Wednesday, May 18, 2016

So How Does IVF Work?



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In Vitro Fertilization (IVF) can be very overwhelming and if you have never gone through it, you probably don’t know what the entire process entails.  So, I wanted to share the process of how IVF works, why certain medications are prescribed, how these affect one’s body, why daily blood draws and ultrasounds are important, what the time line looks like, and so on. While the time line, amount of medications, medication types, and additional procedures differ from person to person depending on their diagnosis and response to the treatment, the basic process of IVF stays the same.

This is how my IVF experience went.


Step one
On March 3rd, I began taking birth control pills. These are taken for a couple of different reasons. They stop natural hormones and allow the doctor to be able to have control over your body and the timing of your cycle. This is important so that the clinic can stagger each couples cycle (they don’t want everyone triggering on the same day!) and they can help work around any major events you may have planned during the cycle.
In addition to the birth control pill, I was also put on a prenatal vitamin to help ensure that my body was getting all the nutrients it needed.


Step two
On March 17th, my husband and I both began taking an antibiotic twice a day (morning and evening) for 10 days. This was to ensure that both of our bodies were as healthy as possible during the cycle.
On March 17th, I also began my first injection. Each injection had to be administered subcutaneously and in the morning. Personally, I was prescribed Lupron. Lupron essentially shuts down one’s reproductive system and significantly lowers one’s estrogen levels. Essentially, it puts your body into a menopausal state and ovulation cannot occur. This is very important as it allows your doctor to wait for your eggs to fully grow and mature prior to triggering ovulation. If your body were to ovulate, then the doctor may miss when your egg(s) are released OR you may not get as many eggs, decreasing your opportunity for a successful round.  I took Lupron every morning until my trigger shot.
In addition to this, I also began taking baby aspirin. Baby aspirin helps to increase movement and flow of your blood, which may help aid in implantation and decrease potential of clotting.


Step three
On March 25th, I stopped taking birth control and March 26th, was the last day of antibiotics for both my husband and I. From there I continued to take my prenatal vitamin, baby aspirin, and Lupron injection.


Step four
March 31st was a big day for us. First, we went in for my baseline ultrasound and blood draw. This was too see exactly where my body was at before beginning the Follicle Stimulating Hormones. Immediately after that, I attended a shot review class and began taking two additional injection medications, Gonal f and Menopur. Gonal f is a Follicle Stimulating Hormone that assists in stimulating egg development within your ovaries in order to help as many eggs grow as possible. Menopur is also a Follicle Stimulating Hormone. In addition to this, Menopur is a luteinizing hormone, which helps increase the health of the eggs and assists the eggs in being able to mature prior to egg retrieval.


Step five
On April 4th, I went in for my first follow-up blood draw and ultrasound. This allowed my doctor to see how my body was responding to the treatments and to increase or decrease my prescribed medication amounts as needed. From there, I continued to take my medications each morning, which now included: a prenatal vitamin, baby aspirin, Lupron, Gonal f, and Menopur.


Step six
From April 7-10, I went in for daily blood draws and ultrasounds. These always had to occur in the morning so that the lab had time to process the results and any changes to the medications could be made prior to my next injection time. In addition, my follicles were closely monitored to ensure that as many mature eggs as possible could be retrieved when the time came and to assess when the best time for egg retrieval would be.


Step seven
On April 10th, I got the call that everything looked good and it was time to trigger ovulation. Ovulation must be triggered 12 hours prior to egg retrieval in order for as many mature eggs to be retrieved as possible.


Step eight
The next morning, I went in for my egg retrieval. I was put under anesthesia during this. When I woke up, they gave me time to rest and told me that they had retrieved 14 eggs.


Step nine
On the day of my egg retrieval, my husband also gave a semen sample. From there, the retrieved eggs and sperm are typically put together to fertilize. Due to our diagnosis, we did an additional procedure called Intracytoplasmic Sperm Injection. Meaning that a single sperm was directly inserted into each of the mature eggs. This increased the chance that fertilization would occur and we would have a lot of little embryos to transfer.


Step ten
The next morning the clinic called to report that seven eggs fertilized, an exciting but slightly lower number than we had anticipated. Three days after our egg retrieval date, the clinic called again to let us know that we had four healthy embryos left. Depending on the diagnosis and quality of embryos, some doctors will transfer the embryos back into the uterus on day three. Our doctor felt that it was best to wait until day five, which increases your chances of success. We were very scared and apprehensive about this as we did not want to lose any more embryos, but decided to wait. On April 16, the doctor transferred two perfect little embryos back into my body. I was given a muscle relaxer prior to the procedure and my husband, mom, and I were able to watch on the ultrasound screen and see exactly where the embryos were placed.


Step eleven
From there, I entered the dreaded waiting period to see if our little embryos were able to stick. I rested the remainder of that day and then went back to life as normal. Seven days after the transfer, my clinic did another blood draw to see if my HCG levels were rising, but no results were shared with me. Then, nine days after the transfer I went in for a second ultrasound. If your HCG levels double, then the clinic considers you to be pregnant.


I anxiously waited for that phone call and began crying with joy when I finally got to hear that I was actually pregnant!


There is a lot that goes into IVF and it doesn’t all necessarily stop after if you get pregnant. However, the whole process was pretty incredible and amazing to see occur.

-Shauni


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