Today was the appointment with the doctor. She asked me for the first day of my last (current cycle) period, how many embroyos that we wanted to transfer, and if we had any other questions.

We talked about the 3 day transfer compared to the blastocyst (or known as 5 day) stage transfer. Everything that we’ve read and heard, was that the blastocyst was the way to go because this mimics the way that the normal cycle is like. The doctor told me that this was all false. In fact, day 3 are better because it’s the least amount of time out of the uterus. With the 5 day transfer it’s a long time to be out of the body and to be transferred again. Also, with the day 3 transfer then you can freeze the embroyos whereas the day 5 are usually for the last of the frozen embroyos. It has been found that the blastocyst stage has a higher chance of miscarrying and failing. We’ve decided because of this, we’ll try the day 3 transfer.

I asked about blood, as I will have to be going through a surgical procedure, and if there’s a backup of this for just in case. She said no because you don’t bleed that much and its not that much of a surgical procedure. Its extremely rare that anything like that is to be needed.

I have a heart murmur, so they will be giving me antibiotics just to be on the safe side for the egg retrival.

Our next steps would be:

This will all be done step by step by the patient coordinator. The cycle will go very fast and our heads will be spinning….but this is the same as what it was with the IUI.

I’ll be on 150IU for the shots, which is double the dosage that I was on for my IUI, but lower than the normal starting dosage of a person which is 225IU.

As per Dr. Vollenhoven’s instructions, I called and talked to our/her personal coordinator, Fiona te Wierik. She went and got our file from the doctor. She said to do the following:

Ø      Get the persciption for our birth control (Nordette ED) pills filled . This is the standard type of pill which is used to regulate a woman’s hormones.

Ø      Take only the 21 which are the regulate pills not the few pills which are the sugar pills (usually taken when you have your period). Start these during my period (day 2) starting in early January 2005

Ø      Call Fiona back on the 11 January as they don’t open up until the 10^th because of the holidays.

I went up and filled the script that Dr. Vollenhoven gave me. Its one packet but there are 4 months within it. I’m to take the one yellow or Levonorgestrel 150µg and Ethinyloestradiol 30µg tablet starting on day 2 of my next cycle. See photos below for more information.

This is the outside of the generic packaging.

Yesterday, 5 January 2005, I finally got my period. Today is day 2 and, as per instructions from the nurse, I will start taking the birth control pills.

7 January 2005 – Today is my 2nd day on them and so far I’ve had the craps (To Much Info I know), felt sick and slightly dizzy. I don’t know if its from the pills or not. I’ve never had anything like this before when I was on Diane 35ED birth control pills. I’ll put up with it unless it gets really bad and then I’ll mention it to the nurse on Tuesday next week when I call.

The nurse read through the many notes that Beverly put down about us. She asked us if we where using a fresh seaman sample (which we are) and asked me why Beverly requested the antibiotics (which is because I have a heart mumur). Also, she asked many times about health insurance and I said no, just Medicare.

We have to pay $2262.70 on our appointment with her. The appointment is Thursday 13 January 2005 at noon.

I’m to bring my IUI bag which has needles, the injection pen, etc in it from when I did my IUI.

I asked about all the reactions etc I’m having to the birth control pills and she said that sometimes the pill gives people high blood pressure and to go see my GP about it. She said they might have to have me stop the pill or something but we will talk about that after I get back from my GP.

I called and made an appointment at 2:45pm today to get my BP checked and if it’s the same dr I always use (Dr. Pathy), I’ll have him see to my back as well. I’m to call her back tomorrow to let her know how I go with the dr appointment today.

Dr Appointment:

Well I my blood pressure’s ok and the new dr I seen (my old dr sold his practice to 2 other doctors) seemed to think it was a stomach bug or something that I picked up or a combination of the BCP and the stomach bug. She just told me to eat bland food for the next couple of days and to drink double the amounts of fluids.

I have to call the nurse back on (tomorrow) Wednesday (12 Jan) to let her know what the doctor had said.

This was a forms and information meeting with the nurse. This is where you filled out forms for paying for the cycle, costs of medications, Medicare health forms, and to ask questions and for the nurse to get to know you and your history.

I outlined our history of trying to have a baby. Next, she told me about rest of the downcycle, which I’m now in. I’m to start the Synarel nasal spray on the 22 January 2005 and my last birth control pill to be taken is on the 26 January 2005. The lapping of the nasal spray and the birth control pill is so it will really downgrade the hormones and send me into a medicated menopause. I may or may not have a period while this is being done.

