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IVF–Fresh Cycle

IVF (fresh cycle)
by Serenity

Why would you be doing In-Vitro Fertilization (IVF)?

IVF essentially means “fertilization outside the body.” People undergoing IVF can have the following diagnoses:

Blocked, damaged, or inoperable Fallopian tubes
Male factor infertility (low count, abnormal morphology, etc)
Women with endometriosis
Unexplained infertility
Immunological issues

In general, an IVF cycle consists of a phase where you will suppress your body’s tendency to ovulate with a GnRh agonist subcutaneous medication such as Lupron, then use a follicle-stimulating medication such as Follitism or Repronex to super-stimulate your ovaries into producing a number of eggs. When you have a number of mature follicles, you’ll “trigger” with a shot of HcG, and exactly 36 hours from that shot, your doctor will extract them in a retrieval which is usually done under general anesthesia. From there, embryologists will take the mature eggs and fertilize them with sperm. Transfers of the resulting embryos (6-8 cells) or blastocysts (multiple cells) take place either three (embryos) or five (blastocysts) days after the retrieval. Any excess embryos or blastocysts from the procedure can be cryo-preserved (frozen) for future frozen embryo transfers (FET).

What you can expect

In general, an IVF cycle involves a lot of needles – depending on your protocol, the agonist repression, follicle-stimulation, and trigger medications are delivered via subcutaneous injections. There are some agonists that can be delivered in an inhaler form – you “sniff” the agonist once or twice a day. But generally you will be required to give yourself daily injections.

When you begin your follicle-stimulating medications, too, you can expect ultrasounds and blood draws every other day and/or every day leading up to the retrieval. Additionally, as you get closer to the retrieval, you might become a little bloated and uncomfortable from the extra eggs that are developing in your ovaries.

For the retrieval, like any other procedure under general anesthesia you will be advised not to eat or drink after midnight. When the procedure is over you may feel some pain from the egg extraction and/or nausea from the anesthesia.

And because a doctor is surgically removing the egg from your follicles, there is no corpus luteum to generate progesterone. So after the transfer, you might also be required to have someone give you daily progesterone-in-oil (PIO) intramuscular injections, depending on your protocol (if you’re lucky like I was, you’ll just get the prometrium suppositories instead).

There are a host of potential side effects of the medications you’ll take during IVF cycle. During the repression phase, you may be prescribed birth control pills, which might cause headaches and PMS-type symptoms. In the stimulation phase, you might feel physically uncomfortable and have headaches (I had massive migraines with my Gonal-F until they reduced my dosage). After the retrieval, expect to stay home from work for a few days – you will be bloated and at least a little sore.

Problems that might arise

The biggest issue that might arise is Ovarian Hyper-Stimulation Syndrome (OHSS), where the follicles after the retrieval fill with fluid and leak into the abdominal cavity and into the chest. Symptoms of OHSS include rapid weight gain (2lbs or more per day), inability to urinate, fullness/bloating in your abdomen, and/or a shortness of breath. Mild OHSS will resolve itself in a few days, though if you get pregnant it might take longer. But moderate and severe OHSS can be life-threatening, though fairly rare – less than 1% of patients end up with OHSS this severe.
However, your doctor will monitor your estradiol levels (E2) via bloodwork just before the retrieval. Levels over 5000 are generally not recommended – if this is the case your doctor may have you “coast” (i.e. skip your injections) for a day to decrease your levels.

Personal tips

Take things a day at a time. I was totally overwhelmed with the number of needles and medication I needed for our IVF cycle at first, so I just focused on what I needed to do that day. Before I knew it my medicines were almost gone.

If you can’t do the injections yourself, have your husband do them. I have no issue with needles and did my own injections. However, most women seem to prefer it if their husbands do their injections, and it’s a nice way to keep him involved.

If you do your injection slowly, chances are you won’t bruise. I found that when I rushed my injections I ended up giving myself a bruise. Slower is better.

Drink plenty of Gatorade after the retrieval to replenish your electrolytes. The more fluid you drink, the better chance you’ll have at healing more quickly.

It takes longer than you’d expect to recover from the retrieval. Granted, my E2 was at 5178 when I triggered, so I had a moderate case of OHSS, complete with a burst follicle. But I couldn’t walk far at all for about 5 days after the retrieval, so I stayed home pretty much for an entire week. Just be prepared that you’re going to be uncomfortable and might need to stay home and rest up.

15 comments

1 Anonymous { 12.26.06 at 8:50 am }

thanks. this was simple and helpful.
peace
shlomit

2 Anonymous { 10.06.07 at 10:22 am }

This was helpful and good to hear from someone else in the same boat.One day at a time is the best advice. It’s easy to get overwhelmed.

