Are You Serious?

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Where was I?  Oh yes, my next appointment.  I think I may have mentioned this but each time I went in for an appointment, I had blood work.  So, not only was I injecting myself, I was being poked in the arm every few days.

Anyways, getting back to my appointment.  I was still bleeding and I made sure to ask the doctor about the pain I felt over the past few days.  He attributed much of the pain to coming off birth control (having been on it for almost 2 months).  I just went with it, even though I felt like something was wrong.  What were they going to do?

The ultrasound revealed at least 10 follicles growing.  I can’t remember the exact number.  I was quite amazed to see all of that.  The doctor would call out numbers that confused me…I didn’t know what some of the numbers meant.  For example, if the doctor said “one twelve, two tens.”  What he was doing was counting the follicles and measuring them at the same time.  So, one twelve meant that there was one follicle that measured 12mm.  The same for two tens, that meant that there were 2 follicles, 10mm in size.  Make sense?

After the ultrasound, the doctor talked to us about the lining of the uterus.  It wasn’t doing what they want it to do…grow!  At my first appointment the lining of my uterus was thick, that was before I got my period.  At my second appointment the doctor expected me to get my menses.  At this third appointment I was still bleeding and the lining of my uterus was not cooperating.  So, the doctor discussed the option to freeze the embryos after the egg retrieval and transfer them at a later date.  It wasn’t part of the plan, but it made sense.  If the doctor transferred the embryos the probability for pregnancy would pretty much be zero.  The lining of my uterus was not thick enough to support an embryo transfer…they wouldn’t have anything to attach to.  It would be a wasted IVF cycle.  The decision wasn’t finalized, we just had a discussion about it.  We would have to see how the next 1-2 appointments go before deciding.

At the end of this, my third appointment I was given further instructions by my doctor and IVF coordinator.  I was going to start a second injection…Ganirelix.  If you’ve read some of my previous posts, you would have seen a picture of this injection.  It is in a clear glass syringe and pre-filled.  The purpose of this injection is to prevent ovulation.  Oh boy!  Now I had to keep track of both injections!  It’s not that hard, but 2 injections in one night?  Oh dear.  One is already enough.  Having to take 2 would be much more interesting.  Since my follicles were growing it was important that my body not ovulate on it’s own and release and unknown amount of eggs…hence the Ganirelix.

My next appointment (4th) was scheduled 2 days later.

Before I get to that appointment, I want to talk about the Ganirelix injection.  The Ganirelix shot was so sore!  I haven’t figured out why yet.  The box says that it’s the same sized needles as the other injections.  It hurt and caused bruising…not fun.  Since I had the other injection, I did that one first and then the Ganirelix.  I alternated sides, not injecting anything into the same side or near the same injection site.  So, I had to do the same thing…pinch the skin about 1-2 inches to left or right of the naval, alcohol prep it, and then inject.  I took a deep breath between the injections!  The Ganirelix injection needle hurt going in, but injecting the medicine didn’t hurt at all.  That shot was the most painful injection.  I knew that I had a limited supply of the Ganirelix injection, phew!  After that first Ganirelix injection, I wasn’t sure how I was going to make through 3 more!  Yikes!  Luckily, I only did one more Ganirelix shot!  It hurt the second time too!

There was something else going on…the lining of my uterus.  So, despite having to do all the injections, the lining of my uterus was going crazy!  I didn’t know what was going on!  At random, the lining of my uterus would shed…and I needed to be near a bathroom or my clothes would be completely soaked in blood.  I first noticed it at the end of my work day (in between my 3rd & 4th appointments).  I was in a meeting and I felt this surge of blood.  It was weird.  My meeting ended soon after and I went to the bathroom…where a huge chunk of the lining of my uterus came out.  This continued at random for 2 more days…with the same pattern, a surge of blood and then a chunk or more of the the lining of my uterus.  I didn’t know what to do.  I thought it was a side effect of the all the medications.  Since I was scheduled for an appointment the next day, I decided to bring it up then.

So, I did.  At my 4th appointment the doctor confirmed that it was most likely a side effect of the medications.  Just as I suspected.  When the doctor did the ultrasound I couldn’t keep up with the number of follicles, there were just SO many…I gave up counting.  I was reminded to take the injections one last time…one more Ganirelix and one more of the Bravelle and Menopur mixture.  It was at that appointment that the doctor decided we would freeze the embryos on egg retrieval day.  We would instead focus on the follicles.  On top of that, I was scheduled for an appointment…the next day.  That was not on the schedule.  I didn’t expect to have an appointment the next day but I just had to go with it.  Like I’ve mentioned before…flexibility.

