogen level (110). Because of these facts, combined with my age, and my mixed diagnosis of unexplained, suspected tubal factor, they have put me on a very, very low dose of stimulants. I am currently taking 75IU Gonal-F and 75IU Menopur, along with a lowered dose of 5IU Lupron.
Yesterday was stim day 5 for me, and also my first ultrasound and bloodwork. Currently I am responding well, with 8 measurable follicles, 4 on each ovary, and an estrogen level of 378, making me a high responder. Because of my high follicle counts, and my high response to low doses of meds, I get to continue on with the low dose of medications and I have a repeat ultrasound and bloodwork tomorrow to see how much further along I am.
Today marks day 6 of meds and so far my side effects have been:
- Mood Swings
Right now I am guessing I will stim for 9 days total. Making trigger Monday and retrieval Wednesday morning. That is just my current guess based on my research and current response to meds. Tomorrows scan and bloodwork will be alot more telling as far as how on target I am.