Kindly,
M

3 Anonymous { 12.14.07 at 10:32 am }

Thank you. My estradiol level is 5012 and am going in for the retrieval tomorrow morning. I’ve been worried about being overstimulated too, so it’s helpful to know that you took it easy for 5 days afterwards.

4 gorgonzola { 04.01.08 at 2:57 pm }

Finally! I’ve been searching all over for exactly this. Thanks.

5 Anonymous { 07.28.08 at 6:24 pm }

I am currently in the stimulating phase. I have cramps and severe headaches. Has anyone else experienced this too?

6 Anonymous { 09.09.08 at 2:53 pm }

I have retrieval tomorrow. My E2 yesterday was 6000. I am a little worried that I will have to freeze all the eggs to prevent OHSS. It is so complicated!! Trying to have a hopeful and positive attitude!!

7 etc @ Fierce and Nerdy { 09.29.08 at 2:01 pm }

I just went through a retrieval this past Saturday and wish I had read this ahead of time, as I had scheduled no less than 4 can’t-miss things this weekend. I could walk, but it was very uncomfortable and though I am feeling much better now, I have these occassional twinges of pressure that feel almost like gas, trying to pass but hurt. Anyway, I’ve decided to start blogging about this in the hopes that it’ll help other people going through the same thing and I also hope it will help me process it all. If you have any interest, check it out: http://fierceandnerdy.com/?p=1574

8 JoyfullyHis { 11.07.08 at 10:06 pm }

My best friend is gearing up to do her first IVF and recommended reading your post first so I’d get a better picture of what she’ll go through. Thanks so much for spelling it out. It’s always easier to get through if you know what to expect. Now I know exactly what I can do to help her through this. Thank you.

9 Zetetic { 02.10.09 at 8:47 pm }

My hubby and I did IVF because we both had factors regarding infertility. I was at risk for Ovarian Hyperstimulation, but luckily I was able to complete the cycle. I had 18 eggs. Unfortunately, I think something was wrong with my eggs because I only had two viable blastocysts to implant. I got pregnant and carried for 8 weeks. I suspect that my embryo was not developing as well as it should have. At 6 weeks they insisted that I come back in 10 days. At that time I didn’t even know something was wrong because I felt very pregnant and had morning sickness. When I showed up at the 8 week marker, I brought my husband because I wanted him to see the baby’s heartbeat. The doctor had to tell us there was no heartbeat anymore. I was so upset, they had to take us into a separate room because I couldn’t stop crying. I told them I needed them to prescribe something to get me through the week. They gave me Zanax. I wanted to find out why the baby had died. I had never been pregnant and I felt like I had been robbed. Later I was told it was trisomy seven(not compatible with life), a random mutation. It has been four months and I am now considering a second cycle. I am thinking of starting in April.

10 Cinderella { 07.31.10 at 2:36 am }

Thank you for your help!! Reading these blogs makes me feel better. I suffered an ectopic pregnancy back in November. Just had surgery to remove my right fallopian tube and was told that my left one was totally scarred and my chances of another ectopic was over 90%. My husband and I have been a huge emotional mess. We are going to try IVF in September. THank you to everyone with their kind words and advice.

11 Lyn { 09.07.10 at 7:40 pm }

Thanks for the info. We are looking into IVF (2 years of IUIs have done nothing) and I’m a little scared of it.

12 CC { 05.10.11 at 12:35 am }

This was helpful, but I also need information on the cost of IVF. My husband won’t even consider it if it costs “too much”. I don’t think there is such thing as “too much”. If you really want a baby, you’ll do whatever it takes, but he doesn’t see it that way. Thanks!

13 Red Nelly { 09.06.11 at 4:20 pm }

Oof! Reading all this makes me feel a bit queasy. I was aware of some of the side effects but no-one had mentioned daily injections before! Or maybe they did and I somehow blocked it out.
We’re not sure if we’re going to go through IVF yet, there’s a lot to think about. But thanks to your article I feel a lot more clued up now. Thank you.

14 IVF terrifies me | Making Babies on the NHS { 09.06.11 at 5:10 pm }

[...] Queens is a brilliant blog with a superb name but I have to admit that reading this page about the realities of IVF has really upset me.  Ultrasounds, blood tests – fair enough, but general anesthetics [...]

15 luckie { 09.21.11 at 5:10 pm }

i am in my first cycle of IVF and just had my retrieval today. I had 7 eggs. I will go in for the transfer most likely on sat. it is not that bad of an experience if you put it in the perspective that you are working on creating a little baby! yes the injections have not been pleasant however will have been worth it. i do believe in the mind body connection so I hope being positive about it will help. Being a nurse it was not bad to give myself the injections overall, you just have to really psych yourself up. Besides my husband passes out if he has to deal with needles.

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