I will continue the nasal spray until the 1 February 2005 at 9:30am. Then I go in and will have a blood test and ultrasound done to see if the nasal spray and pills have worked on my hormones to put me in the medicated menopause.

If it has, then we will begin injections of FSH (Gonal F) at 150 IU dosage (probable start date of 1 February 2005). This will be given into the belly with another type of pen similar to the one used in the IUI. Then after more bloodwork and ultrasounds (about 2-3 per week) when the eggs are a certain size, I will be told to use a “trigger” shot of pregnyl (of 10,000 instead of the 5,000 amount given in the IUI). The time for this will be given to me by the nurse when she calls to let me know of the blood and ultrasound results. Then I will be given the day and time of the egg retrival.

If it hasn’t, then they will wait a few more days and retest me and then start the injections. If, after the 2nd test, then they might be forced to cancel the cycle.

At the start of the injections (about the 1 February 2005), I’m to call and make an appointment with my doctor for 6 weeks time (about 14 March 2005) to either get a good luck handshake or what to change to make the cycle work.

The egg retrival will be around the 14 February 2005. I have filled out the paperwork already to go in and have the retrival and transfer done. The retrival will cost another $600 + surgeon +anaesthetist (if there is one +surgeon assistant). At that time, the sperm sample will be taken and will be put with the egg in a dish. They will watch them for about 3 days.

The day after the retrival, I will start the Crinone Vaginal Gel, which will be squirted into my vagina and uterus. I will continue doing this until the pregnancy blood test. Also, call the nurse, and she will let me know how the eggs are doing and what the results are at that point. Then after the 3rd day when everyone is happy with the result of what’s in the dish, I’m to go in and they will use another ultrasound with small tubing at the end and we will see the eggs be put back in.

From there, its just a waiting game for 14 days. On the 14th day, then I will go in and they will draw some blood in the morning. In the afternoon, we will get a phone call to tell us if we have succeeded or if its another failed cycle. (probable date is the 4 March 2005).

Then we go back to our doctor, which we have an appointment made for the probable date of 14 March 2005, no matter if it’s a positive or a negative result.

This morning (22 Jan 2005), I took my first spray of the nasal spray(one spray to the left side). It was fine and not really hard to do at all. I kept my head back for about 3 minutes and then put everything away then went back and climbed into bed.

I did experience dizziness for about 30 minutes about 30 minutes after I took the spray but then was fine. About 3 hours after the dose, I also started feeling my body going from hot to cold to hot again (in other words – hot flashes). They’ve been tiny but on and off since I took the dose this morning.

I’m getting ready to take my next dose (one spray to the right side) in about 45 minutes. I had almost no symptoms like those during the first spray. This medication will continue until February sometime.

On the nasal spray, I’ve had spotting on the 24th and 28th January and then had a light period on the 30th and 31st January. This is common with the nasal spray and hasn’t been as painful as what it usually is. Furthermore, I’ve been very tired and have had cravings for sugar which are both normal side effects of the nasal spray. Now just waiting for the blood test to see how downgraded my hormones are.

This blood test, which I have to go in for at 9:30am, will show if the taking of the birth control pills (BCP’s) and the Synarel nasal spray have downgraded my hormone levels to zero or near zero. If so we can continue on, if not we’ll continue a day or two and then take another blood test.

If by the second blood test, it hasn’t downgraded them, then the cycle will be cancelled.

Went in and signed a heath insurance form for the blood test and now waiting for results to be phoned to me.

2:40pm

The results just came though. My hormones are downgraded like they are supposed to be. I’m to keep on the nasal spray and start the injections of the FSH (Follicle Stimulating Hormone) Gondal F, which promotes the growth of more than one follicle/egg. I will start on 3 February at night and continue until told to stop along with the nasal spray. This injection will be given the same dosage at the same time at night. The dose I will be on is 150 IU., which is lower than the standard 250IU. because of my having PCOS. This is a precaution so I won’t hyperstimulate on the drug.

My next appointment is on 8 February at 9:15am for an ultrasound and blood test. I will first go in for the internal ultrasound to see how many and how big the follicles are and then into get blood drawn.

I will then get results that afternoon like I did today.

