October 2012....
A few months have passed and we have been busy with baseball trips, saying goodbye to my brother and family as they head out east and a motorcycle weekend to Lions head & area. Taking advantage of my ability to ride while I can. You should see the looks I get at SOFT from the other women when I show up for monitoring in the morning in full gear! It is awesome! The staff know me by now and aren't surprised.
So...early October, 2012 I started IVF preparation. SOFT gives you a detailed itinerary of when to take what, stop what and inject one. They also give you a millions consent forms where you have to decide what you do with extra embryo's, extra "stuff" from the process, destroy them, research, give them away. Quite intensive documentation with big decisions.
So the process: IVF (In-vitro Fertilization) . It refers to fertilization of eggs outside of a woman's body. It's the one where you take egg, sperm but them together in a dish (or in our case inject the sperm in the egg directly)..let them grow..then put viable embryo's back in. It is much more invasive. For those who are interested I tried to break it down a bit.
1. Through medication my hormones are suppressed, then with more medication my ovaries are hyper stimulated in a controlled way.
For me this meant taking birth control pills for ~a month a half, then a nasal spray for about 8 days. Then the fun part of re injecting hormones into my belly began...for 12 days. All of this was fairly time sensitive so I had alarms going off on my phone at all times. The injections were scary at first but now I can do it in my sleep practically. Because of my low egg reserve I was on a strong dose which meant a lot of mixing! Side effects?? I was definitely more hormonal and emotional (which made work a bit challenging)...but overall I thought it went pretty good. I thought I was going to be a monster. Telling this to people after...Dennis had a different story. His statement "I thought I was going to drop kick you a few times". Folks...that is love!:)
Throughout all this I had a schedule to have blood work done and internal ultrasounds. Ultimately we want lots of follicles and by time retrieval happens ones that are mature and can be extracted. I remember being upset with the first ultrasound. You hear of people ending up with 20 or something...I had 4...initially...by the end there was more but not the numbers I had anticipated. So...my work girls had to deal with an emotional me many mornings after my clinic visits.
One thing I remember that was weird was the feeling in my gut. I didn't have a lot of eggs...but my ovaries were bigger than they were used to. I literally felt like I was carrying a dozen rocks.
2 THe next step is "the Trigger". Based on ultrasound and blood work it is determined the follicles are ready. The trigger is another injection which allows my body to have an LH surge which means ovulation/release of the eggs. This is critical to retrieval and timing needs to be exact!! It is usually 32-34 hours pre-retrieval.
So for me...it was one more injection at the time SOFT calls and tells me to do it. Easy after 11-12 days of injections already. And a bit of a relief...my ovaries are stretched and not happy about it! Think of your belly expanding the way it did over 9 months but in 9 days!:)
3. Retrieval and fertilization day! So...eggs are retrieved from my ovaries(sucked out so to speak), Then the lab does their thing with the eggs and sperm. Due to the lower sperm count we also had a procedure called ICSI.(Intracytoplasmic sperm injection)--> sperm are directly inserted into the egg...so they don't have to fight their way through.
For us this was a long day. The SOFT doctor's do the IVF procedures at a clinic ISIS..in Mississauga. We went down the night before due to the early morning we would be having. Dennis' job was his date with the cup. Yes...as a woman I have had picks and pokes, multiple things shoved up and shot up me....but I don't know if I could deal with the pressure of performing on demand! It's not like..oh well...next time. These are important and high pressure circumstances. His next job was to take care of me the rest of the day!
So...me..I was remarkably calm and that was before taking the Ativan I was prescribed. When it's my turn I get set up with an IV for fluids and eventual "conscious sedation"...so I was awake for it all. This isn't the case with everyone. I am fully monitored with ECG, oxygen saturation and BP. Dennis gets to join me in the room too...and Dr M is lovely and charismatic as always. Everyone keeps chatting as my legs are up in stirrups with god knows what being placed in me!:) At this point I get the IV sedation and two local anesthetic injections...those sting the most. Despite a mini crying meltdown (?meds?emotions??not sure really) it was a really cool procedure. we could see on the screen as he would drain the follicle, it would collapse and then allow the egg to extracted. They counted how many were extracted as they are done...I think we had about 11...not a lot but something.
After I had to wait till my vitals were all good, had some food and then we could leave. Other than being tired and crampy I felt good. So...after that we head home trusting the professionals to do their thing.
So...with the eggs...11 wee retrieved but not all can be used. Some may not be mature enough, occasionally damaged during retrieval, etc. The lab takes viable eggs and injects the best sperm into each egg and then waits. As for me I had to take some antibiotics to prevent ovarian hyper stimulation syndrome... which can come on in a few days. Luckily I did not have this issue.
