Switching to IVF- any help??

HBamama2B

After receiving more bad news it looks like if this IUI doesn't take (and we only have about 5% chance of our BFP) my DH and I have made the decision to switch to IVF next month for our last cycle on this insurance. Can anyone provide any words or wisdom, support, or guidance as I start this? TBH I am terrified of the retrieval. We are scheduling an apt with the dr to discuss the switch and his recommendations. Any good or important questions we should ask?! Really appreciate any help!

Wicked4589

You will be asleep for the retrieval, you won't know what's even going on. I had no side effects or pains from the retrieval or implants. The worst part for me was the progesterone shots after the BFP.

HBamama2B

Yeah. When I told DH about the shots continuing after BFP he got very nervous! I've never had general anesthesia so that is a big scary spot for me. Do they put you under for the implantation too? What was your recovery like?

jnissa

These things are all much easier than you are imagining (and also the shots don't have to to continue after a bfp, you can do a vaginal suppository instead). You will be unaware of retrieval. Transfer is like a glorified pap smear with a full bladder. 99% of the shots you will take are small needles into fleshy skin (the stomach) and once you get over the initial hesitation it will be like nothing! 

Recovery from retrieval is about a day of soreness and cramping. That's it for me. Like I said, transfer is basically five minutes like a pap smear - in and out. 

I understand your fear, but trust me, while IVF is a bitch, the worst part is the hormones and the physical part really isn't all that bad. You'll be a star! 

HBamama2B

Thank you so much for the great run down! It sets my mind at ease. Now I just after to manage an appointment with my dr. The next available isn't until 9-3 and my cycle starts 8-26.... Odd, they had no problem fitting me in right away for my new patient apt.... Lol.

mc123mc

Some things to consider that I wish someone had told me:

- If you do not plan to test the embryo's with PGD for abnormalities after the retrieval, you can't really do it after they are frozen. Some MD's will do it but you risk losing embryos with the thaw and refreeze. We didn't consider PGD testing because we thought we'd had great embryos. Turns out my first fresh IVF resulting in a miscarriage -likely due to chromosonal abnormalities. And my second FET, which we transferred two embryo's resulting in a singleton pregnancy (only at 5 weeks so fingers crossed). 

PGD testing, while expensive, increases your rate of success tremendously. I wish we had done it because we would have known that we were implanting good embryos. And we likely could have avoided the miscarriage which was devastating. 

- Be clear with the support staff of your expectations and fears. If your clinic isn't providing you the kind of support you feel you need, look elsewhere. I found this out the hard way and did several cycles under tremendous stress because the staff struggled to work effectively with my insurance.

- Find out what your insurance covers and what they don't. Ask about fertility medications and how they handle those meds. I had to get mine mailed to my house which was a logistical nightmare. Not that I could have changed that but knowing how the process worked helped a lot.

- Protocols are different because patients and doctors are different. If you are questioning your meds, or transfer dates etc, talk to your MD, not the boards. You'll just get confused with all the variables out there. 

As for the retrieval and transfer, they are pretty easy. Just make sure your partner is available to drive you home and be there to hold your hand during the transfer! 

The shots are painful and annoying. I moved my injection sites around, alternating belly and thighs so nothing was super sore. 

Expect bloating and some discomfort before the retrieval. I lived in yoga pants for a few days before the retrieval and that was probably the most uncomfortable part. 

You shouldn't have to do progestrone shots, most places use crinone. If you do get the shots, a heating pad after injection helps a lot!! 

Good luck! 

Wicked4589

Suppositories are not always an option. My doc would only do the shots.

FatPony

One piece of advice I have would be to not tell anyone when your transfer or FET is, if possible. Unfortunately my FET was scheduled the same day as my grandma's funeral, so told family why I had to skip it (needed a damn good reason to miss it). Everyone tried to be on their best behaviour and not ask me about it, but I could tell they were dying to know if it worked. Don't forget that your family and friends can also get emotionally invested in your journey. If I could do it again, I would keep my transfer to myself, so that I can avoid the pressure from everyone. They mean well, but damn that was annoying.

HBamama2B

Thank you all for the incredible advice!! It is very helpful.

@mc123mc I hadn't known about PGD testing, but now I will be sure to ask. Thanks for the great detail, it gives me a much stronger understanding. GL on your pregnancy, FX for a healthy uneventful term for you and your little one!! Congratulations!!!

@FatPony yeah, we haven't told anyone and are planning on playing it close to the ovary (lol). It'll be hard not to share and easy if that makes sense. I know of exactly zero people who have gone through this, so sharing even a little or just the dx can be awkward as our best friends just don't know what to say or how to support.