Last night was the first FSH injection. It was very simple compared to what had to be done for the IUI shot. This injection already had the medicine in it and it primes itself, so all you have to do is swap the area, swap the top of the “pen” where the medicine is, rip the top off of the needle and put the needle in and twist it on. Then Brett dialed the number of medicine which they want us to use (150 UI I think it is), (also, a bubble will appear at the end of the needle or primed automatically) and then put it into the skin and push the button on the pen down until it doesn’t go anymore, wait 10 seconds and then remove it and throw out the needle and put everything back into the refridge. It takes, at the most, 5 minutes. That’s with getting the medicine out, opening everything, giving the injection, and then cleaning up. Usually the first shots take longer (and Brett’s hands shook like crazy) then as you get used to taking/giving them the time gets shorter and shorter.

I have had some hot flashes and can feel tingling around my ovary areas, so the medication seems to be doing something. We shall find out on the 8th how the shots are reacting on me.

I’ve been on my injections now for 6 days (tonight I will be have my injection number 7 at 6pm – as per normal). I had to go for my first ultrasound and more bloodwork today. We went in and had the first ultrasound and could see a lot of follicles sitting there. It was really encouraging. This was on both right and left sides. The nurse which did the ultrasound said that they are going to have to watch me carefully the next few days because they don’t want me to hyperstimulate.

Next, I went next door and had my blood taken. Now its just sit back and wait for the results.

3:15pm

I just heard from my personal nurse that everything is looking great. I had the following:

1 15mm
2 14mm
1 13mm
1 12mm
2 11mm
----------
7 eggs

They will not count the ones that are below 11mm because they are too immature and will not fertilise properly. Also, remember only about 75% have eggs in them and then you have the ones which don’t fertilize as well.

My egg retrival is now slated to be done on Saturday 12 February 2003.

This means that I take my medications tonight (Tuesday) and tomorrow(Wednesday). Nothing on Thursday morning and call the nurse after 2pm on Thursday to be told what to do next concerning the trigger (10,000 pregnyl) shot and time for the ER (egg retrival).

I called the nurse and she had to call me back because she was on the phone with someone. She rang me back and asked me to do my trigger (Pregnyl 10,000iu) shot at 7:30pm tonight.

Then I go in for my egg pick up on Saturday 12 February 2005 at 8:30am. Brett’s to bring a sample with him within an hour of my adminitance time of 8:30am. We’re to keep the sample in the inner most pocket of Brett’s jacket until we get there.

I asked about getting photos of the embroyos that will be inserted and I’m to tell the embroyologist that we want photos of the embroyos and they will take them and give them to us next week when we have them put back in.

I will be given Cinone vaginal gel which I will start on Sunday 13 February 2005 and will continue this until the pregnancy test.

At about 7:25pm, we took the small vital of water and mixed it with two vitals of powder. When the water is put in, it instantly dissolves the powder into the water. We then draw up the whole mixture into the syringe and then change the needle to a smaller one. You hit the outside until all the air bubbles disappear and then you wipe the alcohol swap on your lower belly, and insert the needle then push down and inject the mixture into the lower belly.
This is to be done 38 hours before egg collection.

We left about 8:10am and arrived at about 8:25am. We checked in the office, filled out forms and checked the information on labels. I gave them the $600 for the egg collection and then waited in the waiting room for about 5 minutes.

About 8:40am, we where collected from the waiting room and brought around by the nurse. She took my weight, heart rate and blood pressure. She then had me sign the permission slips understanding about the procedure. We then where taken to a small cubicle which had a chair and small bench in it. I took off my clothes and put them in a basket, and put on one gown frontwise (opening in the back) and one gown as a robe. They also gave you a small blanket to put on your legs along with some paper slippers.

We waited there for about 10 minutes until moved into an office to meet with the doctor, anaesthesist, embrologist (spelling?), and nurse. The embrologist came to talk with us about the eggs and any questions. She stated that I had 23 follicles in one ovary and 22 in the other, but because they only take the follicles greater than 11mm, that’s why there was only 7 on Tuesday. She also took the sample from Brett and said that usually its about 10 follicles that they want per person. You could have more or less but that’s a general number which they go by. The anaesthesist listened to my heart on both the front and back to make sure everything was ok. Then I was taken by the nurse from the room, said goodbye to Brett and walked into the area for staff.

I stopped by the embrology room so that way they could check my bracelet, state my name and date of birth. All paperwork was checked. I then was told to go into the operating room. I had to take the outside gown, so all I had one was the one with the opening in the back. They took my glasses and everyone said hello again to me. The anaesthesist and nurse talked to me and put my IV in. Then the anaesthesist gave me one shot and then another and then I was out like a light.

