IVF: Second Scan & Trigger Shot!



Amazing how much can happen in a week, isn’t it? On Sunday, I’d only been having injections for a week, no other contact from the clinic, and I’d just added a second shot of Orgalutran to stop myself ovulating. Now, it’s only four days later and I’m preparing to go into hospital tomorrow to have my eggs collected!

I had the second scan yesterday morning, and my little eggs had blown up in size. From the ultrasound, I now have 15 developed follicles with an average size of 17mm. By today, that could have increased even more! My fertility specialist has said that anything over 17mm is considered ready, so I’m well and truly there. That meant, thankfully, that last night was my last Orgalutran shot (nasty, nasty needles!), and I was to stop taking Puregon. It also meant that we’re now entering the “all systems go” phase!

I was entrusted with the trigger shot yesterday morning, with strict instructions on its usage. The trigger is an hCG shot, designed to tell your ovaries to “Let it go, let it go! Don’t hold them in anymore…”. This shot has to be given at a very precise time, as exactly 36 hours after it’s taken, the eggs are released. Pretty amazing stuff. This meant that as I was booked in for egg retrieval at 11:30am on Friday, I had to take the shot at exactly 11:30pm last night. As these drugs have been kicking in, I’ve been completely knackered. The prospect of staying up until 11:30 on a school night was an impossible one. So, sensibly, I set myself an alarm to get up to take the shot, at which point I jolted awake and had no idea what was happening. Mr Nester had to basically drag me out of bed and down the hall to get the shot, and it wasn’t until it was stabbed into my stomach that I really twigged on what was happening. Crazy! Good thing Mr Nester was far more lucid than I, or we might have missed the window of opportunity. 

So all of this means that firstly, I don’t have to stab myself with any more needles for a while! (Hurray!) Secondly, I’m off to hospital tomorrow where my fertility specialist inserts a rather long needle into all 15 follicles (plus any more that might have developed), and sucks out the eggs. They’ll bring me out of the general anaesthetic (and hopefully sweet peaceful dreams), and let me know then and there how many eggs they’ve retrieved. From there, it’s a waiting game to see how many fertilise, how many continue developing, and then if we have a good one to transfer back to me, and hopefully some to freeze. 

Like I said, it’s all happening! I’m hoping to post tomorrow after the procedure, but groggy old Jane might just take herself straight to bed until Saturday. Either way, we’ll speak soon. 

Until then,

Jane xx

IVF: the first scan

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50 Shades of Grey has NOTHING on this baby…

How is the whole world still ticking along at a normal speed when I seem to have slipped into hyperdrive? What a week so far! I feel like I’m still coming to terms with the fact that we’re going to be doing IVF, and I’ve realised today I’m half way through the process already! I was in for my first scan this morning, using everybody’s favourite: the vaginal ultrasound. This is just as lovely as it sounds – a great big rod, straight up the clacker, to get a good view at my bits. The purpose of this scan is to have a look at the thickness of the endometrial lining (the bit that will feed the egg when it implants) and to see how many follicles I’ve been growing. The follicles are basically the housing for the eggs – most should successfully develop an egg and therefore be able to be fertilised.

So far, my results are looking good! Good endo lining of 12mm (although now I’m worrying it’s too thick), and a total of 13 developed follicles, with an average size of 14mm. They need to reach 18mm by the trigger day to be likely to fertilise. Thankfully, some are already there! Fingers crossed when I go in for the second scan on Wednesday, they’re looking nice and big. There are also quite a few little follicles that may well be the underdogs of my fertility (what an odd sentence!) and make it over the line on trigger day. Having the scan today has renewed my obsession with all things fertility based – I had been starting to think that my lack of crazy symptoms had meant things weren’t happening for me, which makes for a rather large waste of $6,000.

We’ve reached the point of no return cost wise now, although we could pull out if we wanted to (pun intended), we’d still be forking out the big bucks. I snapped at poor Mr Nester today who pointed out a screaming baby and said, “you’ve got that to look forward to!”. See? Horribly insulting. I was completely justified in flying off the handle at him, right? Maybe those hormone shots are doing something…

So today’s Monday, on Wednesday I’ve got the second scan, and the doc thinks that Friday could well be the day for sucking these little potential humans out of my ovaries. Which means Wednesday night will be the big one: the trigger shot. We’re on the road now, no bumps so far (again, pun intended!), let’s hope we get to the end of the week smoothly, and with some fertilised eggs!

