Hi, this is my first time on mumsnet, I'm 39 and have been trying for a baby for 3 yrs now, we are being referred for IVF at Nuffield Woking, can anyone who has gone through this already offer any advise, any questions I should ask, can anyone tell me the whole process step by step? Thank you xx
Ok, you'll be called in for an initial appointment and be asked how long you've been trying to conceive, how often you have sex. With that one you can't seem to win, you get a head shake if you say "every other day" and also if you say "two or three times a week".!
After that you'll be sent a huge batch of firms to complete for you and your partner. A lot of these forms are essentially duplicates, there's also one form asking you both what you want doing with any stored eggs and sperm - kept frozen for a set amount of years, or kept and then donated to science. When you return those forms you'll need to take in your passports as proof of ID.
I'm assuming you'll gave had all the pre tests - Day 3 (I think it's day 3!), Day 21, hydrosalpogram (to check your tubes aren't blocked), internal and external scans, blood tests to check you are Rubella immune. There are bound to be a few more tests I've missed, it's been a while since I had mine done. Oh yes, you'll also be asked when your last smear was as they do like a v recent one (well my clinic did).
You'll not be told anything about the actual IVF process at this appointment but you'll either be long or short protocol. I believe long protocol involves taking the contraceptive pill for a set time before the drug taking starts.
Once you've got the green light, you'll be told to ring your clinic on day 1 of your next period. They will then arrange for your drugs to be sent to you by courier. This is where my memory gets a little hazy but I think once your period finishes and you reach day 21 (don't quote me on that bit, I could be wrong) you start taking your Down Regulation drugs. Some are nasal spray, others are injection. This is the longest part, DR dehydrates you, it also stops your ovaries working so essentially putting you in menopause. Some say they get foul moods, I got bad headaches after week 2 of DR'ing. Eventually you'll have a period called a Breakthrough Bleed. You call your clinic when this happens and they book you in for an internal scan in about 7 days. You should have stopped bleeding by then but it's not uncommon to still have a light bleed. The clinic will still scan you if bleeding but obvs warn them! The purpose of DR is to get the womb lining thin.
You'll then go and see the IVF nurse and she'll give a refresher demo on how to inject. With Menopur there were little tablets that you had to squirt saline (?) in to to then suck into an injecting needle. Gonal F comes in a really easy dosing pen. Menopur also has a toughening effect on the skin after a few days of injecting - after a week of Menopur I actually bent needles trying to jab myself. Menopur also caused me to bruise more.
Everyone was "the needles are SO thin you won't feel it". I felt it. So I got everything all ready and held an ice cube to my abdomen for 1 minute before injecting so I was totally numb. Post injection I held a heated cherrystone pack to my abdomen as heat promotes blood flow, which helps the ovaries and follicles.
You'll have an internal scan after about 4 days of injecting and then a scan every other day. You'll be told these injections make you moody, I was fine.
You'll eventually be told you are ready to Trigger. You'll be given a precise Trigger time and your time to get to the clinic for egg retrieval. You must not Trigger before or after the given time, if they say you Trigger at 3am, that's when you do it. I've heard personally of more than one girl who forgot the trigger time, just did it, arrived for egg retrieval and found that she'd ovulated before the eggs could be collected and was told to "go home, have sex, maybe it'll work".
So, a Trigger done and then you have (I think) a day of no sniffing DR drugs and no injections. Hurrah. Your ovaries will by now feel like navel oranges - they are normally little fingernail sized.
Egg retrieval - you have to get to the clinic one hour before your time slot. They'll check you and your partner are who you say you are. You then put on hospital gown. You'll be given an injection in the back of the hand, it's a light sedative so you'll find you wake really refreshed and not groggy, tearful or with a head swim sensation a deeper sedative gives.
Whilst your are there having your eggs removed, your partner (if male) will be led to a room containing the worlds oldest porn mags (My OH "The women had so much hair, it was crazy!!") and a jar for his sample. He won't have to hand it to a nurse, he'll leave it on a shelf - our clinic had one of those mini doors- and it'll be spirited away. If donor sperm, they'll already have it.
Once you are awake you'll be given tea and biscuits and then do road will come in and tell you how many eggs they got. They will be checked, IVF cab be any egg but ICSI has to be 'nature' eggs. I don't know what makes a mature egg.
You'll then have to pee before you leave, you'll be asked if anything hurts or stings (it will smart a bit) and if there is any blood. A little is normal. Oh yes, when you wake you'll have the hugest sanitary towel wedged between your legs.
You'll be hold to sleep propped upright, they kind of inflate your abdomen so you'll look a bit puffy and sleeping propped helps this deflate. You'll also be told of OHSS. As I can't recall the warning signs, I wont detail this but you can Google later in advance. You then commence daily insertin of progesterone suppositories.
The clinic will call next day with the fertilisation report. Your heart will be in your mouth. By this stage the clinic will have a good idea of your transfer day. For me they had two strong runners and told me Id be a 3 day transfer. Sometimes they might not know for sure if all are level pegging, they want to put the best back so they may well call the next day with a transfer day.
