IVF

[JosieSmith1]

I am starting my first round of IVF next week. As I have low egg reserves I have been given a 10-15% chance of success but the dr suspects my ovaries won't respond to the drugs and that they will have to abandon the IVF before egg collection. Needless to say I'm pretty miserable right about now.

I'm looking for people to give me a heads up on what to expect during IVF. I have some info that tells me the side effects of the drugs ut I wondered if some lovely ladies could tell me realistically, what to expect

Thanks

[FlipFantasia]

Sorry to hear your Dr is being so negative - it's hard enough embarking on IVF!

Anyway, it really depends on your protocol. I'd expect you to be on a short protocol, if you have low egg reserves. This means you get your period and start stimulating your ovaries straight away. Is this the plan for you?

The long protocol involves downregging (shutting down your ovaries) from day 21 (although my clinic had me on the pill for a cycle first before downregging) and then stimming after about 2 weeks of downregging. The risk with low egg reserves is that the ovaries don't "wake up" after downregging, which is why the short protocol tends to be used in these cases.

Wrt low egg reserves, you should also look into Create as Geeta Nargund there works with "natural cycle" IVF which can be useful in low egg reserve cases.

In my experience, IVF was better than trying and failing to get pregnant naturally. I took the approach of getting over each hurdle rather than trying to get over the whole thing, eg get the ball rolling, start downregging, start stimming, go for scans etc. We did long protocol, had ICSI for male factor and I got pregnant first time (I had normal hormone levels but DH has low low sperm count).

I'd also recommend accupuncture, especially on the day of transfer (pre and post transfer). Try to find a practitioner who's worked with ladies doing IVF before.

Also, the fertility friends website has a huge range of information/experiences. I know you're already on the assisted conception thread on here (I'm a graduate of it and sometime lurker) so you've already "spoken" to a lot of experienced Mumsnetters. Fertility friends is great for finding women who've been at your particular clinic, who have the same hormone results as you etc etc.

I wish you the best of luck with it.

[MalibuStacy]

I am pregnant after our third round of IVF. My best advice would be to take it one step at a time and not project too much into the future.

Are you having IVF on the NHS, or are you paying for it yourself? If the latter, how many cycles have you signed up for?

[TopazMortmain]

Second the question re long or short protocol? I have low reserves and had short protocol and worked first time!

Fertility Friends is a great site for info etc.

My doctor said that often the first round of IVF is simply a way to measure the body's reaction to injectables. I had two rounds of injectables before my actual cycle which was expensive but gave a very good idea of what dose to go for in the actual IVF cycle.

Do you know your starting dose of (menopur?) and how many antral follicles you have?

[YuleingFanjo]

I did the short protocol so after a month on the pill (which was bizzare) I started doing the injections of menopur. I found it so much easier to get my DH to prepare the injection and then me inject it. About halfway through I got quite stressed by it all but was then able to count down the days to egg collection.

Egg collection was fine, I don't think the sedatives they gave me worked as I was completely alert but it still wasn't painful.

I was on a very high dose of menopur as I was considered a poor responder but we had something like 6 eggs and I got pregnant the first time (son is now 13 months old). Definitely have a look on Fertilityfriends, it's such a supportive site.

I also did stuff like eat a high protein diet, eat wheatgrass and had acupuncture even though I am quite sceptical about stuff like that.

[Nordicmom]

