IVF Cycle Day One

My husband and I talked last night and agreed that we are going to move forward with our first round of IVF this cycle! Here’s our timeline, which is totally subject to change depending on how my body responds to treatment:

  • October 16th: Start period, call clinic to confirm if doing IVF.
  • October 21st: Nurse will call on or before period day 5 to discuss treatment plan and meds.
  • October 23rd: Start birth control pills, continue for 15-18 days.
  • November 11th: Hysteroscopy under anesthesia. I will need to take off work that day, next day normal activities. If all goes well, start injectables (follicle stimulation) and continue for 9-13 days.
  • November 25th: Egg retrieval under anesthesia when follicles are ready. Take day off work but normal activity next day.
  • November 28th or 30th: Embryo transfer 3 or 5 days later (usually day 5). Feels just like IUI.
  • December 9th: Pregnancy test.
  • August 17th: Have baby! Hopefully. Ha!

If this round doesn’t work my insurance will cover me for two more rounds of IVF, though they require that I use up any frozen embryos from the first egg retrieval before they’ll pay for another retrieval.

I have such mixed feelings about this process. Going into this journey I never really thought we would do IVF. My doctor was pretty confident that IUI would work based on my issues alone (CF-related thick cervical mucus, somewhat unpredictable ovulation that can nonetheless be tracked by ultrasound) but that was before we started having issues with my husband’s sperm count. Maybe with more IUIs we would eventually get our +, but we’re not willing to keep gambling with such low odds. So: IVF. I had a moment, looking at myself in the mirror last night, when I felt the biggest jolt of excitement I’ve had so far in this journey – that this could really, actually make us parents! I could actually be pregnant by Christmas!

And yet – IVF just seems like such a big, scary thing. When I think of IVF I think of businesswomen in their 40’s, or celebrities, or octomom. Not me, at 26, in grad school. But here we are, embarking on this whole new chapter.

I think the thing that scares me most is the thought of going under anesthesia. And I’ll have to do it not once, but twice! First, for the hysteroscopy (more on that in a minute), then again for the egg retrieval. The last time I was under anesthesia was as a teenager when I had the last of a series of CF-related sinus surgeries that began was I was a child. I absolutely hated it and have bad memories of the whole process. In fact, I hated the feeling of being drugged out so much that I have never in my life used any sort of recreational drug, including alcohol (to the point of intoxication). I can count on one hand the number of times I’ve drunk any sort of alcohol at all, and I stopped before I even felt tipsy. I don’t even really like drinking caffeine. I hate the feeling of giving up control of my body so much that I have zero interest in any of that. At least it made it super easy to “give up” alcohol and caffeine for TTC and pregnancy!

I know it’s going to be a different experience this time around. I’ll be an adult, not a sick little kid, and the procedures I’m having done will be quick. I’ll go home an hour later and rest in my own bed instead of recovering in a hospital. Post-op pain won’t be nearly as bad. But I’m still nervous about it, and I’d like to talk with my doctor more about how the anesthesia is given (mask? intubation? IV?) and what the experience will be like. I’d also like to talk with my CF doctor to find out whether he has any concerns about me going under anesthesia – though I don’t think he will.

At first my hesitation about going under anesthesia made me question whether a hysteroscopy is actually necessary. Last night I spent some time perusing PubMed to learn more. There’s been a fair amount of research on this topic over the past few years and whether or not it actually helps (on average) is a bit controversial. Some large studies of thousands of patients show it does improve the live birth rate for IVF procedures while others don’t find any statistically significant improvement. However, depending on which study you look at, abnormalities such a polyps or scar tissue are found (and often rectified during the procedure) in 10-40% of women who have it done prior to their first IVF. These abnormalities could be the reason they haven’t gotten pregnant sooner and could prevent implantation or cause miscarriage. So, of course it makes sense to check prior to IVF! IVF is a really freaking expensive and invasive undertaking, so it seems like a good investment to make sure it’s not doomed from the get-go. To me, the aversion of risk outweighs the unpleasantness of the procedure.

Plus, I had to laugh – during my research I found a number of papers advocating the use of hysteroscopy, co-authored by my doctor himself! No wonder he wants it done! Don’t worry, he’s actually a prolific and well-respected researcher as well as a practitioner – he’s not a lone weirdo with an agenda.

I do feel like we’re in very competent hands with him, but I also sometimes feel he’s too busy to address our questions adequately. When we do get face time with him during our appointments – which, to his credit, are all done by him and not by nurses or other colleagues – he has a great bedside manner and answers every question we ask him. But trying to get information from him by phone or email is kind of a pain. We’ll call or email and 99% of the time a nurse is the one getting back to us with second-hand info. I’d like to talk with him about using ICSI, the risks and benefits of PGD, and how he expects my ovaries to respond to stimulation. But thus far the most “conversation” we’ve had regarding our desire to move to IVF is my emailing him to say we’re interested in it, then the nurse calling us back to say we’re set up to go. My husband isn’t concerned but I guess I prefer a more hands-on approach.

All right, I’ll wrap up for now. I just started my period while writing this (very long) post, so I called my clinic to let them know today is Day 1. A nurse will be calling me on Monday to get me set up with medications and schedule my hysteroscopy. Here we go!

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2 thoughts on “IVF Cycle Day One

  1. I like my RE practice very much, but I can assure you it’s very common to have more of a relationship with your nurse. I RARELY see my actual RE But my nurse so so thoroughly responsive via email. I think it’s normal 🙂 we also just started IVF, I’m on Stim day 5!

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  2. Make SURE to talk to your RE, no matter how interactive your nurse is. You need to own this process and that means sitting down for 30-60 minutes to talk to the actual doctor about the process, his experience, your questions/fears/etc. It’s not the nurse’s job to be speaking for what the doctor will be doing. You need and deserve to get the attention of the doctor. Sure, I see the nurses a lot, but the doctor runs the show at my clinic as he should, and he’s the one who calls me with the important news. I am very passionate about this after having mixed treatment at the first place I went to, and encourage everyone to take charge in the process, as REs work in so many different ways depending on the clinic, so make sure you know why he/she does what they do, and don’t assume the nurse knows all. They are an ally, but not the one digging the eggs out. Trust your gut!

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