IVF "training"

Today we went in for our "nurse's appointment" for IVF.  Some clinics make you go through a class or training, ours does a private 1-hour session with the nurse.  Love this.

This is going to be a fairly boring post, but I do want to document our visits and protocol this time around.

Our nurse started out discussing our protocol with us:  I will get a shot of Lupron Depot for suppression today.  The Lupron will prevent me from ovulating on my own during the IVF cycle.  My RE uses this depot shot, which means I will only need 1 shot (vs. a daily dose) and there is a delayed release of the medicine.  This doesn't appear to be a very popular protocol from my research, but my RE uses it exclusively in long-Lupron protocols and has great success.  And, who am I to complain about a few less shots at home?

After I start my period next week, I will go in for a baseline ultrasound and blood work to verify I don't have any cysts and check my estrogen level, among other things.  Then I start "stims" - I will be on 150iu (2 vials each) of Bravelle - a follicle stimulating hormone - and Menopur - which stimulates FSH and luteinizing hormone (LH).  I can combine these 4 vials into one shot which is great.  I will have to give myself a shot in the belly for 10 days, while they monitor my progress via blood work and ultrasound on days 5/7/9.

Then, when my follicles are ready, I will take a shot of hCG to trigger ovulation and go in for egg retrieval 36 hours later.  The mature eggs will be fertilized via ICSI, and then we will go in for blastocyst transfer 5 days after the retrieval.  I will be under anesthesia for the ER (technically sedation), but awake for the transfer.  While they are doing the ER procedure, Josh goes to give his sample.  Both of these visits take place in the Rochester office (still performed by my RE), which is about an hour and 15 minutes drive for us.  Oddly enough, its only about 2 miles from my brother and sister-in-laws house.

Whew.  That was long, sorry.  But that is nothing compared to all the paperwork we had to sign.  Obviously we we made aware of all the fees - sign.  How many embryos are we willing to transfer - sign.  What about selective reduction - sign.  And should we both die while we still have embryos frozen, what happens to them (what?  now we need to work on a will) - sign.  Willing to use donor sperm (no) - sign.  And I think there were a few more pages too, but this was heavy shit.  It definitely feels all grown up and real now.

We learned some cool things: like if I am pregnant, I will be monitored by blood work and ultrasound every other week through the first trimester.  That's 5-6 ultrasounds!  Many women don't get to see their baby that many times in their whole pregnancy!  Definitely one of the few pluses to IVF.
And we learned some not-so-cool things: like I am on activity restriction not only through the IVF procedure, but throughout the entire first trimester!!  Yikes!  What exactly am I allowed to do?  Walking and prenatal yoga.  Wow, I'm gonna be bored!  Apparently not only is the risk of OHSS high after ER, but that risk persists for a while since my follicles are likely to re-fill with fluid, leaving my ovaries large for a while until it can all drain.  The risk of doing too much activity is torsion - the ovaries can twist since they are free-floating in the abdomen which has serious complications. So, I guess I'm officially sidielined for what I hope is approximately 3 months.

After all of that, the nurse showed us how to mix our injections.  I brought our box-o-meds, so she went through all of it with us.  It will take a little time, but it doesn't seem so bad.  Then she gave me my shot of Lupron, and off we went.

My emotions are definitely a little all over the place today.  Nervous, excited, scared, anxious.  But mostly, I'm hopeful for what will be waiting for us at the end of this crazy journey.