I wasn’t too happy about having to postpone the embryo transfer because I knew that meant I would have to wait longer to know whether the IVF cycle was successful or not.  I was frustrated though, only because I had to wait.  I felt as though I’d waited for so long already.  I thought, “You have got to be kidding me!”  There’s really nothing I could do about it.  The follicles and the lining of my uterus were the new focus and priority.

So, that night after my appointment, right at 6:00pm I did my last 2 injections!  Well, not exactly…but close enough.  I knew I still had 1 more injection, the HCG shot.  The Ganirelix still hurt but I was relieved to be done with that.  Up to this point I had done 8 consecutive days of injections, 10 total injections.  The last 2/8 days were 2 injections each.

Ok, the next day I went in for my 5th appointment.  It was a Sunday and due to the time of my appointment, I was unable to attend church.  Just in case you’re wondering, we went after we came back.  Getting to the appointment was little different.  The building where the doctor is located is closed on Sundays.  So, we had to call so they could let us in.  I think it’s more work for the employees because they have to run around everywhere and be available for the next client coming in.  We made it and everything went smoothly.

The ultrasound went well and I still lost count of the number of follicles.  I didn’t care at that point, I knew it would be enough when it came time for the egg retrieval.  We left with more instructions and injections.  The doctor made me a special dosage of HCG and added a second injection of Lupron.  While he made those for me, my IVF coordinator talked to me about the antibiotic (Doxycycline).  My husband and I were given the same instructions to take one pill each that night and the next (2 days total).  It was an antibiotic to prepare us for the egg retrieval.  The doctor gave me the 2 injections with instructions to refrigerate them until it was time to inject them at 9pm.

Here is a picture of the antibiotic Doxycycline (left), and the alcohol prep pad.  I used an alcohol prep pad for each injection.  A little further down you’ll see the last 2 injections.

  

The HCG shot makes you ovulate and it is given at a specific time, 36 hours before the egg retrieval.  Lupron is used to treat endometriosis, which I have.  So, at 9pm that night the shots were injected one at a time.  I have to say, I think the needles were smaller.  I didn’t feel anything.  No pain, nothing!  That was awesome and such a relief after the Ganirelix injections!

Below you will see the 2 injections.  The injection on top is the Lupron and the one on the bottom is the HCG.  They are not labeled so I’m guessing here. But I’m pretty sure I’m right because the one on the bottom is a higher dosage (75 units), exactly what I was prescribed for the HCG injection.  The one on top is a thinner syringe that has 35 units.

The next day I went in again just for blood work.  I also brought in my HCG shot.  Since the doctor made one for me, I still had one at home.  He said I could give them mine, so I did.  That was one less medication to worry about.  The lining of my uterus stopped shedding.  I believe it was the Lupron injection that stopped the random shedding for 3 days.  That was a blessing and very helpful.  We took our antibiotics that night and reviewed the instructions for the egg retrieval.

As promised, here is the video!!  It shows how to mix the injections.  I’m just going to apologize in advance, it’s a long video.  I’m not a professional.  Lol.  I hope you have a better idea of how it’s done.

Thanks for reading and watching! 🙂

Next post:  Egg Retrieval Day


Ready, Set, Go!

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It was time to get started!!!

The IVF process, mainly the injections, remind me of riding in a bumper car.  You wait in line until it’s your turn.  Once you’re up, you get in the car, buckle your seatbelt and enjoy the ride!  Well, not totally of course, you get bumped and bruised as you drive around, sometimes not knowing where to turn.  It can be chaotic, painful, funny, and crazy…but luckily it’s a relatively short ride.

The night before my baseline appointment, I took my last birth control pill.  It was quite nice not having a period, especially when it’s associated with A LOT of pain!  The next morning I went in for my appointment, very curious about the lining of my uterus.  The verdict: thick.  I thought, great we’re going to have to postpone!  Well, to my astonishment, we carried on.

According to my calendar, I was scheduled to start the injections 2 days later.  However, due to the lining of the uterus, the doctor requested to see me again in 3 days.  So, I was not starting my injections until instructed.  He told me that I should expect to get my period within the next 3-4 days.  I was not looking forward to that!  It was a little delay in the process but I was still hopeful.