You'll have decided on a one or two embryo transfer. You'll be given a transfer time, these always run late. You'll be told to drink about a litre of water proof to transfer, this pushes the uterus up so easier access for the transfer.
So, in a room, scanner gel on tummy, legs akimbo, one nurse will hold the scanner on your abdomen and the other will put one of those smear tests clamps in, followed by a long tube holding your embryo. You'll see it on the screen as a white dot. I asked how big it was in reality, was told pin head sized and totally naked to the eye, so after transfer even though you can see the embryo on screen, someone will come in, take the transfer tube and scan it to check it really is clear.
You then get given an info sheet, a pregnancy test and a test date. Depending on if you had a 3 or 5 day transfer depends on the time you wait. This is called the Two Week Wait. This is when you analyse every twinge and weird thing your body does. Do not be tempted to test before you are told to and stay away from Dr Google.
Once you have your BFP, you call your clinic. They'll book you in for your 7 week scan. After your 7 week scan your care gets transferred to your regular GP and local midwife service.
I think that's it!
If you have any questions, don't hesitate to ask.
Thank you so much woobeedoo , this is really helpfully. Ive had all the tests done, its good to know sort of what to expect. Xx it sounds like a lot of medication...
And I'm slightly scared about being sedated, can the egg retrieval be done while awake?
its not too bad but it does sound a lot! You'll have two nasal spray packs for down regging, these don't have to go in the fridge. You may inject your DR drugs so I'm not sure about storage for injectable DR's. If Menopur you'll have maybe half dozen mini vials then about 12 mini vials of the liquid solution. This has to be refridgerated but I believe once mixed, it can be kept in a cool place. If Gonal F it's dosage pens (like an Epi-pen) and you'll probably get about two. These to be refridgerated. You'll get two packs of progesterone suppositories, non-refridgerate. You'll also get one Trigger shot, again mine was like an Epi-pen (refridgerate). Oh, and a box for Sharps as if you have Menopur you'll have mixing needles and self assembly injectable needles and for Gonal F you get little mini twist on needles, plus several instruction leaflets plus mini anti-bac wipes for wiping the injection site (which I never bothered with).
The egg sedation can be done awake but to be honest you'd rather be asleep. You've had 1001 pre-tests so your dignity has long flown out the window but it's a bit to be there, legs akimbo with several people in the room and the surgeon with his/her head right up your bits. (I don't even know where to look when I have a smear test!). You can buy a cream, I think it's called Emla, it's a topical numbing cream. I thought they'd inject the left hand so put a big dollop of cream on then covered in cling film before setting off for egg retrieval. I was horrified when they said "we work from the right, so right hand" but it genuinely didn't hurt - those injection people are skilled is all I can say! If you say you're nervous of the sedation they'll distract you whilst they are doing it and they are very very nice people. The funniest bit pre-sedation was I was asked "oh, you have removed your knickers haven't you only you'll be surprised how many forget and it is very hard to remove them once you're under". Made me chuckle.
Again, if any questions don't hesitate to ask.
I'm about to have my transfer on Monday (if any of my eggs fertilise that is). I'm the same age as you with a slightly high fsh of 10.4 and low amh of 8.9. I was on the short protocol as that is best of poor responders like me. From CD3, i started on menapur which is an injection in your tummy. I didnt feel the needle too much but the medicine stung for about a minute afterwards. At CD8, i had to inject orgalutran which stops the eggs being released. This was on the top of the thigh, just underneath the skin. This gave me a hot, raised rash each time. I also had scans and blood tests every other day from CD 9 which meant a lot of hanging around. At my scans, i only had 2 follies growing with some much smaller following behind. When these follies both reached 20mm they scheduled me in for egg collection. They usually like at least 3 but they let us go ahead anyway. It was at this point i was told to inject pregnyl in the tummy 2 days before ec. This is start the eggs to mature i think. I stopped all other medication at this point.
At EC, you are given a gown, plastic pants and socks to wear. You are wheeled to theatre but on the bed and your legs are put in stirrups. It is embarrassing but they will cover you up intil the procedure starts if you ask them too. The anaesthetist will give you some antibiotics through an iv drip and then the sedation. You start feeling woozy but then i fell asleep until the end of the procedure. They wake you on the table and wheel you to the recovery room where they can give you pain killers to make you more comfortable. I had period like cramps and they gave me codeine which took the edge off. You are then taken to the clinic to sit with your partner and given something to eat and drink. It didn't take me too long to recover and was discharged a couple of hours later. You are given progesterone pessaries for the next 18 days which are very yucky.
I will be getting a phone call on the next couple of hours to see if any of my eggs have been fertilised. In the end i had 5 eggs, so some follies had a massive spurt on in 2 days. So don't worry if the scans show only a few follies as these can grow drastically. I am pretty sore but not too bad. Hopefully it will all be worth it.
Good luck. Its not too bad but expect to feel like a pin cushion, wait around a lot and let your diginity go out of the window. I never thought i could do it but its suprisingly ok.
Good luck and sorry for the very long post x
Thank you so much, this is all so very informative and helpful. Xx
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