Hello - newbie here

Adoc86 · October 2016

Hi guys,

I am about to start my very first IVF cycle and am feeling a little overwhelmed. I figured that joining this community and being part of this support group might be helpful so here I am

A little about us (DH and I):
We are both 30 and are in a little bit of different circumstances than the majority of people here are in, in that we have only ever TTC for 2 months. Two months into TTC we were blindsided when my DH was diagnosed with Testicular Cancer. Thankfully it was caught very early, but DH still had to go through chemo and obviously our baby plans came to a halt. Prior to treatment the doctors urged us to visit a sperm bank, as the surgery and chemo would pretty much kill his sperm production temporarily and possibly permanently.

It has been 6 months since DH finished his treatments and he is doing great. The chance of the cancer returning is extremely low, and even if it does it is just as curable as the first time around (TC is 99% curable when caught early). So now that life has returned to normal we are ready to revisit our baby plans. We were told to avoid natural pregnancy for at least 2 years, as there is a chance chemo can cause birth defects, however it often takes 5-10 years for sperm to return to normal after the treatments anyway. So here we are about to jump into IVF.

I went through all the routine fertility screening and everything came back normal, so it is assumed that we have no fertility hurdles, but one never knows since we weren't TTC for very long. My RE has put me on a High Responder Antagonist protocol and we will be transferring one embryo.

I had my bloodwork and ultrasound today and am set to begin injections on Monday. Something very strange, and the main reason for my uneasiness, is that I was never given any real kind of direction on how to do these injections. We just returned from a 3 week vacation so I wasn't able to meet to go over anything earlier this month and today when I visited the office my nurse was busy so she didn't have time to meet with me. Basically she called me this afternoon and told me over the phone what to do, but it was so overwhelming and I am scared I am going to screw this up. I've basically been watching YouTube videos on it all afternoon LOL. They've been surprisingly helpful, but its still intimidating. My protocol is the following:

37.5 iu Gonal F
37.5 iu Menopur

(Then Cetrotide added in at some point later on).

With HCG and Lupron triggers.

I had a high number of follicles (>25 in each ovary) so the doctor wants to try to prevent OHSS by using the Lupron Trigger.

Anyway! Has anyone else ever just had to jump into this as blindly as I feel like I am? I don't know anyone that has had IVF (at least not well enough that I feel comfortable approaching them about it) and I feel like I am out in limbo here. I really wish I could have gotten some hands on direction with this. Since I have been on leave from work for 3 weeks there is no way I can take Monday off to go into the doctor's office to have it shown to me in person so it is what it is.

Another concern I have is that I just received my Lupron trigger in the mail today from the pharmacy and the expiration is 11/3/16! I was told that this drug had a 30 day shelf life, which is why it was shipped out later than my other meds, but 11/3/16 is not 30 days from now and my anticipated trigger date per my RE is 11/5. Is this going to be an issue? I know most drug companies pad the expiration dates a bit and that usually its fine, but its one more thing to stress about. The pharmacy was closed by the time I received the package so I was unable to call them about it. I just feel like when paying so much for this stuff it should be correct.

Sorry for this ridiculous long post!

Adoc86 · October 2016

Oh, I forgot to mention that we are doing IVF with ICSI. Since we are using DH's frozen sperm and we only have so much to work with my RE felt this was the best route.

JamieH2000 · October 2016

Welcome! Sorry you are here, but glad your husband is doing good and you are able to dive into IVF. Feel free to join us on the October/nov IVF board. Lots of us are just starting stims now too. As far as the injections go, our clinic doesn't do a formal training. The nurse has showed me some stuff and given some printed directions, but direct us to watch videos at designrx.net. I think there are other good videos on freedom med teach too.

JuliaAnn86 · October 2016

Welcome! Glad to hear things are going well for your hubby. I'm a pedi oncology RN and we definitely encourage our teen patients to look into egg/sperm banking before undergoing treatment. Very glad your hubby decided to do it, hopefully this is a smooth process for you. The youtube videos are very helpful as far as injections go, but if you have any questions feel free to private message me! Definitely call the pharmacy about your lupron, but in the mean time try not to stress. You have plenty of time to straighten it out. As for jumping in to IVF blindly, I'm kind of in that position too. After trying for a 1.5 years and getting nothing but an unexplained infertility diagnosis, I switched doctors, and found out I had stage 3 endometriosis (the main symptom of pain, is something I didn't have much of so my other Dr missed it) after reviewing my labs and hormones levels my new Dr suggested being aggressive and heading straight to IVF...so here I am.

