IVF: A Basic Rundown

Disclaimer: I'm going to be sharing a decent amount of physical details. Maybe the human body makes you squeamish, so bail now unless you're the type of person who is intrigued by all the gory details (kind of like watching a train wreck). Except they won't really be that gory, promise, just intriguing.  PS it's long.

First of all, why IVF? I was asked this week, "Why IVF? Didn't you get pregnant before?"

Good question. One that maybe you have asked as well. To be honest, we never thought we'd need, or even do, IVF. And believe me, we wouldn't be doing it if it weren't recommended by our doctor as the way we will hopefully be able to have kids.

I did get pregnant before. But it took two years & four looooooong months and fertility treatment. That's not forever, but it was mostly a lucky fluke, unfortunately. Taking that long just isn't normal, especially with everything we tried. And though my doctor is confident that at some point in the next eight years (my childbearing years) I may get pregnant on my own, if we want more than one child we need to get a move on. Since clearly, nothing we've done so far has really been the key.

After losing the baby, we did try for "on our own" six months (three of those months using the fertility meds I was on when I got pregnant), and that is the recommended amount of time to try before going into a doctor if you've been pregnant before. So it's not like we tried for two seconds and then took the easy way out by starting IVF. Since you know, IVF is the easy way ;) and totally the cheapest (ha).

I like to do my due diligence on things and so we've waited the right amounts of time trying all the different options and methods and routes. But along with all these reasons, one of the main reasons we are moving on to IVF is because we feel compelled by God, simple as that. And thankfully, it makes sense logically at this point, too ;) because sometimes when you feel compelled by God, it's hard to wrap your mind around it logically. And I don't think I could get Dillon to spend allllll the money if it weren't for feeling like this is what we should be doing right now ;)

Anyway, what goes on during IVF? Let me tell you. And here's where I get detailed with the human body stuff, FYI.

1. The very first thing is an appointment with your doctor where he or she checks your uterus and ovaries via ultrasound, gets blood work, and gives a prescription for birth control.

The birth control is to give your body a rest from all the fluctuations in hormones and to calm things down in your ovaries since they are about to be stimulated to oblivion. Typically you are on it for about three weeks, but it ended up that I'd be on it for four.

And that ultrasound? I'm talking about the transvaginal kind where they use a wand up there, like a Pap smear. Thankfully they're less uncomfortable than a pap and since I've had about 12 of those ultrasounds already from all our other cycles of treatment, it was no big deal. My ovaries looked "beautiful" so we have high hopes they'll stimulate well. But still, fingers crossed.

After our appointment, our blood work and ultrasound info was sent off to a shared risk program to see what programs we could qualify for finance wise. Thankfully we qualified for the lowest (cheapest) brackets, but all the money stuff is in this post.

2. Next up is a financial consultation and an appointment to get your calendar which tells when to start and stop certain medications, when all the blood work and ultrasound appointments happen, and when to maybe expect egg retrieval and transfer. It is incredibly scheduled out. You'll see in the coming points ;)

3. After that, birth control is started when your period starts.

4. Then, in the middle of that cycle if you haven't already, you have a water ultrasound where they thread a catheter into the cervix, then fill it with water and do another transvaginal ultrasound to check out the lining and cavity shape. If things look good, you're good to go with the timeline set out on the calendar.

5. This is about when you order your medicines from a pharmacy separate from the clinic. The pharmacy is a specialty, out of state pharmacy since regular old Walgreens doesn't have baby making drugs just laying around. It was kind of a fiasco for us and I'm surprised we finally got our meds without more going wrong, but we have them now so I can finally rest easy.

6. A week before stopping the birth control, both partners take an antibiotic and the wife starts taking baby aspirin. I never would have thought either one would be involved, but it makes sense now.

7. A few days after stopping the birth control, you go in for the first official appointment of IVF. Up until that point things are pretty preliminary. You can technically back out if you haven't paid yet, since that's when all the money is due (besides what you paid to the pharmacy). They do another ultrasound and some blood work just to verify your levels are good.

8. If things are good, you start giving yourself shots! And so begins the schedule:

Day 1-2: two different shots in the morning (mine are follistom and menopur--super cool names for meds that should make my ovaries explode). All these shots are given in the stomach, which relieved Dillon and I because we had to watch injection instructions videos and the intramuscular ones scared us.
Day 3: same two shots and a blood work appointment to monitor if you need to adjust meds
Day 4-5: same two shots
Day 6: same two shots and a transvaginal ultrasound/blood work appointment to monitor egg size and potential quantity. This is also when you would add in a shot that makes it so you won't ovulate all the eggs that are growing, because that would seriously be awful to waste all that time and money for eggs to just disappear.
Day 7: Same two shots plus the new one
Day 8-10: Same two shots plus the new one and a transvaginal ultrasound each day to make sure the eggs are getting to the right size. On one of these days (most likely day 10) you get instructions to take a trigger shot to release those eggs! For a lot of women with ovarian problems like diminished ovarian reserve or PCOS, it can take a few more days of "stimming" aka taking the shots.

9. Two days after the trigger shot you go in for the retrieval. This entails being put under and then having a very long, thin needle poked through your vaginal wall to be able to suck up all the little eggs that have (hopefully) grown. The science behind it is amazing and I would love to be able to watch it, but I'm also really glad I'll be knocked out for that poking stuff.

10. After the eggs are retrieved they put the eggs in a petri dish with the husband's sperm where hopefully they fertilize. Then they are monitored for development for the next few days. By day 3 after retrieval and fertilization you will know how many were mature, fertilized, and are developing normally. A good rule of thumb is half the eggs retrieved will be mature, half the mature eggs will fertilize and half the fertilized eggs will develop into embryos capable of being transferred or frozen.

This is also the day when you will be given the date and time of transferring either one or two embryos back in. It is usually the fifth day after retrieval if your embryos are good, but can happen on day three if they are struggling.

11. Transfer day! You take a valium to relax, especially because the uterus is a smooth muscle and that's what valium is supposed to relax. Then, a catheter is threaded up into the uterus and the embryos are transferred. It's a little anticlimactic, but you do get to watch it via ultrasound so that's pretty neat.

12. After that is the dreaded two week wait until you get to take a blood test to find out if it worked and you got pregnant, or you get to start planning a frozen embryo transfer (if you had any left to freeze). During that wait time you either do progesterone shots or progesterone suppositories until you find out. If you are pregnant then you keep doing them until week 10.

Welp, that's about it. We are excited but nervous about this opportunity. We know we're lucky to be able to even attempt this and hope that luck keeps staying on our side. If you have any questions, feel free to ask!