Upon coming to, at about 10:30am, I heard someone talking to me. I had a drink and then they waited a few minutes and then let me sit up and then gave me a second cup. While I was drinking that, the doctor came around and asked how I was feeling and told me that they collected 11 eggs! A lot better than the 7 eggs that they counted on Tuesday (8 February)! Brett was called then and told to come and get me about 11am. I was then given my clothes and told that I could get up out of bed, but to be careful as I would still be woozy from the anaestheia. I slid over and had my legs off the trolly, and put my top half of clothes on, socks and dropped my slip on sneakers. I then slowly got up and waited a few minutes. Then I put on my underwear (careful to keep the pad into place because you have a tiny bit of bleeding), pants and shoes.

Brett arrived at 10:50am because he knew better than be late. He sat with me in the chairs and I had another glass of water and a sandwhich while talking to him and the nurses. The nurse told me about the Crinone gel that I’m supposed to start using tomorrow night. It is a progesterone gel which you insert up into your uterus. I had the IV taken out and finished up the food. I waited a bit longer only because I was still feeling woozy a bit and didn’t want to chance leaving and the fainting or something. I went in to the toliet to see how badly I was bleeding, but it wasn’t that bad only about a light spotting. The pain really isn’t that bad either. Its about equal with monthly cramping if you get that. You do have to be careful with how you get up and down from sitting/laying because that’s when its at its worst.

Once we got home, though, I remembered about my script for some antibiotics for my heart mumur and had to call them at the clinic to get the doctor to make me out one. This is only a precaution because we don’t want any kind of virus to get into my heart. I rang, the nurse went into see the doctor and he wrote out the script. I had Brett go back and pick it up. Later I will go out and get it filled, but just relaxing at the moment.

I was told just to sit back and put my feet up for the rest of the day and that’s what I’ve been doing since I got home.

Next steps are: start the crinone progesterone gel, get the script for the antibiotics filled and take them, and call on Monday to see how the embroyos are doing. Remember its very likely that we will loose a few embroyos during this process, so we’ll be happy with anything over 6 embroyos.

I have started the progesterone gel as well. This is fairly simple. You just shake the tube down like the old fashioned thermometer (spelling), twist off the one end and insert it like you would a tampon. Once inserted, you squeeze the bulb end until you can’t squeeze anymore. Wait a few seconds and then take out the tubing. There will be a tiny bit left inside the tubing, but its ok because that’s how they’ve measured the dose. I asked and they said it would probably be good to take this right before going to bed, so that’s what I’ve done.

I just heard from the nurse. We found out that out of the 11 eggs they collected only 5 fertilized. Out of the 5, only 3 are normal. That means that if these don’t work, next time they will have to do ICSI, which is where they put one sperm inside each egg. It’s a very low rate at this stage, but we still have a chance with the 3.

I will still have the transfer done tomorrow. I need to drink 2 glasses of water at about 8:45am and then have a admission time of 9am.

15 February 2005 – Embroyo transfer of 2

We have 2 good eggs and a not so good 3rd egg, and will be transferring 2 embryos. The third one will be frozen, if it survives and to be used later if these don’t take. My admission time is 9am in the same place as I had the egg collection taken.

9:30 am

I went in and was readmitted and filled out the paperwork (Name, address, etc) and signed more payment paperwork ($200 for transfer). We then sat and waited until they were ready for us. We sat there for about 10 minutes and were taken in the back. We seen the nurse that we seen to get the egg collection done. She asked about a full bladder. I was then taken into a room to talk to the embrologist (sp?). They said about how many survived and about the two that were going to be transferred. I then asked after the 3rd egg that was possible for a frozen/transfer later. It was looking ok until the day before and then it was slowly looking not too possible. They said that they’d keep it until noon today and if it wasn’t progressing it would be discarded. I asked for a copy of the photos of the embroyos, which I got.

Transfering of the 2 embryo's took place. It took about 20 minutes to do the procedure. They had to have me with a full bladder because of the external ultrasound. It acts as a "window" to see into the uterus and helps them place the embryo's in the right spot. We where then taken down to the transfer room. I walked in and there was an ultrasound machine, a chair for me and a chair for my husband. There was a stool as well for the person putting in the embroyos. I had to take off my underwear, pants, shoes and hop up on the chair and put the blanket over my legs. One of the girls wheeled in cart that would hold gloves and other things that they would need. You had one girl holding the ultrasound wand on my belly with jelly and the other one that stuck the thing that keeps your cervix open. Once that was done and everyone was comfortable and they inserted the tubing for the transfer to take place, they used a walkie talkie to call in and had them bring us our embroyos. The one between my legs (which was one of the nurses we had contact with when we did our IUI) put the embroyos in and you could see fluid inserted into my uterus. It didn’t hurt, it was a warm feeling in your uterus.