JaysensMom

I was terrified of the retrieval as well. When you have it done all you worry about is how many eggs they'll be able to get and what the quality will be but that's so normal! Also afterwards I was a little sore but during the retrieval itself you're completely out of it. My stomach would just hurt when I i would laugh afterwards but not terribly bad.

If you haven't considered it either FET (frozen embryo transfers) can sometimes have better results. We did a fresh cycle with one embryo (it was a day 5 blasto) and we got a BFN last month. This month we did FET and I'm feeling much more confident. We transfered 2 frozen embys and I have much higher hopes just from what I've read. If you do a frozen, it gives your body an extra month or however long you choose to rest up and have a better chance at implanting. Plus the medications aren't as harsh and its much less stressful.

My husband and I went through 8 failed IUIs and 1 failed IVF cycle so far so I understand how badly it hurts. I also remember how scared I was to do all this. The progesterone shots terrified me! Honestly tho they aren't even as bad as the belly shots you do for some reason. And I have some tips for it if you'd like!

Stand with your feet shoulder width apart and whatever size hes sticking, try to keep as much pressure off of that side as you can. It helps the muscle not be so tight. Also ice the spot he'll be sticking for about 5 minutes before hand. Bend over a counter or sink to help when he's giving the shot too. And when he's all done have him massage the area or apply heat to it and walk for a few minutes. That helps with the pain the next day from a sore muscles and it gets the progesterone spreading faster.

And expect bruises still. They happen but I promise it's not all bad. And remember its SO worth it. And you can ask your RE to draw circles on you on where DH should give the injections so he feels better about it.

Also ask your RE if they offer acupuncture. Some people swear by it. I didn't have one done with my fresh cycle but I decided to try it with my FET. Good luck darling! Let us know what you decide!

MKLEWIS2010

Alot of what pp have said is accurate.  I would just make sure you are on the same page with your doctors.  The retrieval is really not that bad it is light anesthesia and about 20 minutes.  I slept a lot after and was just bloated and slightly uncomfortable for a few days after.  The transfer was painless, my hubby was not allowed in the room after.  Also the injections for the retrieval arent bad as they are subcutaneous.  Our nurse had a teach class to show us everything which I think is important.  The menopur burned a little but other than that they were okay.  The trigger shot is intramuscular and my nurse drew a circle on where to inject it.  You also inject the PIO there if you are doing the shots.  My doctor wouldnt let me do anything but shots, so definitely ask your doctor about your protocol.  We can all give you advice here however every doctor does things differently and everyone is different with how they react to the meds.  I have to do PIO shots and estrace pills until 12 weeks.  Also ask about skipping the fresh cycle and doing a frozen instead because they are usually more successful.  I had a BFP on my first frozen (7 weeks tmw)  but BFN on fresh, we are all different so that doesnt mean you cant get a BFP on fresh.  Your doctors should also monitor you, I was monitored almost every day.Good luck, the injections and procedures arent the worse part it was easier than i initially thought. The hardest part is the emotional aspect.  Also once you receive your box of medications(mine came in the mail) that was overwhelming because it was a lot of meds so that made me anxious.  The teach class calmed me down a lot because they showed us what to do and we were able to ask lots of questions.

Good Luck! 

HBamama2B

Wow. Thank you both so much for the info. Very helpful and calming. This is overwhelming. I understand the parameters change a bit given your specific dx and dr, but it's good to know to set my expectations about the fresh tx. I meet with the dr on the 26th (Friday) to discuss the switch can to IVF. I'll post updates about how it goes. Still nervous but feeling better armed and ready to tackle the new challenge.

Congrats on your BFP!! It's always so exciting to hear success stories and know there are moms out there where women like me used to be!

NicWalker10

We just finished our first IVF cycle at the end of last Month and are doing a FET in September.  I can honestly say that the retrieval was a breeze.  I was very tired after and slept most of the day, but didn't have any cramping or pain at all.  Just some spotting for a few days which I was told was normal.  I was able to go back to work the next day.

My regimen was a few days of Follestim with a lo HCG, then added in Ganirlex,  then trigger shot, then Lupron.  The shots themselves weren't bad--the needles are very thin which made them very easy to get into the skin quickly and release the medication. The first few days were fine, I just started to feel very bloated and tired by day 3. I wasn't overly emotional or snappy, really just tired! I did all of my shots in the stomach, and just tried to move them around a bit.  I did not have any intramuscular shots.   My belly wasn't really sore, just had some bruising.   The trigger shot has to be taken at a very precise time and your DR/nurse will give you that time.   Also an easy shot to do.  The Lupron similarly goes at an exact time (to prevent your body from ovulating the eggs by itself before ER)--- I had that twice and of this whole thing the funniest part was having to administer the shot to myself in an dunkin donuts bathroom at a train station two minutes before boarding so I could get to work!  