Hi! I did IVF twice recently. First time nov/dec 2010 and the second last summer . We're doing surrogacy in the US since I can't carry our second child without miscarrying ( had 10, reason not found). The first time ended in a miscarriage/ possible ectopic after a frozen cycle ( we transferred two both times ) but the second cycle (fresh cycle) worked even though I only had two embryos to use ( so none left in a freezer) ! Now our surrogate's almost 28w! I also had low hormone levels and egg count despite my age . I think I was given similar odds for a cycle to work as you but it did and I did respond and produce a few precious eggs both times even though the drs were quite pessimistic ! I was devastated to hear the numbers and shocked since still felt young and had no trouble of having my son a few years before or getting pregnant all the times I miscarried. I did how ever decide to try since I thought I would never be able not wonder about it . I thought I'd give it three goes and then move on to egg donation. I was on the short protocol so they worked with my natural cycle which is regular. I have to say I didn't really notice any side effects since feeling a bit unwell or moody etc I reckon I'm on and of anyway due to normal hormone cycles and a chronic ilness I have . In general it wasn't as bad as I thought it would be from what I heard . It's hard when you don't know at all what to expect when put in a new situation ! As others say I recommend taking it one step at a time and not getting overwhelmed by the whole process. It's perfectly doable. Obliviously the shots aren't fun and I really hate needles and you do feel like a pincushion by the end . My husband was my" nurse" and gave them all to me in the evenings which really helped ! Some of the time didn't feel a thing and other times it did hurt but it's over quickly. Maybe I didn't react as strongly to the drugs as some so might have been lucky in that sense. And running back and forward to the doctors for endles scans and bloods and the waiting for the result anxiously is torture . But it's just a few weeks of your life and you can get through it . I know several people that it's worked on the first or second go as well . For Some it's no help no matter if you do it 20 times...In total I think it took about two weeks to get ready for the retreaval which in the US is done under general anesthetisia but here I think it's done while being sedated. The retreaval was a bit scary ( hate general a.) but went well and I didn't have too horrible pain after it but some lower back and stomache pain for a day or two ( used heat pads they helped and normal painkillers) and didn't have bleeding at all really . No complications. The difference is that I didn't have the embryos transferred back to me but to our surrogate but that's meant to be much easier thing to do. Good luck with your cycle ! I'm sending you happy thoughts:)

[Nordicmom]

Btw I used to think IVF is expensive but then we had to look into surrogacy since I can't keep a pregnancy and that is soooo much more so would give almost anything ( and ofcourse would have liked to carry my own baby myself otherwise too) to just do the normal IVF!

[JosieSmith1]

Thanks everyone, I needed some support this afternoon after all my colleagues (all parents) kepp talking about when their kids were young, I feel so left out thinking of the things I could miss out on

I'm on the NHS but have no idea of what protocol, I wasn't aware there were different ones! I had my appt on Tuesday, see the nurse on Wed for meds and syringes etc then she says it'll be a couple of weeks. AF is due tomorrow, could this mean I have to start next month?

It's so hard not to get overwhelmed. Lots of people have said to me 'well loads of people go through ivf, it's nothing' yet when I describe what I'm going to go through, they're horrified! I'm so scared

[TopazMortmain]

If it's a long protocol (with down regulation e.g. Zoladex) please ask to see a doctor too before you go forward as short protocol (straight to stimms) is more effective for slow responders.

For what it's worth, the injections seem horrible but they are really really tiny :-)

The meds sting a bit so take them out of the fridge twenty minutes or so before you inject so they are not so cold under your skin.

If you are self injecting then lay everything out beforehand in order of use (e.g. Alcohol, cotton wool, open medicine pack...) so you just follow the sequence.

[worldgonecrazy]

Whoever has said "ivf is nothing" obviously hasn't been through it themselves. It's stressful, it's expensive and regardless of how many hundreds or not of eggs you have, it doesn't have a great success rate. But 1 in 10 is still 1 in 10, for IVF I think the odds aren't that bad, so it could be you this time, and if not this time, then maybe next time. Everytime you have a round of IVF the doctors will learn something that may help boost success next time.

My DH used to try and distract me if I had to do my injections in front of him, which was rather sweet and irritating enough to take my mind off the injection.

Good luck, be gentle on yourself and your DH and anyone else that is less than understanding. It's one of those things that unless you've been there yourself, you have no idea what it's like.

And remember miracles do happen, I've got one to prove it.

My acupuncturist also told me to drink a cup of plain hot water every morning to help get the energies moving in the stomach/womb area - absolute woo but at least I felt like I was doing something positive. I think chocolate cake was beneficial too.

[JosieSmith1]

Well the info I've got (which is a general info, it wasn't specifically adapted to me) says something like buscaril (something like that anyway) to stop my cycle, then with menopur to start my follicles growing, not sure if that helps figure out if it's long or short protocol. They said if I don't respond to the drugs they'll abandon it, but I got the impression even if I do produce some follies, they won't do it unless I produce a lot, which seems a bit unfair.

I also got the impression that if I didn't respond, they wouldn't try again, which also seems unfair. Could this be an NHS thing? We can't afford to go private, but I didn't realise you get a prescription for the drugs, god knows how much that is going to cost me!