4.Waiting to hear how things are going with fertilization.
The day after we get a call and are told 4 fertilized! We had hoped for more...but again this was good with our history of issues on both of our sides. Day after all were still growing.
5Transfer day. Procedure is fairly similar to an IUI with a speculum and catheter.
The next morning back to Mississauga we go. It was one of those full bladder procedures to help with guiding the catheter. I HATE those! Dennis will tell you I have the bladder of a 4 year old...and it goes through me so quick. I was so uncomfortable I to pee out so much prior...just so I could relax. The transfer itself only took 10 minutes. Again we could watch. Embryos are microscopic so they put an air bubble on either side so we can see when they are being transferred. We decided to transfer two...which is quite common with most people.
Unfortunately we found out that one of the other 2 did not survive...they still weren't sure if the other would be viable enough to freeze. A few days later...I found out it didn't survive either. That was quite devastating for me....but we were still hopeful with these two!! The next week I took off work to just relax and let nature happen. It's not a protocol but something I need to do for me physically and emotionally. No injections after but I did have to take a medication called Prometrium (type of progesterone) which helps with the uterus environment and implantation. Let's just say you don't take it orally....and of course since my body has issues I got to take a higher dose more often! So..they make them in these "rocket" forms and give you a "rocket" launcher to insert them. My names for them...not how they are referred. But I think it was quite accurate. They are taken until a negative Beta or so many weeks into a pregnancy.
COST?
I won't spend too much on this but I know some want to know. It does vary clinic to clinic and unfortunately isn't covered under OHIP. Those who have blocked tubes due get some coverage...but that is the only fertility diagnosis that does at present. For those at SJHC...not covered under our health plan. I could put drugs through the drug plan. Rough costs:
Meds(after drug plan) $1000+ (mainly due to my high doses)
IVF ~ $5000
ICSI ~$1000
Other expenses are travel, freezing (if applicable, etc)
The good thing is you can claim all of this on your tax return.
I have to say that we are fortunate enough to have the savings to do this. I know many people out there who don't have the same opportunity. SOFT does have some supports for less fortunate families. I have donated back meds that are unopened that I won't be using.
A few months have passed and we have been busy with baseball trips, saying goodbye to my brother and family as they head out east and a motorcycle weekend to Lions head & area. Taking advantage of my ability to ride while I can. You should see the looks I get at SOFT from the other women when I show up for monitoring in the morning in full gear! It is awesome! The staff know me by now and aren't surprised.
So...early October, 2012 I started IVF preparation. SOFT gives you a detailed itinerary of when to take what, stop what and inject one. They also give you a millions consent forms where you have to decide what you do with extra embryo's, extra "stuff" from the process, destroy them, research, give them away. Quite intensive documentation with big decisions.
So the process: IVF (In-vitro Fertilization) . It refers to fertilization of eggs outside of a woman's body. It's the one where you take egg, sperm but them together in a dish (or in our case inject the sperm in the egg directly)..let them grow..then put viable embryo's back in. It is much more invasive. For those who are interested I tried to break it down a bit.
1. Through medication my hormones are suppressed, then with more medication my ovaries are hyper stimulated in a controlled way.
For me this meant taking birth control pills for ~a month a half, then a nasal spray for about 8 days. Then the fun part of re injecting hormones into my belly began...for 12 days. All of this was fairly time sensitive so I had alarms going off on my phone at all times. The injections were scary at first but now I can do it in my sleep practically. Because of my low egg reserve I was on a strong dose which meant a lot of mixing! Side effects?? I was definitely more hormonal and emotional (which made work a bit challenging)...but overall I thought it went pretty good. I thought I was going to be a monster. Telling this to people after...Dennis had a different story. His statement "I thought I was going to drop kick you a few times". Folks...that is love!:)
Throughout all this I had a schedule to have blood work done and internal ultrasounds. Ultimately we want lots of follicles and by time retrieval happens ones that are mature and can be extracted. I remember being upset with the first ultrasound. You hear of people ending up with 20 or something...I had 4...initially...by the end there was more but not the numbers I had anticipated. So...my work girls had to deal with an emotional me many mornings after my clinic visits.
 |
| Example of follicles being measured with an internal ultrasound. This is like what I would see on their big screens! |
 |
| Another example of someone after medication stimulation. Those are all follicles which become eggs. You can see different sizes. Kind of cool eh! |
One thing I remember that was weird was the feeling in my gut. I didn't have a lot of eggs...but my ovaries were bigger than they were used to. I literally felt like I was carrying a dozen rocks.