After the procedure, you have to sit there a bit, because they have to check the injection syringe, to see if the 2 embryo's both have left the syringe. A lot of embarrasment will happen, if they didn't do this procedure. Nothing like going through the whole process only to find out that no embryo's got transfered. Then they had me get up and put on my pants and other things and gave us a drink and something to eat to calm down, the paperwork for a blood pregnancy test in 2 weeks and relax. Also, a visit to the bathroom was in order as well. Once we were done, you could leave and go home.

10:30 am

We left to go home and put the feet up. And now we will see if 2 weeks, what happens. Here's what they look like at the time of the transfer : One is a 5 cell and one is a 6 cell which is what they look for in doing a transfer.

I’m to keep up the gel and take the pregancy test in 2 weeks time.

16 –23 February 2005 – Yep I’m bored.

Well, in the last week and a bit I’ve done nothing really except for watch TV, read and basically laze about. Its different than when you want to do those things because you have to relax and hopefully things take.

24 February 2005 – Spotting

Today, I’ve started spot. At first it was just a tiny bit but I’m also having cramping as well as the spotting, which is still there. I’ll have to call the nurse tomorrow and let her know.

25 February 2005 – Call to nurse and bleeding

Well, I’m still bleeding and the cramping is getting more painful. I called and talked to the nurse and she asked me how much I was bleeding. It was a light period I was having but a lot of cramps. She wants me to keep up the gel and still do the pregnancy test on Monday.

26 & 27 February 2005 – Still bleeding

I’m still bleeding and its still painful at times. Also, its gotten very heavy as well. Its strange really because I come to that conclusion and it lessens. Since a few days after the transfer, I have my boob tenderness that I’ve had since a few days after the transfer, feeling sick, going pee about every hour and getting up during the night (which is different because I didn’t even have this when I was pregnant before!). Its very strange but everything will be sorted out tomorrow with the blood test.

Also, I have the bill from the person who put me to sleep for the egg collection to pay which is a further $200.

28 February 2005 – Pregnancy Test day

I went in and had blood drawn for the test. At about 3:30pm, I got a call telling me that I was not pregnant and I had to go back and see my specialist, Beverly Vollenhoven again, which I have an appointment for on the 15th March 2005.

15 March 2005 – After Cycle Dr appointment

Today was the final outcome of the cycle with our main Specialist, Dr. Vollenhoven. She said that all my eggs were mature, sperm was a normal and good range. Our main problem was fertilization (as like we didn't know THAT one). She says that we'll go through ICSI next time to try and get the range of fertilization to about 50-60% which is the ideal rate. About 10% of couples which go through a normal IVF cycle will have this, so it is common.

We also asked some questions regarding more of the treatment and some other concerns.

Question: Clomid - Is overextended use make you infertilie?

Answer: No. There is no concern because it does not affect fertility.

Question: Assisted hatching - Do you do assisten hatching?

Answer: No. Here in Australia we cannot get the hamsters which they use, so they do not do this here. Also, they have done trials with hamster eggs that are hardened and no hamster eggs that are not hardened and there was no difference in fertility of one over the other.

We where told that my eggs were all mature and in proper condition, which is the main part but now we have to go ahead and have the ICSI done if we do another cycle. The dosage would stay the same (150UI) because I was good on that dose and another scan at day 6 for the follicles to see how many eggs there are.

Our next step, if we go that far, would be to contact our nurse, Fiona, about 3 weeks before we want to start our next cycle. Upon doing that, we will be told what day to start the birth control pill again and when to go in and see Fiona for more meds. The only thing that would stop us from doing this is if we wait something like 3 years before giving it another shot on the IVF.

At this point, we got $1033.20 back from Medicare (for the IVF itself), and have paid all accounts. Also, the $600 and $200 for the egg collection and the transfer we cannot claim back as it is in a private hospital, which you cannot claim on. I will have to claim on the $200 from the Anaesthetist later this week.

Last updated 15 March 2005
© Copyright by Jo Ann & Brett Fitzgerald
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