As several people noticed last week when I posted the picture on instagram, the official kick off to IVF #1 began last Wednesday night when I took my first ever birth control pill.
I got some questions about that, both in person and online and figured this would be a great start to explaining how an IVF cycle works. Or at least, how my cycle will work.
An IVF cycle starts when your Dr decides the type of protocol you will follow. What this means is there are several different drug combinations that can be given, and choosing one is the first step in the IVF process. Your Dr bases the protocol you will use off of your diagnosis and/or response in previous cycles. The go to protocol for most women is what is called a long lupron protocol. It is most often the first protocol a Dr will try, despite your diagnosis.
This is the protocol I am being put on. One other thing to keep in mind is that each clinic has it’s own variation of a protocol. They typically use the same meds, or types of meds, but might use different dosages or start them on different days. It often even varies by patient. This is one of the more confusing aspects of an IVF cycle, as each woman has different instructions and different things she is taking at different times.
Anyway. To start a long lupron cycle, your Dr will start by putting you on birth control. This is to basically reset your ovaries and to help prevent cysts from forming. Sometimes it is also used to sync you up with other women at your clinic, as some clinics like to have everyone on the exact same schedule so that all retrievals and transfers occur around the same time period. My clinic is simply doing it to suppress any cysts.
So for the first time in my life I am taking birth control. Which is… odd? I will be on the pill from the 17th until October 1st, at which point I will stop taking them and expect a withdrawl bleed, or period within 3 to 4 days.
The next step of the protocol starts on the 26th when I will begin injecting 10 units luprolide acetate every evening. This will be one of the easier injections I do, as it uses an insulin syringe and is a subcutaneous injection. From there it will be getting more bloodwork and another baseline ultrasound on CD1 when my period starts and then I will be given the schedule for my stimulation, which should start sometime around October 5th or 6th. That is when the real crazyness will begin.
After my last post, I decided to call the previous RE I had seen, prior to my most recent RE and after my RE from hell. Turns out they don’t regularly do local monitoring for a travel IVF cycle, but they were more then willing to do it for me. So this past Tuesday morning I made the long haul up to Beachwood at the
ass crack of dawn, wait, before dawn to be there bright and early at 6:15 am for my date with Mr. Transvaginal ultrasound wand. After that I went downstairs to sit and wait for my blood to be drawn. I then made the hour treck south to work and waited for my call with my calendar and instructions. Except when that call came it was just telling me that while my STAT order for my ultrasound results had arrived, my STAT bloodwork had not.
Peeved I ended up having to call them this morning to get transferred to the lab customer service line to get them to call my results over. Which also means I have to watch my insurance like a hawk and make sure they don’t charge me for a stat order that wasn’t processed as a stat order. At any rate, all bloodwork came back good. I got the thumbs up to proceed with this cycle.
So. Monday I got my meds in, which when all sat out is really intimidating to look at:
As far as the schedule goes, right now I am set to start birth control tonight and take it until the 1st, then start 10 units of lupron nightly from the 26th to the 5th.
Commence me freaking the hell out.
So. Here I am, 10-ish days from my first baseline ultrasound and bloodwork for IVF #1 and I STILL do not have somewhere local for my monitoring. You’d think this part would be easy. I have a local RE. Neither the ultrasound, nor the bloodwork require the RE. My IVF clinic will fax the order’s to them. My insurance covers this portion. All should be well. But it’s not.
My previous RE recently left the office I was going to, and the RE I now have basically told me that since I am not cycling there they won’t do anything for me. Despite talking him into doing my HSG and my saline ultrasound (And after the fiasco that has turned in to, I’m not sure I want him doing it anyway).
While this sat as a draft I did hear back from the other hospital system and they will do it, but not at the facility 15 minutes from me. They’ll only see me at the facility an hour from me and 2 hours from work. Thanks guys.
So worst case, I can go there. Still waiting to hear back form the closer private clinic. I hadn’t gone there as they were a client at my previous job and that cold have been awkward. If they say no, not sure what I will do. Not sure I can push 3 hours late to work every other day for two weeks at work. Anyone else ever done a travel cycle and if so, how did you manage your local monitoring?
An update on the HSG and saline sonogram situation. Both complete. Now it’s a matter of waiting for my next period and then it is on to suppression!
As for the procedures themselves? Yeah. About that.
First, I have had 2 HSG’s prior to this. But, because my last HSG was over a year old, they wanted a repeat. No big deal I figured.
Second, I’d never had a saline sonogram, but it didn’t seem bad from what I had read online.
I was completely wrong on both counts. I think however it was due to scheduling two procedures back to back that involve clamps on your cervix. And then the RE doing my HSG forgot I don’t have my left tube, so kept pushing more contrast trying to visualize it.
But, I powered through and both came back good. Right tube still normal. Uterus is clear of polyps and fibroids. The only thing he did note was that the top of my uterus comes down about 6mm. So instead of looking like a triangle, it almost looks heart shaped. Now if they would just fax my results over to CNY all would be good. Still also looking for remote monitoring, but I think they are going to do it.
Now it’s just a matter of figuring out how to patiently wait 1 more month to really get things going.
Today is the last battery of things standing between me and starting my cycle. Today I go in for a repeat HSG and a saline sonogram. The HSG is just to make sure the endometriosis hasn’t caused any issues with my remaining tube, the saline sonogram is to check that I don’t have any polyps or fibroids in my uterus or anything else that would interfere with implantation. Overall, not my idea of a fun day, but considering how hard it was to even get them to do this, I am looking forward to it.
Getting my appointments this month has been like pulling teeth pretty much. While I am beyond grateful to have found a way to do IVF, not going to lie, traveling for IVF is a pain in the ass. No one locally wants to help. I’ve spent so much time on the phone talking my RE’s office into these 2 tests, it’s ridiculous. While I understand the frustration they might have that I am not cycling with them, they are the ones at fault here. If they offered 0% interest in house financing, and it was as cheap as it is at CNY, I would gladly cycle with them. But they don’t, and they are almost 3 times more expensive. So they only have themselves to blame in losing me as an IVF patient.
My next battle will be getting them, or someone else locally to do my monitoring. Thinking of that, I am starting to mildly freak out at this point. After this, I start lupron, have another period, then start stims. My tentative timeline puts me at possibly having my transfer on Halloween. Which I’ll take as a sign of good luck, it being my favorite holiday.
Right now I am excited, nervous, worried, scared, you name it. I’ve waited so long to get here, and I am so happy to FINALLY be here. But I am so scared this will fail. I’m scared I won’t have any eggs. I’m scared I will and they will be shitty. I’m scared I’ll over stimulate and end up with OHSS and blow up like a balloon. I’m scared the transfer will happen and fail. I’m scared the transfer will work, but I will end up with another ectopic or a miscarriage. I’m just scared. I want to have hope, but I have failed so many times to get to this point, hope seems pretty pointless. But I’m going to try anyways. Maybe I can be positive this will work, and it just will. I just hope those around me can catch me if it fails.