I had to go for ultrasound and bloodwork 5 days in a row at the end of the meds.  After the first few, the US just became old hat--but I would recommend really talking to your nurse or RE after each US to understand the progress of the follicles, what your RE's goal is for your cycle (how many eggs is he looking for)  and the explanation that not every follicle has an egg in it...when I went for my US, the DR (who was not my RE, a different one every time)  would just count out the follicles, their size  and they would record them, measure my lining and leave the room.   I wasn't really sure what the follicle count meant, what the sizes meant etc...I would try and get as much info on that as possible.   I didn't get a lot of feedback on that and I was frustrated.     Also before my ER, I would have liked to have known what my RE's plan was in terms of a goal # for retrieval.   11 eggs were collected during mine and I had no idea if that was on track with what he planned for or if my body didn't respond as he wanted etc; I was particularly freaked out when I would read online that some people collected 25 or 33 eggs!   So I would recommend having that conversation so you can avoid the freak out I had!

We had planned to do a fresh transfer and didn't find out until we were close to retrieval day that it was possible that our clinic might want to culture any embryos for 6 days rather than 5 and if that happened,  then we would not do a fresh transfer.   I did not understand this going into it and would recommend that conversation before you give your meds.  We were told sometimes they like to give an extra day and then they couldn't do a fresh because it wouldn't work due to synchronicity with the uterine lining and embryo stage.  I would ask about this out of the gate.

We did opt for PGD.  It is very expensive and not covered by insurance, so just be prepared for sticker shock.  We were happy to do the PDG to avoid greater heartache with potential miscarriage with an abnormal embryo.   We had 8 embryos, but only 3 made it to day 5 and after PGD we had only 1 embryo left.  If you do consider PGD, I would recommend talking to your RE about the testing parameters,  standards and expectations.  We were pretty shocked and upset when we found out we only had one left and then ended up reading stores about how diff clinics have different standards for PGD so I would have liked to have known that going in.

Weds, I start my natural FET cycle.  Also something I wish I understood before beginning the whole process.   because or fertility issues are MF,  my doctor said it's perfectly ok for me to do a natural and not medicated FET cycle--I had to specifically ask about this because my nurse automatically jumped to a medicated --so I had to ask why. If I didn't ask, natural wouldn't have been put on the table. 

Sorry for the long post, just wanted to try and give you as much info as possible from my recent experience.  Best of luck to you!!!

HBamama2B

Thank you so much! I'm about to go in to talk to my RE and that is incredibly helpful!! I never knew a natural cycle was possible. It's unlikely in my case, but I definitely want to ask! And definitely I've been struggling with asking questions at the right time and getting frustrated by the kind of 'in and out' care where the DR doesn't walk you through the decision making process.

NicWalker10

no problem!  yeah,  once we converted to the FET procedure,  they immediately started talking about progesterone in oil shots, and estro shots and I immediately responded why is this necessary? cant I do the progesterone suppositories?   And then my nurse talked to the RE who reviewed my records and based on the regular nature of my cycle,  he said the FET could be a natural cycle.  the negative is that the FET itself cant be scheduled on a specific date so you need to be more flexible---they follow your cycle and monitor when the time in your cycle is to implant as tho you are in a natural pregnancy situation.  they don't me that the medical is necessary for women who don't ovulate regularly or have other issues.   I had NO IDEA that a natural was possible and was happy to hear it is an option because from what I hear the progesterone in oil shots are a bit tough--also after transfer,  if you are in a natural cycle (at least for me) I only have to do the progesterone suppositories, and not the PIO.  For either --that needs to be taken for 3 months  after transfer if successful.   I was very happy natural is an option so as not to have to do PIO for three months.

Also, my RE said the success rate is the same --natural v. medical. 

Good luck with your convo--ask everything you can even if you think it's dumb! I wish I went in loaded with qs at my initial meeting! 

HBamama2B

Well, met with the dr. He agreed that next cycle is IVF with ICSI (assuming this iui didn't work). It's 'covered' under insurance, but what that really means is a bit different then expected. Still high OOP costs. The protocol is different too. He's considering putting me on OCPs for 2.5 weeks at the cycle start to sync the follicles up but may decide not to as I've gone anovulatory every time I've before for at least 3 months.

He also pushed PGS, but we aren't sure. Anyone have a good medical journal I can review on it? I'm looking for stats and studies specifically.