I'm flitting quite quickly between depression, anger, frustration, then strength and a belief that I can do it, but other times it's blind panic and a complete belief that I can't do it. It's so confusing but I'm hoping by the time I start, I'll have pulled myself together.

I wasn't keen on getting DH to do my injections but it might be a way of taking the pressure off me and will maybe help him feel like he's contributing, and will probably help us stay strong and support each other through this nightmare

[CareBear1]

I had those two drugs when I did my round. I found they had me in for a scan every other day (i was at the bridge clinic) and when they thought i wasn't responding very well, upped my drug intake. I was told i only had 1 or 2 at the right size along the way but eventually ended up with 9 eggs. Its a real 'take it one day at a time' type thing as you just don't know what will happen which i think is what makes it so stressful. One thing i would definately recommend for de-stressing is some kind of relaxation cd - the zita west one for ivf is really good, and i've since got quite into these having never been into that before - i've just had delivery today of one from Randine Lewis that i'm looking forward to trying. Best of luck with it all.

[Nordicmom]

Hi again Josie! I was going to also say about warming the medicines up by taking them out of the fridge a while before . That definitely helped me to hurt less. And I'm sorry if I scared you about the shots but I thought it's best to be honest . It's just a little sting and I thought that since I don't have an ilness that requires to use them everyday of my life I'm lucky. Also I guess you'll have to decide for yourself if u want to inject or your husband / partner but i found it easier to deal with someone else doing it like when you are at the doctors. My husband had never so much as practiced on anything although we had a teach about it with a nurse and I just had to trust him but he was very good and I'm thankful for the help! My private US clinic would not have done retreaval either unless they thought there were at least 4-5 good sized ones so not necessarily a NHS thing . It seemed really unfair because you only need one to make the baby and I did feel desperate... In general i'd say if you do truly want to have children in this life then don't give up on it and live unhappy ! It's up to you to keep on going. It does pay off in the end .I do believe where there is a will there's a way . Maybe you have to consider other options like we did. I know it seems hopeless but it isn't . You might not succeed with IVF but there are other routes though none of them are easy .I really hope you get what you want in the end ! I thought our hell was never going end with the years of endless miscarriages and then getting sick from stereoids i was given to treat them but now I dare to hope there's end in sight in 3 months ! :) All the best

[KnackeredCow]

I think those drugs mean you're on the long protocol.

I did the short protocol and the drugs were different (Gonal F, Cetrotide and Ovitrelle)

Did you ask them why they won't do it unless you produce a lot of eggs. The clinic I'm with doesn't use aggressive stimulation (which is possible on short protocol too). They got 12 eggs from me, which was way above their average. They do have a very good pregnancy rates despite using mild stimulation - think it's due to and excellent embryology department.

You really don't need lots and lots of eggs to have a good chance. It's quality, not quantity that counts.

The injections are a lot easier than you think they are going to be. Once you get the hang of them they really aren't bad at all and do them whatever way you feel is best. I did mine myself, but I like to be in control!

Best of luck with it all.

[JosieSmith1]

No you didn't scare me Nordicmom (I'm terrified already) just made me think that maybe I don't have to do it all myself and I could let him in a little bit. He's agreed to doing them aswell so maybe it'll be that little bit easier.

I'll try and remember to ask about long and short protocol. The info does say the first injections stop your cycle, then you take the buserelin at the same time?! to stimulate the follicles.

Is egg retrieval as horrific as it sounds?

[CareBear1]

I had those exact drugs on a short protocol. Retrieval was fine due to ga, putting the embryo back hurt like a difficult smear

[KnackeredCow]

Don't know if this helps, but did a bit of research. Short protocol is the antagonist regime and long protocol is the agonist regime.

Buserilin is a gonaderiin analogue (been thumbing through DH's copy of the British National Formulary - he's a dr). So I'm almost certain Josie that you are on the long protocol, which involves shutting down your cycle and restarting it. Initially the drug stimulates and then it causes down regulation.

Egg retrieval depends on a lot of factors. I did find it uncomfortable, but on review, due to surgery I've had (and peritonitis - infection in the abdomen) I had a lot of scar tissue, which probably caused this. They're front-loading me with more fentanyl for my next EC to take account of this. Some people are whacked on the pain relief / sedation. It's a very individual thing. You might sleep throughout it - one of my friends did! Don't be afraid to tell them if you need more pain relief during the procedure. My clinic were really good and kept topping me up.

