And So It Begins

A familiar package of meds, but
far fewer than last time.

As you know, we decided to do another IVF cycle this November and my first "protocol" appointment was yesterday. And, despite his busy schedule, Brian was even able to meet me waaaayyy out there and then rush back to work.

Just like the first time, it is mind boggling how much happens on that first appointment. But my first mistake was likening this to my informational appointment last September. As I was getting ready a the crack of dawn that morning, I thought, "I guess I should shave my legs, huh?" But then I thought about my first appointment last year - a nice, sit down and chat sort of thing, and decided I'd be fine with a little stubble and a little less speeding on my way to work. That wasn't the right call. We walked into the office to find the full spread on the counter. (Women, you know what I mean. All the little swabs and cups and tools.) I was thrilled, but what could I do?

What you may not realize is that each appointment takes forever. I know some doctors take a long time, but usually once you get back in the room, things move along. Not with my experience with IVF. Yesterday, I filled out the mountain of paperwork, waited a bit, went back into the room, got changed, waited some more, had my uterus measured (they check for a clear path as "practice" for the transfer), talked to the doctor, changed, and waited some more. Then, we saw a PA who explained one thing, went and did something, came back with more info, left again, and so on. In other words, I should always bring a book. And this is pretty standard practice.

My appointment yielded some interesting news. My doctor was very sympathetic - like genuine sympathy and concern - about how our last IVF attempt, which was nice to see. Then, he reviewed our options and our odds for each. As I heard the first time, there is a 40% success rate for one baby with two blastocysts, a 25% chance of twins, and a 3% chance of multiples. He then said that in the 25 years he had been doing this, he had only seen six cases like ours. Six! I think that's way less than 3%! (And once again, I felt an urge to play the lottery.) He then explained that there is only a 17% chance of pregnancy with one frozen embryo, which was our plan. However, their last cycle had a 74% success rate with that same scenario, so clearly these odds are not always accurate.

Since the last time we did this we did a fresh transfer, he explained the frozen process, which was enlightening. Normally, they pump the woman full of hormones, but prevent her from ovulating, which causes the production of an excessive amount of eggs. They fertilize those, watch them for 3-5 days, choose the best looking two, and freeze the rest. We already did that, so we get to use the frozen ones. Because they normally transfer two blastocysts at a time, they freeze them in pairs. So in our case, they will defrost (I'm sure there's a technical term for this that doesn't make me think of thawing a turkey for Thanksgiving) a pair of blastocysts and choose the one that looks the best. They will then refreeze the second blastocyst and prepare the best candidate for the transfer. We have five fertilized eggs, so we'll have some backups if we end up in the 83% who's transfer doesn't take.

What I think has surprised me even more is how easy this process has been thus far. By this time in my first cycle, I was putting down $2,000 for meds and scheduling blood draws every week. I also had a special diet that basically left me eating apple sauce, grapes, and toast with butter. Today, I filled all of my prescriptions, which totaled less than $350 and I was only told to limit my caffeine and sodium consumption. I did have to have a second uterine X-ray (which was no fun and also required me to show my stubbly legs on Wed) but I don't have to have any blood work done in the immediate future. Piece. of. cake.

Well then... what do I need to do? I'm already taking birth control, low-dose aspirin, and prenatal vitamins. Now I will add Luprin (hormone) shots every night. I am also taking an antibiotic to prevent infection after the uterine X-ray, which is done kind of like an angioplasty, but with clear dye and a catheter... and definitely not in your heart. (I know you're jealous.) I have other meds that I will start taking later, but that's all I have to do until my appointment a week from tomorrow when the doctor will perform a vaginal ultrasound (again, I know you're jealous) to see if I have any cysts that have developed since we did this a year ago. If all goes well, they'll put me on some more meds (yay) and I'll go back in a week and a half for another vaginal ultrasound (I can see you're turning green with... envy. Let's say envy.) to check the thickness of my uterine wall. And when that's thick enough... whammo! We do the transfer. That will happen sometime during the week of November 5.

So, that's where I am right now. The visit really wasn't very emotional for me. It's rather easy to detach when everything is tests and paper blanket covers and unending forms. And that was pretty much how I felt the last time. It all felt pretty clinical until everything began to go downhill. Hopefully, that won't happen again, but I guess we'll know before too long. I can't believe how quickly time has passed. In some ways, February feels like yesterday; but in others, it feels a lifetime away.

Thanks again for joining us on this journey. I hope that you find my posts entertaining, educational, and even therapeudic. And I still encourage you to share this with others. I hope it will become a valuable tool for people to learn about IVF and coping with preterm labor loss. I'll be posting here before too long and giving brief updates on my facebook page www.facebook.com/imgonnabeawhat. Feel free to "like" me there for more exciting, hormone-filled, clinical baby-making commentary.