Till Wednesday,

Jane xx

IVF #1: Cycle Day 5

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Day 5 of my cycle today, day 3 of injections. I’m still on Puregon, still the same dose, and tonight will be the third jab. I was a bit all over the place today – my mind spontaneously fell into pits of nothingness, and actually, I just did it again then trying to finish that sentence.

The sinus style headache is still here, building slightly, but still nothing to complain too loudly about. If these are the side effects, I’m pretty happy so far!

The emotions are building today, still no tears but I’ve been very snappy and then instantly teary. Also quite tired. What a delight for my colleagues and poor suffering husband.

The enormity of what’s going on inside my body is not really hitting home yet, but I’m guessing as the side effects ramp up it’ll start to sink in.

That’s it from me tonight – just a quick update to try to capture this experience day by day!

Jane xx

IVF: here we GO!

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Time for some self-stabbing!

And we’re off! After what has seemed like an age since Mr Nester and I decided to give IVF a go, suddenly we’re here, and we’re racing.

December consisted of meetings, decisions, planning and budgeting. January was forms, forms, and more forms. Tests, appointments, and…oh yeah. Forms. February has – as a lovely departure from the previous months – just been gung-ho all go. To start IVF you need to wait until the start of a new cycle (hello Aunt Flow/crimson wave/other terrible clichés). So of course mine was late, only by a day, but enough to get my frustration building.

Once you officially hit Day 1 of a new cycle (technical definition: full flow before midday), the first step is to call the fertility centre. This is basically to get the ball rolling – you call, bark “Day 1: the eagle has landed!” and they throw 20 syringes at you. Apart from my very minor embellishments, this is the general gist of the process. With a standard IVF cycle, you start injections on Day 3 (called “stims” in the IVF community). That means of course you need to collect the medication, in order to start taking the medication. Medication must be collected between 9am and 4:30pm. On a weekday. On the other side of the city. You also need to get home sharpish (hah! A needle pun!) as the medication needs to be refrigerated to stay useful. That was a fun afternoon. Race off from work as soon as possible, battle peak hour traffic to get into and around the city, sit panting for 15 minutes at reception while life carries on as usual, then receive a barrage of info on what’s in the bag (insert “Se7en” scream here), how to inject yourself, when to inject yourself, and when you’ll need to come back to have what is essentially a high tech dildo prod around in your lady bits (that’s actually a scan to check the development of your eggs, not an odd sex act to spice up the process…more’s the pity!). Then, you must drive home manically while trying to keep the cool bag directly in front of the air conditioner and in a shaded section of the car. Note to self: become a better driver. And WATCH THE ROAD! Oh and of course you have a prior commitment in the city later that night, so head back out AGAIN and home AGAIN before having the first shot. Phew! I should note here, that the nurses and support staff at my fertility clinic have been nothing but absolutely lovely, and it is really just the enormity of what we’re delving into that makes it seem so frantic. That, and my driving. Sorry other people on the road. Really. Sorry about that.

So, fast forward to later last night, when the first dose was administered. I’m not particularly phobic of needles, but they’re also not my favourite pastime either. So willingly relinquishing myself to Mr Nester’s needle holding hands (and rather evil gleam in his eyes…) was an interesting prospect. You receive a nice little pen that becomes the nasty needle, with a few twists here and clicks there. We’ve been started on Puregon, which is a follicle stimulant.

The Puregon pen

The Puregon pen

This little jab happens every night for about a week, and tells your body to make as many eggs as it bloody well can. A hot tip I learnt from reading the fertility forums is to ice the injection site prior to the jab, and it certainly worked for me. Although a little uncomfortable (the needle needs to stay in you for 10 seconds to make sure all the drug has gone in), it was relatively painless. A little red straight afterwards, but otherwise fine. The side effects are quite impressive, as mentioned in a previous post, but thankfully I’m yet to experience most of them (although I’m only on the second night of injections, so stay tuned!). The only reaction I’ve had was a bit of pain on my right side this morning (the side I injected), and what feels like a tension headache, but very mild. That sort of feeling you get if your sinuses are getting blocked and it reaches your temples. Very manageable so far.

