IVF 1 - Day 12 third scan and tenterhooks

Back from the clinic this morning, my gut was cooperating but the equipment was not.  All week my clinic has had some trouble with their new ultrasound machine in that it won't let the nurse tag the follicles correctly.  This happened on Monday and on Wednesday; today the nurse went and got the old machine because it was happening again.

The uterine lining was looking good and the ovary was clearly visible this time.  There are 6-7 good sized follicles of assorted sizes.  My biggest was 20mm and second was 18mm and then there were 4 or so around 14/15mm and a bunch around 10mm.  This creates a slight quandry.  Typically you can trigger once you have follicles over 18, but I have a bunch just behind.  So do we sacrifice the 20 to get the others to grow?  This decision will determine whether the egg retrieval is on Monday (I trigger tonight) or Wednesday.  Now I'm waiting for a phone call.  In the meantime, I decided to buy more drugs because I'm obviously very much hoping that they decide to do the retrieval on Wednesday.  I mean, obviously I want to do what's best to get the best result, but a Monday retrieval puts me in a 50% chance of having the bad schedule (if I need a 3-day transfer) whereas the Wednesday retrieval will be completely fine.  So now I'm waiting for them to check my blood estrogen levels and have a consultation with the doctors who meet over lunch.  I don't think I'll get a call before 4pm-ish.  So now I just wait.

It took 3 tries for them to get blood out of my fussy veins this time.  One of the nurses is getting super determined that she wants to get it on the first try.  I'm sort of hoping it's possible this is my last go at bloodwork there though.  I mean, I don't think I need another scan because they will just decide today when the collection is and another scan and blood test won't change that.

In the hopes that they will decide that my retrieval will be Monday, I had to buy more drugs; a 300 Gonal F pen and 3 Orgalutran/Ganirelex doses.  Luckily they have all that in the clinic and charge you the same as Healthcare at Home so there's no mark-up on the drugs.  I was also happy they had a 300 Gonal F pen because that's all I need and a larger pen would have cost more.

In other too much information news, all these drugs and what the nurse says are my estrogen levels are causing me to have a lot of vaginal mucus.  This is not so fun and perhaps a bit gross.  I hate wearing pads all the time as the lady bits like to breathe, so I'm just trying to be very clean and remember to go to the bathroom more frequently.  At least that part shouldn't last too much longer!  I think I remember it from my egg freezing cycles but maybe not this much?  I can't remember.

New budget update:

Previous total	£12588
Extra drugs for cycle 1	£241
New total	£12829

IVF 1 - Day 8 First scan of the cycle

I had my first scan today on day 8 of my cycle (day 7 by stimulation days).  I managed to get completely confused about when the appointment was based on how I put it in my diary which meant I showed up at 9:30 for a 9:00am appointment.  Luckily this was no problem at all and they saw me pretty much straight away.  It took the nurse two tries to get blood out of my arms.  I've decided that I think this blood issue is related to the 15 minute cycle ride I take to get to the clinic.  Typically if I've been cycling for over 10 minutes, my hands start to go numb and feel like I'm having circulation problems.  Because the first thing they do at the clinic is the blood draw, I think the problem with getting blood out is related to this.  I suggested next time they do it after the scan, we'll see if that helps.

So anyway, the scan was fine.  The nurse who did it had a little bit of trouble with their new equipment because it wouldn't get to where she could tag the follicles.  This meant I had the wand in me for a while until she managed to reboot the machine and finally get it it to work.  It also means though I got a pretty good look at the ovary.  So far so good.  The Gonal F is clearly working even though I'm not feeling anything yet.  I had around 7 follicles that were all 9.5-10.5mm, so that was great.  The ideal is for them all to be around the same size and they generally were.  It was clear at that magnification which ones were slightly bigger, but anyway, that was good, and there's still pretty much the rest of this week to go and for things to continue to grow and change.  In addition, my uterine lining also looked good.  The nurse was very positive and pleased, so that made me happy.