2 THe next step is "the Trigger". Based on ultrasound and blood work it is determined the follicles are ready. The trigger is another injection which allows my body to have an LH surge which means ovulation/release of the eggs. This is critical to retrieval and timing needs to be exact!! It is usually 32-34 hours pre-retrieval.
So for me...it was one more injection at the time SOFT calls and tells me to do it. Easy after 11-12 days of injections already. And a bit of a relief...my ovaries are stretched and not happy about it! Think of your belly expanding the way it did over 9 months but in 9 days!:)
3. Retrieval and fertilization day! So...eggs are retrieved from my ovaries(sucked out so to speak), Then the lab does their thing with the eggs and sperm. Due to the lower sperm count we also had a procedure called ICSI.(Intracytoplasmic sperm injection)--> sperm are directly inserted into the egg...so they don't have to fight their way through.
For us this was a long day. The SOFT doctor's do the IVF procedures at a clinic ISIS..in Mississauga. We went down the night before due to the early morning we would be having. Dennis' job was his date with the cup. Yes...as a woman I have had picks and pokes, multiple things shoved up and shot up me....but I don't know if I could deal with the pressure of performing on demand! It's not like..oh well...next time. These are important and high pressure circumstances. His next job was to take care of me the rest of the day!
So...me..I was remarkably calm and that was before taking the Ativan I was prescribed. When it's my turn I get set up with an IV for fluids and eventual "conscious sedation"...so I was awake for it all. This isn't the case with everyone. I am fully monitored with ECG, oxygen saturation and BP. Dennis gets to join me in the room too...and Dr M is lovely and charismatic as always. Everyone keeps chatting as my legs are up in stirrups with god knows what being placed in me!:) At this point I get the IV sedation and two local anesthetic injections...those sting the most. Despite a mini crying meltdown (?meds?emotions??not sure really) it was a really cool procedure. we could see on the screen as he would drain the follicle, it would collapse and then allow the egg to extracted. They counted how many were extracted as they are done...I think we had about 11...not a lot but something.
After I had to wait till my vitals were all good, had some food and then we could leave. Other than being tired and crampy I felt good. So...after that we head home trusting the professionals to do their thing.
So...with the eggs...11 wee retrieved but not all can be used. Some may not be mature enough, occasionally damaged during retrieval, etc. The lab takes viable eggs and injects the best sperm into each egg and then waits. As for me I had to take some antibiotics to prevent ovarian hyper stimulation syndrome... which can come on in a few days. Luckily I did not have this issue.
4.Waiting to hear how things are going with fertilization.
The day after we get a call and are told 4 fertilized! We had hoped for more...but again this was good with our history of issues on both of our sides. Day after all were still growing.
5Transfer day. Procedure is fairly similar to an IUI with a speculum and catheter.
The next morning back to Mississauga we go. It was one of those full bladder procedures to help with guiding the catheter. I HATE those! Dennis will tell you I have the bladder of a 4 year old...and it goes through me so quick. I was so uncomfortable I to pee out so much prior...just so I could relax. The transfer itself only took 10 minutes. Again we could watch. Embryos are microscopic so they put an air bubble on either side so we can see when they are being transferred. We decided to transfer two...which is quite common with most people.
Unfortunately we found out that one of the other 2 did not survive...they still weren't sure if the other would be viable enough to freeze. A few days later...I found out it didn't survive either. That was quite devastating for me....but we were still hopeful with these two!! The next week I took off work to just relax and let nature happen. It's not a protocol but something I need to do for me physically and emotionally. No injections after but I did have to take a medication called Prometrium (type of progesterone) which helps with the uterus environment and implantation. Let's just say you don't take it orally....and of course since my body has issues I got to take a higher dose more often! So..they make them in these "rocket" forms and give you a "rocket" launcher to insert them. My names for them...not how they are referred. But I think it was quite accurate. They are taken until a negative Beta or so many weeks into a pregnancy.
COST?
I won't spend too much on this but I know some want to know. It does vary clinic to clinic and unfortunately isn't covered under OHIP. Those who have blocked tubes due get some coverage...but that is the only fertility diagnosis that does at present. For those at SJHC...not covered under our health plan. I could put drugs through the drug plan. Rough costs:
Meds(after drug plan) $1000+ (mainly due to my high doses)
IVF ~ $5000
ICSI ~$1000
Other expenses are travel, freezing (if applicable, etc)
The good thing is you can claim all of this on your tax return.
I have to say that we are fortunate enough to have the savings to do this. I know many people out there who don't have the same opportunity. SOFT does have some supports for less fortunate families. I have donated back meds that are unopened that I won't be using.
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