In terms of mental state, I think my emotions are heightened slightly – I nearly cried about 3 times today for quite minor reasons, but managed to hold it together. The end of this week should be interesting! In general, the whole experience is pretty overwhelming. It’s something we’ve waited for for quite a while, but once it starts, the speed at which everything happens is pretty mind-blowing. We’ve gone from “in a month”, “later on”, “when it all starts”, to now, tomorrow, as soon as you can. It’s very exciting, but also completely terrifying. From starting on Saturday, I’ve begun injections 2 days later, I’ll be going in for my first scan in a week, and I’m likely to be having the egg collection procedure next Friday. So, in a week and a half. 3-5 days later, I’ll have an embryo transferred back into me (if all goes well), and I could well be pregnant from then on. Holy crap.

So. We’re off and running. I’ve already apologised to Mr Nester in advance for anything I say that I may later regret, and I’m trying very hard not to manufacture the symptoms I’ve read on the information booklet (mission: impossible). I’ll keep you updated as much as I can on this process, but it feels like as fast as I’m typing (13 words per minute, thank you very much!), I already can’t keep up.

Speak to you soon,

(the soon to be hormone-ravaged) Jane xx

IVF: what needs to be done

I knew IVF would be a fairly large departure from the natural course (a lot less fun, a lot more pain, about the same amount of anxious waiting). I had thought, however, that these added complexities would be part of the actual process – the shots, the procedure, the waiting to see how many eggs had fertilised. What I hadn’t realised was the sheer amount of organisation involved, long before the first injection. As a heads up to any of you travelling towards the IVF path, here’s what we’ve gone through so far:

Step 1: the fertility specialist

This one I was expecting – you want IVF, you need to see the doctor. While waiting for the appointment to roll around, my main concern was convincing the doc that we should go straight to IVF, and not try IUI to begin with. Let me explain. For most couples who are having trouble conceiving, the first step tends to be IUI, or Intrauterine Insemination. This is basically a more advanced version of a turkey baster, where you wait until ovulation day (predicted by ovulation test kits), and then the doc squirts swimmers directly into your uterus, bypassing the initial journey, and making conception more likely. IVF (In-vitro fertilisation) on the other hand is when eggs are extracted from the woman, thrown into a petri dish with sperm, and monitored to see which eggs fertilise. One of these is then injected back into the uterus, where hopefully it sticks.

My concern with using IUI first is that we have a limited amount of frozen sperm. Also, the rates of success are much lower for IUI (around 20%), compared with IVF (more like 40%). We would potentially use up a chunk of our frozen swimmers when we could get success on the first try with IVF.

So I had gone in to the appointment with the Doc with my argument in mind. We spoke to her about our situation (husband undergoing chemo, one miscarriage, abnormal shaped sperm, frozen specimens only). She told us that IUI was fairly pointless, as frozen sperm tend to not pick themselves up particularly well. She also discounted regular IVF, for the same reason. Her recommendation, from the start, was to go with ICSI IVF, which is a more specialised form of IVF. The eggs are extracted, the sperm is defrosted, and the best sperm are selected from the batch. One sperm is then injected into each egg using a needle, and the eggs (hopefully) fertilise. They then transfer one (or sometimes two) eggs back into the uterus, and again hopefully they stick. This process has a few detractors, mainly due to the absence of natural selection. A scientist selects the best sperm, not the natural process itself. It does, however, have the highest success rate. Personally, I’m happy to trust the scientists, and the process. It has been used for nearly a decade to provide pregnancy, and studies that I can find don’t show any adverse effects when compared to regular IVF. The biggest drawback with ICSI is its cost. The additional procedure carries an extra cost for us of $800.

Mr Nester and I discussed the approach, and decided we were both happy to use ICSI if it meant success. So, on to the next step.

Step 2: the information session

In which you are bombarded with information on what drugs you’ll be taking, how you’ll take them, when you’ll take them, and the side effects of taking them. Here’s a brief rundown:

Drug 1: Puregon (makes lots of eggs develop) taken from Day 3 of cycle until Day 14, injected into stomach fat (ohhh yeah). Side effects include: abdominal swelling, breast tenderness, mood swings, nausea, dizziness, headaches, bloating, tender ovaries.

Drug 2: Orgalutran (prevents you releasing eggs until the doc says so) taken from Day 8 of cycle until Day 14, injected. Side effects: headaches, nausea, itching, soreness and redness at injection site.