Of course I don't want to get my hopes up too high because in the last two of my egg freezing cycles, I had I think 9 and then 7 follicles and then only got 4 and then 3 mature eggs.  So even though seven sounds exciting, I'm trying to preparing for a low return.

My next scan is on Wednesday, and then I've already got one scheduled for Friday.  By Friday it should be clear if I'm coming in for a scan on Monday or if  I trigger or what.  I'm still thinking that based on previous egg freezing cycles that my egg retrieval will be next Wednesday, but we'll see.  I did ask this morning about this process as they require someone to take you home and stay with you (for 24 hours - or anyway that's what they say).  A friend of mine has offered to collect me in her car and stay with me for the afternoon, but she can't come until noon give or take.  However, I saw in the reading they gave me that they want the person who is going to take you home to be there from the start.  Well that's crazy- I can't just have random friends taking all day off work to sit around for a few hours while I have a procedure!!  It's hard enough to get people to be able to take time off to collect me at the right time!  This is for sure one of those times where I get very frustrated with the single mother element, and I also was frustrated during the egg freezing process.  Having been looking at doulas recently, I wonder if this isn't a service they should maybe consider starting to offer.  I'll deal with it, but it's annoying.  And now I have to wait to find out if I need someone there 'all day' or if someone can just come at the end.  I don't want to ask the boyfriend as I think it will upset him. Also, he doesn't have a car, so I'd have to book a taxi at which point I get annoyed about why I have to have anyone with me to begin with.  But I will work it out.

In other news I was at a dinner on Saturday night with some of my students who were graduating this weekend.  I had 1/4 a glass of wine.  I'm not going to kill myself over this.  I've been very good at taking all of my vitamins and morning pills, etc.  1/4 glass of wine is not going to make a difference!

Oh yeah, and I've started taking the Ogalutran which is Ganirelex (which I didn't know) in the morning.  I like that it comes in pre-filled syringes unlike the Cetrotide I had to mix and took during the egg freezing cycles.  However, it stings a bit after injecting it which I don't like as much.  For some reason the shots this cycle have all been more bothersome and often quite pokey.  Occasionally I get one in where I really can't feel it, but more often than not they feel pretty sharp.  Annoying!

Anyway, next update  Wednesday I imagine.

IVF 1 - Day 2

First shot tonight.  Happy to get this show on the road.

I called the clinic yesterday to tell them my period had arrived and schedule my first scan.  They said the doctor had put me down for an 'early' scan so they scheduled me to come in on Monday which will be day 8.  This is not early.  I was sort of taken back by this, as when I did egg freezing, or even when I had the IUI I think they scanned within the first 5 days. Day 8 seems a bit late.  I mean, some women even trigger on day 8!  Although I for sure will not.  I feel that day 8 is a bit late to make any adjustments to the medications.  I would have thought I should go in on day 5 which would be Friday. At the moment I'm undecided about whether or not I should call to ask for this or as for the reasoning for putting it off until day 8 or just to suck it up.  In general I'm not a fan of the suck it up approach and I prefer more information to less.  However, I also vaguely assume my clinic knows what they are doing.  Although maybe I shouldn't.  Seeing how many follicles there are in the scan, and how they are growing is supposed to help them decide how much drugs I should be taking.  By day 8, I'll be more than half way through stimulation, and I don't know that there's much more opportunity for adjustments.

The women on the SMC forum all felt I should push for an earlier scan or at least get in touch with the clinic.  I think I'll at least give them a call.  The women on the forum also all unanimously supported ICSI for the fresh eggs and assisted hatching for all embryos.  So that was interesting as well.  I did a bit more google research on ICSI and think it's probably a good idea to just go ahead with that. Assisted hatching also seems like a no brainer although there will be an additional cost per embryo for that.  Still, anything that helps.  And also, what's £125 when you're spending £6k+?

So it's Gonal-F only for the next few days before I add in the Ogalutran in the mornings.  All the drugs are currently taking up the cheese drawer in my fridge.  Huh.  Actually now that I'm thinking about it, I'm going to the movies tomorrow when I need to inject so I'll have to take the drugs with me.  At least they gave me a useful drug carry pouch with a portable sharps container for being away from home.  I'm going to go for an 8pm/8am schedule, or as close to that as possible for my injections.

