The IVF procedure explained (very gently)

If we are facing in the right direction, all we have to do is keep on walking.  ~Buddhist Saying

The IVF procedure at work. Sorta.

The IVF procedure at work. Sorta.

My friend, K is considering IVF. She’s 41 years old and has been trying for a baby for at least four years now. After 6 unsuccessful IUI attempts, she’s decided that enough is enough.

This January she is going to start her protocol. I am thrilled for K. I sense things will work in her favor.

When she told me she was secretly terrified, I completely understood why. IVF is no over night fix. Nor is it simplistic. Truth is? There are appointments averaging 3x – 4x a week for monitoring and daily self – injections (usually in the stomach region and on a tush cheek.)

So what exactly IS an IVF procedure? What is in store for my friend, K?

In vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.

I read the above on Wikipedia. (I LOVE Wikipedia, by the way.)

What this means is that some time, during the process of undergoing IVF, a woman will lay down on a table, and experience a procedure by her RE. Her developed eggs will be taken out carefully.

At the same time, the male partner is in another room, releasing his sperm for collection.

Once the eggs are taken out and the sperm is collected, they are mixed together and an Embryologist carefully monitors them. If all goes well, in 3 to 5 days, the couple is called back in to the RE’s office, with embryos ready, willing and able to be transfered back in to the woman. In the United States, four embryos are the limit per IVF protocol. Octomom was a very RARE occurrence…

After the transfer date, the waiting game begins. I was asked to return in 12 days for my blood test. Every day I waited, I wondered, “ARE WE?” All couples ask themselves that question. Trust me. If Fonzie was waiting the 12 days, he’d still be cool. But he’d be cool with sweaty palms and raised eyebrows.

And viola! Pregnant or not, the question is answered with that blood test. Nerve-racking, eh?

But not as nerve-racking as what happens BEFORE the retrieval of eggs or transfer of embryos. Needles. YES. Many needles.

Now, before I really scare anyone, please know, the needles are NOT that painful. The first injection is always the most nerve-racking. And after that? It’s just routine. I was told to take my injectable in the evening between 6p – 10p. But every patient will be told when to administer their meds by their RE’s office.

I started my protocol (after a month of birth control pills and five days in combination) with Lupron.

What does Lupron do? It overstimulates certain hormones in the body. and shuts down the production of hormones. Testosterone is greatly reduced. And premature ovulation is suppressed.

I am not a doctor, so I am explaining what I think I know. Let me just state that before continuing on.

Now, once I was on Lupron, I saw my RE every two days or so. I had a blood test and ultrasound EVERY time. And was later called by the nurses once the blood work was read that afternoon. My Lupron dosage was never changed to higher or lower and so I continued on it until told otherwise.

I forgot how many days passed but it seemed to be around a week when my RE decided I was ready for the next step – stimulation of my ovaries. Time to make some eggs.

Gonal-f, like Lupron, was an injectable and also was taken in the abdomen. Both had to be taken in the same window period so
I started with my Lupron and waited about twenty minutes. Then I took my Gonal-f.

My dosage of Gonal-f changed a few times, based on my blood work and ultrasounds (based on those RE appointments )

Okay, so now I was controlling my ovulation situation and making eggs. I had my nightly shots. I was on a roll.

I believe I did the Lupron and Gonal-f cocktail for one week or so before being called by my RE’s office. It seemed my blood worked showed I was doing well and was ready for the next step. Egg retrieval time!

So the nursing staff told me NO more Lupron and NO more Gonal-f. I was instructed to take ONE shot of something called Novarel. I had to take it at a very specific time because 36 hours later, my eggs were coming out.

Novarel was taken in my tush. This shot is commonly known as the trigger shot. It induces maturation in whatever eggs the woman has produced over the weeks and it loosens the eggs from the follicle walls, making for a successful retrieval. A VERY important shot to inject, right?

And after Novarel and prior to that, the Gonal-f and Lupron – I went out for a wonderful, Italian dinner. No wine. No cigars. No chances on that. Just some elegant pasta and a warm, chocolate dessert.

I suggest everyone do the same.

A reward comes in all forms – medals, trophies, and even those big checks endorsed by Ed McMahon. But no reward is sweeter than a relaxing moment after the injectables are disposed of and the retrieval is hours away.

And no, there is NOTHING odd in buying yourself flowers either.

I hope this helps my pal, K in understanding what IVF is going to be like. Every woman has her own protocol with own meds and own doses. No one woman is alike. But I am hoping my experience serves as some sort of example.

What were your experiences like? I am so curious to hear all about them. And if like my friend K, you are in the pre-IVF stage, I wish you all the best. And loads of warm, chocolate desserts.

3 Responses to The IVF procedure explained (very gently)

  1. HarvestArt May 20, 2011 at 2:26 pm #

    Thank you for this post.  🙂 

  2. Renee Olesek July 30, 2011 at 4:50 pm #

    I’m in the BCP/Lupron stage.. I start stim drugs next week.. baby dust our way please

  3. Anna Maria April 12, 2012 at 8:01 pm #

    I’ll be beginning the whole journey in a week’s time (starting Suprefact nasal spray).  Suprefact prevents ovulation and decreases estrogen (so there will be more eggs to retrieve next month I guess?).  Anyone else out there going through any part of this process right now?

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