Adoc86 · October 2016

@JamieH2000 - thanks! I'll definitely check out the Oct/Nov ivf board. Good to hear that I'm not the only one that didn't get any type of formal training. I feel like its probably pretty simple and I was just overthinking it since there are emotions and a lot of money on the line lol.

@JuliaAnn86 - thanks so much! Luckily DH's doctors were very informative & encouraging with banking sperm right from the beginning. Honestly its something that never would have crossed our minds as we were pretty much only concerned with his health from the moment he was diagnosed.

beary67 · October 2016

Welcome! I don't know the answer to your questions regarding the expiration, but I did want to share the website I use for medication instructions.

https://www.freedommedteach.com/eng/

I'm so happy to hear your husband is doing well!

I hope this cycle works for you and your husband

joneser1281 · October 2016

@Adoc86 Welcome! I'm sorry to hear of your struggles... I am glad to hear that your DH is doing well! A friend of mine is currently PG from a FET because her husband also had testicular cancer, so though I don't know exactly what you've been through, I can relate based on what I've seen her go through.

I actually took the same exact medications (although different dosages) as you for my fresh IVF cycle this past summer. That's disappointing that your nurse couldn't show you firsthand what to do for your injections, but I will tell you that I did have an injection class with my nurse and still felt clueless! Haha. My first night of injections I was so nervous and was sure I totally messed up the mixing/administering of the Menopur. I was a wreck! I'm not sure what pharmacy you received your meds from, but I used Walgreen's Specialty Pharmacy at the time and was able to call them (I think they're available if not 24/7, then at least later into the evening than my clinic was open) and one of their pharmacists talked me off the ledge and step by step through my injection. It was great! I felt so much better having someone right there to answer every little question and make sure I wasn't screwing anything up. I don't think the injections necessarily get easier (because I always hated knowing what was coming... Not a fan of needles), but you definitely get more comfortable with knowing what you're doing.

I too used the Freedom Med Teach videos... I actually had to watch them during the injection class and they come in handy at home too.

I would definitely call your pharmacy and tell them about the expired prescription. You have enough time for them to send you a new one. It's not easy, but try to stay calm... Even if you mess something up somehow (I had my first PIO injection yesterday... It was a total fail... My DH was nervous and didn't inject it into the correct spot on my butt, so my butt has been killing me so much I can barely sit lol) it doesn't mean you've ruined your chances for the whole cycle... It will still be alright. We're here on the boards if you need us!

Adoc86 · October 2016

@beary67 thanks! That was really helpful and so much more official than the random YouTube videos I had watched

@joneser1281 seems like everyone knows someone that has had TC! Its crazy to see how many young guys seem to be diagnosed with it. My first night of stims went well. My biggest fear, like you, was that I was going to screw up the mixing of the Menopur. I guess in my mind everything was just going to be pre-mixed and ready to go. When the nurse nonchalantly mentioned on the phone that I was going to have to mix this many ml to that and then draw out this many, etc etc I was like 'wait wait wait, what?!' Too funny about your DH getting nervous and missing the target!

I called the pharmacy and was told that the shelf life of the Lupron trigger used to be 30 days, but as of this month (go figure) regulations have changed to 14 days. I guess the person I spoke to when ordering it must have forgotten about the recent change when sending it out. Apparently its formulated and compounded the exact same way it always has been, so technically they said it was fine to take it but that they'd send me a new one if I felt more comfortable.

sberries · October 2016

Welcome! I'm so glad that your husband is ok...that had to have been so scary! I totally understand your apprehension about the shots. I sat down with a nurse and she explained everything, but I didn't get to have her show me one since I had to take the shot the next morning. At first I didn't think I could do it on my own so I was explaining how to do it to my husband that night, which freaked me out even more! My step dad worked in hospitals years ago so I called him and asked if we could go by in the morning. We were able to do it with him while he walked my husband through it, but it was so scary. I didn't feel a thing and it didn't hurt, but I had myself so worked up that I lost all my color and thought I was going to pass out, ha! It got way easier over time and eventually I was able to do the shots on my own, which was much easier than having my husband do it since I felt like I had more control.

It will be super scary the first time you do it, but my best advice is to count to three and go for it. The needles are so sharp you won't feel a thing when you inject. The injections in your stomach are easy. The IM injections are more intimidating, but I was amazed how easily the needle went in. After that, it's easy to inject the medication and take the needle out. After awhile, you won't think anything of it!

I also used Lupron as a trigger with one of egg retrievals and it worked much better for me. The first one we triggered with HCG only and I did get OHSS and was miserable for two weeks. The second one was much better we triggered with some HCG and Lupron...still got a little sick but nothing like the first one.