So, still happy to be starting.  Still feeling positive.  This may obviously be significantly tempered whenever I actually get my first scan and see how many follicles are happening.  But also looking forward to finding out what will come out of the frozen eggs.

Drug Delivery

The box itself didn't look like much....

However, inside the box was a shitload of drugs!!

We've got 4 x 900 Gonal F pens, 7 Orgalutran pre-loaded syringes, an Ovitrelle pen, 3 boxes of Cyclogest pessaries, an amoxicillin pill, and of course the sharps box.  My cheese drawer is looking very full at the moment....

No period yet.  If it comes tomorrow that's risky because I think my clinic only does egg collections on Monday, Wednesday and Friday.  That would mean they may try to collect on day 15 (Friday) which would be earlier than all of my egg freezing cycles, but otherwise would have to wait until day 18 (Monday) which could be too late.  If my period comes the day after tomorrow, or the day after that, then they might be going for the Monday collection (day 17 or 16 depending).  I'm pretty sure the clinic does embryo transfers on Saturdays, so if I had a Monday collection, I could have the transfer on the Saturday, avoiding the two days (Thursday/Friday) which will be a horrible work conflict.  If I have the collection on a Friday, the transfer would be on the Wednesday which would not be ideal because I still have some conflicts, but would also be okay, or at least, way better than the Thursday/Friday conflict.  So actually... I might end up alright with the work conflict either way- the only difference would be if they collect on the Monday and if I don't have more than 2 embryos that don't look so great, they could recommend a day 3 transfer which would be on the Thursday.  Complicated!!  I don't care though.  This month is a go, and I'm sort of excited about it.  Even though there's no guarantees in all this, I prefer to be taking action than waiting, that's for sure.

IVF package and drugs - budget update

I've just spent a large sum on the drugs for my first IVF procedure as well as the procedure itself. My clinic has a package deal for IVF which includes:

• Ultrasound scans for monitoring
• Monitoring blood tests
• Blastocyst culture (if needed)
• IVF/ICSI process (if needed)
• Embryo transfer
• Pregnancy scan or review consultation as needed

The cost for this package is £3130 if you are not using ICSI and £4030 if you are.  Because my frozen eggs will need to have ICSI, then I am paying the higher cost.  There is no additional fee for the processing of both types of eggs, or the defrosting, or if they end up doing two different fertilization procedures on the fresh and frozen, or anything else apparently.  So that was good.  At the moment I feel this cost is very reasonable for an IVF cycle with drugs included.  But I don't have a huge amount to base that on.

The drug cost for 12 days of treatment came out to £1858 which includes: 4x900iu Gonal F pens, 7 Orgalutran injections, 1 Ovitrelle injection, and 45 Cyclogest pessaries.  I will probably need to buy some more medication as my cycles tend to run longer (from both the IUI and egg freezing experiences).  But these drug costs seem reasonable.  I should go back and compare them to my old egg freezing costs as they are again from Healthcare at Home.

I'm still trying to pay for the courier to get the frozen eggs from London to Cambridge.  I have left a phone message with the Cambridge clinic today and replied to an email over the weekend, but so far nothing.  I don't think that will be a problem but I will feel better when it is paid for and underway. The courier quote I got was £175 + VAT.  So I'll have to add that to the budget later when I find out how much the tax is.

Apparently I need to fill in yet more paperwork to permit the thawing of the frozen eggs.  Of course I do.

So the budget update:

Previous total	£6490
IVF Inclusive Fee with ICSI	£4030
12 Days of IVF drugs (see above)	£1858
New total	£12378

I've now spent approximately... a little over 1/3 of my savings for this endeavor.  It would be amazing if this would work so I could keep the rest for caring for a child, childcare, etc.  But it also means if I need to do this again, I certainly can.  Of course fingers crossed I won't have to.