I went in 3 days later for my next appointment.  We got the green light to start the injections that night, with a minor change!  Hooray!  I was both relieved and nervous.  I felt a burden lifted because we were able to continue…nervous because it had been 4 months since the last injections.  The injections are not something I’ve enjoyed doing, but sometimes you just “do whatchu gotta do” (do what you need to do).  It was that same day, I felt I was going to get my period and just like the doctor said, I did.  It had been 4 days since I took my last birth control pill.

The minor change was an increase in dosage.  Remember now, I had all the medications and I knew what the prescriptions were.  So, I knew that I was prescribed 5 Bravelle (an entire box) for each injection.  The doctor changed the dosage to 6 Bravelle but kept the Menopur at 1 vial.  I was surprised by the increase but I trusted the doctor.  I knew everything would be ok.  I took a deep breath and set my phone alarm (for 5 days).

Like I mentioned, at the same time, I got my period.  I wish I had the eloquent words to explain the pain!  It was hands down one of the worst periods I’ve ever had!!  I couldn’t even walk.  I had such a hard time using the bathroom, didn’t have much of an appetite, and still had to do the injections.  So not fun!  I attributed a majority of the pain, to the endometriosis and to the fact that I was on birth control for almost 2 months!  Luckily, the pain subsided.  The bleeding however, was different.  It varied.  It started off heavy, went light and then came back heavy.  I thought it was weird.  Eventually, it lighten but I thought it would still be important to share that with the doctor at my next appointment.

Below is a picture of what I call my “IVF prep.”  Each night, for 5 nights @ 5:50pm my alarm would sound, reminding me to start preparing the injection for 6pm.  I gave myself 10 minutes to get the shot ready.  I learned after that first night, it wasn’t enough time.  I needed more than 10 minutes.  After each injection, I gathered everything I needed in preparation for the next injection to following night.  That might sound too organized for some or maybe even a bit obsessive…but who cares.  I know I’ve said this before…IVF is very structured.  You take the injection at the same time every night, without excuses.  The injection takes priority…that’s just how it is.

At the top of the picture are all the vials, 7 total.  The gray vial is the water.  The peach vial is the Menopur, and the green vials are Bravelle (6).  Below the vials is the syringe, followed by the 2 alcohol prep pads.  At the bottom left is the needle and on the bottom right is the Q-cap.  You’ll notice that there are 2 alcohol prep pads…this is because one prep is to clean each vial after removing the caps, the second prep is used to clean the skin right before the injection.  Also, you may have noticed a difference with the needle and syringe.  In my last post, the picture showed pink needles and syringes with needles attached to them.  I didn’t need those.  Unfortunately, I paid for them, which was a $4.80 loss but it’s ok.  (Let me know if you have any ideas or suggestions as to what to do with them.  I can’t return the syringes and needles.  It was all sales final.)  Anyways!  My IVF coordinator provided me with the syringes and needles that I used for the injections.  They are the same used for all the previous shots, which I was familiar with.  That was good for me!

The shots were pretty much the same as I explained before, except they were quite potent!  It took 2 injections for me to feel side effects.  I think the side effects contributed to the additional pain I felt during my period.  Because the dosage of medication is MUCH higher than when doing ovulation induction, I experienced more than I bargained for.  When I did ovulation induction with IUI I didn’t experience any side effects.  Doing the IVF injections, however, I had what my family calls an “OVARYACTION!”  Get it?  LOL!  The injections were not nearly as painful as the ovaries themselves.  I literally felt the ovaries growing.  Well, when I’m taking the highest dosage that should be given (according to the medication insert) I’m bound to experience something!  The crazy thing about it was I felt pain in the front and back of my body, in the same areas, all related to the ovaries.  If you think about it, my ovaries were highly stimulated to produce follicles and mature them so they hopefully contain eggs.  I hope that makes sense.  The pain from the ovaries came whenever.  It was never a set time, pretty much at random throughout the day and night.  So, although I originally thought the pain from period was from the endometriosis and birth control, I think it was actually from the medication – the injections!  (Not to worry, I’ll write more about this)

I did the injections for 5 days…then I had an appointment the next day!

In my next post I’ll add the video showing you how to prep the injection.

Next post: Are You Serious?