Best of luck!!! You can do this!!!

Adoc86 · October 2016

@sberries thanks so much! As hard as it was to stick myself the first time (this past Monday night), it had to be done. My husband gets squeamish and close to fainting with needles (and after going through chemo he doesn't ever want to see a needle again) so that was never going to work lol. So far its going smoothly so that's a relief!

So glad to hear that the lurpon & hcg combo worked out better for you! I am pretty worried about getting OHSS :-/

kaseycoco · October 2016

Hello @adoc86! I'm new here as well and it's nice to feel like a part of a community here. Sorry to hear about your DH but glad to hear he is doing better and you guys are on to the next steps.
As for the injectables, I have to do a trigger shot this month for the first time and my doctor just told me to watch a video online. I wish someone had shown me what to do, but I guess after you've done it once it's not so bad?

PennStateCait · October 2016

Welcome! First of all, I'm glad your hubby is in remission. That must have been a terrifying time.

I haven't started IVF yet so I can't help with your injection questions but I can totally identify with your fears. I am glad you joined us here because there's so much support, you'll get your answers like you already have!!

Looking forward to seeing you around more! Be sure to participate in some of the threads we've got going!

Adoc86 · October 2016

@kaseycoco hi!

it is definitely nice to talk to other ladies in similar circumstances. I don't personally know anyone that has struggled with infertility/gone through fertility treatments and its such an awkward subject to bring up that I just don't.

The videos I watched for injections were pretty straight forward so by the time I had to actually do it I wasn't so nervous about it anymore. Afterward I was like, "that's it? Not so bad" Are you doing IUI and that's why you only have a trigger shot or?

Adoc86 · October 2016

@PennStateCait thanks for the welcome! Yeah 2016 has been stress city so we are ready to put it behind us and fall into happier times. Looks like we might be in the same area! I live in York, Pa.

PennStateCait · October 2016

@Adoc86 I'm in Centre County

I juuuust moved back here after living in the DC area for 5 years.

mrsdaddario · October 2016

@Adoc86 I was annoyed with the shelf life of Lupron too!! Luckily my insurance covers the majority of the cost, but I pay the rest OOP. I was told once opened it had a shelf life of 30 days, no mention of the new regulations! I'll have to look into that! I had to order another round anyway, we're doing injectables (Gonal and Menopur) in conjunction with an IUI, so when last cycle failed I was bummed I couldn't use the leftover Lupron for this cycle! I only take 1ml as a trigger dose so it seemed like such a waste! Very glad your H is on the up and up! As far as the injections I hope you are feeling more comfortable now with the videos as examples! Their very easy. I have my H do it so I don't hesitate if I do it myself lol.

Adoc86 · October 2016

@mrsdaddario oh! I was told originally that it was 30 days even if unopened. I ordered all of my drugs back in August and the pharmacy held off on sending the Lupron for that reason (we weren't quite sure of the exact start date for IVF yet). Now they are telling me its 14 days even if unopened. It seems like there is so much inconsistency with what people are told regarding these drugs. Maybe the regulations vary by state?

mrsdaddario · October 2016

Adoc86 said:

@mrsdaddario oh! I was told originally that it was 30 days even if unopened. I ordered all of my drugs back in August and the pharmacy held off on sending the Lupron for that reason (we weren't quite sure of the exact start date for IVF yet). Now they are telling me its 14 days even if unopened. It seems like there is so much inconsistency with what people are told regarding these drugs. Maybe the regulations vary by state?

Could be regulations by state, but I was told specifically 30 days if opened. Also there's an experation date on the box it comes in that's like over a year. So that's super weird! Now I'm worried lol. But either way I haven't had the new stuff for 30 days, actually I haven't even had it for 14 and it's unopened so I think I'm covered! But it's good the pharmacy doesn't send it early to you, that would really be a waste!

Adoc86 · October 2016

@mrsdaddario I am only using Lupron to trigger, so I didn't get a box (two week kit?)- only the one syringe trigger that has its own expiration stuck to it which is for 14 days from the day I received it.

My RE told me that in order to get a Lupron trigger you actually have to order the two week kit, but that since I won't be using the kit they wouldn't send me all of that extra product since it would be a waste anyway. So I am wondering if the syringe I got is technically "open" and maybe that is why its only good for 14 days now. I didn't get any vials or anything like that - only one pre-filled syringe with the exact amount I have to inject. That would explain the confusion. Either way I wouldn't worry about it since we'll both be using it within 30 days :-P

Hello - newbie here

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