HTH

[libertychick]

You really won't know how your body will respond until you have a treatment cycle. I became pregnant on first IVF cycle with an FSH of 14+ and on the final scan before EC there was only 2 decent sized follicles but they collected 14 eggs - of those only one made it to blastocyst stage and that that was all I needed. Just had a second cycle and on 2WW now hoping to be lucky again.

Try not to get too caught up in the detail and just deal with one stage at a time. I found waiting to start the worst bit, once things are underway you just have to go with the flow.

I slept through both EC's - my clinic must go for lots of sedative!

[YuleingFanjo]

I just wanted to add that i felt no pain at all during the egg collection and the embryo implantation. I really didn't think the sedative worked on egg collection as they tried to force me into a wheelchair afterwards 'because you will be woozy' but I was able to walk perfectly ok and didn't feel at all sedated.

definitely go with the flow.

good luck with your recent cycle Libertychick.

[TopazMortmain]

Was completely asleep for egg collection - out for the count! Was a bit uncomfortable afterwards but nothing particularly painful.

Embryo transfer did not feel a thing BUT bladder was so full (for better imaging) I thought I would would not last another second

[JosieSmith1]

Thanks so much ladies, I' really taking notice of the one day at a time recommendations. So far I'm looking forward to wed which is my first appt with the nurse to get my prescription and needles etc. As far as emotions go, I'm taking that one day at a time too, yesterday was a pretty bad evening but DH was there to support me and I've realised I have a lot of people I can, and will need to, lean on. I'm realising I can't do it on my own, and I don't have to. I'm helping my nana move house on wed after the hospital and in hindsight, probably not a good idea, so DH has said if I'm not up to it, he and his bro can do it, so I'm considering sitting it out. I'm trying to be aware that I have to look after myself through this and if it means not helping someone else to look after myself, then so be it. After I got upset and had a good cry and lots of hugs last night, I felt a lot stronger and now, although I'm still scared, worried and upset, I WILL NOT BE BEATEN!!!!!!!!

[Nordicmom]

Good on you Josie ! Do not give up on what you want ! :) It'll be ok in the end one way or another if you persist !!!!

[JosieSmith1]

Just a quick update - start my meds on Sunday. I'm pretty sure I'm on long protocol cos I've got three weeks on buserelin to stop my natural cycle, then another week with buserelin and menopur, and then egg retrieval etc etc. Had a practise of the injections yesterday, wasn't too bad. It stung a little but it stops pretty quick and then you wouldn't know it had happened. I've got the teeniest little red pin prick left. I'll look like I've got a funny rash by the end of the three weeks

Feeling a lot more positive than I was at first, almost excited even!

[missbrightside]

Hello Josie

I've just been reading this thread as I too will be starting IVF in the not too distant future (referral has gone off and just waiting for a start date .... ). Good luck to you with your treatment.

Could I be incredibly nosey and ask if you had to pay for your drugs in the end ? I too will be having treatment on the NHS and was led to believe that all drugs would funded too. Is that not the case ??

x

[jumpingjackhash]

Hi Josie, I've just read throught this thread and some great advice on here.

I'm on FET after isci last autumn and have been sniffing Buserelin for a few weeks to stop my system (now taking oestrogen pills while on a reduced buserelin dose for a couple more weeks). Odd that you're on long protocol but I'm sure your consultant will have recommended the best approach for your situation.

the injections become a doddle - you get used to them and tbh the thought is worse than the deed. You'll get to a point where you can count up all the dots across your stomach towards the end of the injection run!

Excited is definitely the way to approach this - see every step as an achievement, it makes it easier.

I echo worldgonecrazy in that whoever said 'ivf is nothing' clearly has no clue what they're talking about! It's long, hard emotionally and physically and can be very lonely. I also agree with her on the chocolate cake.

[PicaK]

Good luck.

The drugs made me very clumsy bizarrely enough so my piece of advice would be to half-fill your coffee mug for the next few weeks and NOT to pick up any particularly well loved and/or expensive ornaments.

Take a week off work after eggs have gone back in - physically you won't need that time, mentally you might.

If it doesn't work go for the counselling - it can really, really help. But I hope it does work.

Avoid the morons who think it's not a big deal