Big update!

(Forgive me – this will be long.)

So much for our extended break! About a week before my latest BFN Kim called me with some news. She hesitated in telling us, because she knew that we struggled with the decision to take a break and this news was going to throw a kink in the plans. Someone had donated MANY vials of Repronex to the office - and they were giving about half of them to us. Repronex is the more expensive drug, that was about the only other thing we could think to try. It's also the drug that Dr. S uses for IVF. The catch – they expire in December. Obviously this meant our break was going to be cut short – not that we’re complaining – we are SO blessed to get these drugs – roughly $4000 worth!

This lead to some interesting discussions – should we try a few more IUIs with the meds, or use them all for one IVF cycle. The answer ….

We’re doing IVF!!! We had a consult this morning with Kim, Dr. S, and some resident thrown in for more fun. They feel that we’re at the point that we need to move past the IUI’s – we did 7 of them and they obviously never worked. She thinks that IVF will increase our chances a lot, and it will also help us potentially figure out some of those iffy questions (quality of eggs, are they really fertilizing, etc.)

The original plan was that on CD21 of the cycle prior to IVF, I would start taking Lupron, to suppress things. However, my cycle isn’t regular so that potentially wouldn’t be timed out right. That meant that we were adding birth control, when I start my next period. Again, because my cycle isn’t regular, that could be too late and potentially end up conflicting with when the lab is closed around Thanksgiving. SO, I start birth control today – this should give us more control over when we start everything. We’re planning on starting the Lupron around the 3^rd week of October. I’ll take that for about 10 days (I think) and then start the Repronex (with potentially a drug called Bravelle added in.) At that point she might have me stop the lupron completely. She normally has patients continue that at a smaller dose, but she's worried about my response and I think this could potentially suppress things too much? The stimming process will be much like stimming for IUI, but with more shots. I’ll have an appt every few days to check how things are going. When there are enough mature follicles, we’ll do the trigger shot.

She’s hoping that we have 12-14 mature follicles for retrieval. That will be 36 hours after I trigger, and will take place at this joint lab in Carmel. Also, I’ll be awake for it!! I thought that most people were knocked out, but the paperwork says that I will be given medication to feel drowsy, but that Jason and I will be able to watch the aspiration of the follicles on a monitor. I’ll stay there for 3-4 hours afterwards to recovery and then go home with some painkillers.

They’ll call me the next day to tell me how fertilization went. They always try to do 5 day transfers. Apparently at this point they are blastocysts and we’ll be able to pick out the better quality ones easier. If I don’t have very many or they aren’t doing as well, then I think we’ll transfer at 3 days. Starting the day of the retrieval I’ll add progesterone (in oil), and estrogen.

For the fertilization part - it sounds like they want us to do ICSI where they actually inject a sperm into each egg, rather than letting them fertilize on their own. There is another test they could run on Jason to check “binding”, which would help us determine if we need ICSI or not, but that would just cost more money, and if there are issues the answer is ICSI, which is only an additional $500 anyways. Apparently “some” studies somewhere have shown that it can sometimes decrease quality, but Dr. S said that their lab (which is where she works with Dr. Gentry and Dr. Henry, two other Indy REs) hasn’t found that.

I’ll be awake for the transfer as well, and from what I can tell it will be much like an IUI. They’ll insert a catheter through the cervix to transfer them, while watching on an abdominal ultrasound. I’m supposed to take it easy for 1-2 days afterwards. Basically bed (aka “couch”) rest – who wants to keep me company?

I have a whole calendar, listing each day and what meds I’ll be taking. I’ve already mentioned the birth control, lupron, repronex, possibly bravelle, estrogen, and progesterone. Others are: baby aspirin, antibiotics at some point, and prednisone after the transfer.

I’m going down on Monday to retest my insulin and see if we should increase the metformin. Also, Jason and I both have to do STD tests sometime in the next month. (Some rule having to do with storing frozen embryos.) And we’ll have another appointment where we fill out all sorts of consent forms, contracts, etc.

I was a little upset about starting birth control now, only because I was thinking that we’d have a hail mary, last chance, miracle break cycle BFP. Chances of that happening were slim though. So for the most part I’m really excited! It will still be awhile, but we’re starting it!

Until then, I’m trying to really watch what I eat, and exercise. I’d like to lose 8 more lbs before we actually start the process and I think that’s a realistic goal. Also, we’ve decided that sometime in October we’re going to have pictures taken of the two of us – think engagement pics I guess. I feel like it would be something that is just for us, that has nothing to do with baby stuff at all. I thought it would be a fun way to de-stress before IVF.

I’m also looking into acupuncture – some people just swear by it. Worst case, I think it would at least help on the stress/relaxing front.

So there you go – that’s what we’re doing! We are still getting somewhat of a break, as it will be another 5-6 weeks before any shots and some time after that before the appointments start.

Sorry for the novel!

Laura