Drug 3: trigger shot Day 15 (makes the eggs spill out of you, basically). Injected. Side effects: nausea, bloating, constipation, breast tenderness, tender ovaries.

Drug 4: Crinone (a progesterone supplement), Day 19 onwards. Used as an applicator up the wazoo. Side effects: all of the above, plus the bonus of cottage cheese discharge. Oh yummy.

These do not include the two scans, multiple blood tests, and day in hospital where they knock you out, stick a bloody big needle in you, and yank out however many eggs you produced. Of course, some of the drugs need to be refrigerated, some not, all must be taken at a specific time, and all of this may change depending on your body’s reaction. Easy.

Step 3: the counsellor

A government mandated session, basically to make you aware of who owns the embryos if one of you dies. We chatted to a lovely counsellor, she was great, this bit was easy. It was also free. Win!

Step 4: the paperwork and the rest

Holy cow the paperwork. Three forms to fill out, sign and have witnessed. A police check for each of us, certified, sent off, paid for, forwarded to the fertility clinic. Child protection checks applied for, received, forwarded to clinic. Blood tests, one for Mr Nester, two for me, one of which was not claimable and so cost $90. Oh, and a partridge in a frickin’ pear tree. Also, as we have Mr Nester’s sperm stored at another facility, we have to pay to have it transferred, then pay again to have it stored.

Step 5: the costs

As you can imagine, this was the gasp moment. It is bloody expensive. Without Medicare (thank god for Medicare), we would be out of pocket by around $12,000. Yes, you read that right. 12K, 12 big ones, twelve thousand bloody dollars. With Medicare, we’re looking at about $6,000. Nowhere near as bad, but still a lot. This is all my working out, so there may be some leeway here, but I’m expecting the worst.

All of this leads to next month. Around the 15th Feb, I’ll be collected my meds and starting the process. We’ve done all of the above (aided by numerous check lists and trips to the post office, police station (to certify bloody EVERYTHING), and bank. We’re ready. Except we’re sooooo not. This is going to be a rollercoaster, and if the side effects of those drugs are anything to go by, I’m going to be the screaming, crying, vomiting one. Lucky Mr Nester.

Jane xx

IVF: the beginning

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Another doctor appointment today (I’m going to laugh at that line after the next few months), this time discussing how we get going with, as they call it, “assisted reproduction”. Mr Nester and I had a long chat last weekend, and we came to the conclusion that there’s not a lot of point waiting. Since he is currently receiving chemotherapy, a return to normal fertility levels/sea of swimmers could take anywhere from 3 months to 2 years. Or not at all. And since he will be having more chemo early next year, that will mean we won’t be able to try again until this time next year, at the earliest. That’s assuming the swimmers return, which they may not. So, we’ve decided that instead of adding more uncertainty and more waiting to our already limbo-like lives, we’ll give a big fuck you to nature, and have a chat with science instead.

We spoke to our GP tonight, and he recommended one of the IVF clinics in Melbourne. I looked them up, along with other options, and we’re going to meet with a couple (one recommended, one cheaper!), to see what they suggest. From the website estimates, we’re going to be out of pocket by at least $2700, most likely quite a bit more. What they don’t say (well not loudly) with the prices are that they assume you have reached the Medicare Safety Net threshold (for those from o/s, this is basically an amount of accumulated medical costs where the government will give you more of a helping hand if you go over it). They also assume you have private health insurance (which we do), that covers fertility services (which ours doesn’t). We could be out by another grand or so. We’ll see.

Thankfully, we have a little bit of money set aside, which was to be saved so I could take extra time off work if we managed to fall pregnant. Fingers crossed the treatment works first time, in which case we may be able to make the shortfall back up in the resulting 9 months. Otherwise, we’ll be a little broke. You know what, though? Broke is fine. I’ve been broke, and I’ve been (relatively) well off. Money has never made me happy. Sure it makes the stress less when the bills roll in, but there’s no way I’m letting a bit of cash come between us and the chance of having a family. Not yet, anyway.

So I’ve contacted the two IVF clinics, now we wait to hear back so we can set up the initial appointment. Here’s hoping this is the start of what this blog was meant to be: a log of our journey to parenthood.

Jane xx