IVF - can anyone tell me what it entails?

[CountessDracula]

Am considering for No 2....

ladymuck are you around?

Hi CD . I didn't have ivf but did have iui which is mostly similar apart from the egg collection. What do you want to know....everything?

what is iui?

yes pls

I want to know how invasive it is, what the drugs do to you, how much time you have to take off work etc

It took dh and I 3 yrs to conceive dd, nothing wrong with either of us just took ages. Have been trying for a while and not used any contraception for 2 years but nowt. Will be 40 soon so don't want to wait much longer

TBH I won't be too gutted if we only end up with one, but I think dh would be :(

I had it for both ds's. We were unexplained infertility so had a lot of 'waiting and seeing' and agonising over whether to go for it before we finally decided to (after 3 yrs ttc for ds1).
The details of treatment regimes vary from centre to centre but broadly the stages are:

1. Downregulation of your natural ovulation cycle with a drug that simulates the menopause. For me this meant twice a day nasal spray for about 3 weeks. I didn't have too many side effects from this. Blood test and transvaginal ultrasound to check that this has been successful.
2. Stimulation of mega-ovulation with a follicle stimulating drug - this will mean daily injections for about two weeks, with monitoring by transvaginal ultrasound to check on the development of follicles (I think I had a couple of scans during this time).
3. An injection to 'ripen' the eggs - must be strictly timed.
4. Egg collection - the most invasive part - transvaginal insertion of a needle under ultrasound guidance, to drain each follicle and egg. USually done under sedation rather than ga. Sounds worse than it is, but definitely the most unpleasant bit. DH does his bit on the same day as egg collection and then they put them together to do their stuff...
5. Two or so days afterwards - assuming all has gone well - have embryos transferred. This is straightforward, no worse than a smear.
6. 12-14 days later - pregnancy test.

Took ages to type that and someone else has probably beaten me to it - but if you have any more specific questions please ask.

well I suppose it may be possible that you may not need ivf but obviously i'm no expert but anyway. I'll write down what happened with me.
It seems like a distant memory now and I hope I remember correctly.

Day 21 of cycle, you'd probably have an internal scan to see how things are with the ovaries then you'd start with (usuualy) a nasal spray which suppresses your hormones. It kind of makes you have menopausal symptoms which can be a bit unpleasant. You need this so they can control everything else and make sure you dont spontaneously ovulate.

Then day three of the next cycle (I think) my af was always about 10 days delayed at this point, you start the injections, usually in the stomach or leg but this could be different with ivf. I didn't find it painful as I used a pen.

You still take the nasal spray too and carry on injections and spray until about day 8 when they'll start scanning you regularly every other day or so until the follicles have reached the right size. With ivf, they collect the eggs, I think you might have a local for this and I've heard it can be quite uncomfortable. They'll mix it with the fresh sperm and put any suitable embryo's back after a couple of days I think.

I only needed time off work for the insemination. The scans I had were early in the morning before work and I was fortunate that I could have it done at my local hospital.

Anything else?

Time off work - my work is very flexible and also not far from the clinic so it wasn't too bad for me. I had about 3 or 4 short appointments for scans etc in the weeks leading up to the egg collection/transfer week. My clinic suggests clearing a whole week off at that point because the timing may be changed at short notice, and quite a lot is going on, but physically you need a day or two off for egg collection and then you are fine straight away after embryo transfer. With ds2 I had egg collection on a Thursday and was back at work on Monday.

Thanks all, that is very helpful indeed

Given that I have never had a miscarriage, I figure that once am pg have a reasonable chance of it working (?) so am also concerned about the possibility of twins - do they always implant more than one embryo?

CD, there is a higher chance of MC due to the treatment I think. I'm sure you'd be fine but still. I think they usually put back 2, they dont tend to put back more these days as it's more risky with multiples. If you really didn't want twins then you could always ask them to only put back one but the chances of both taking, well I don't know the stats, you'd have to ask. I mean to say iui stand for intra uterine insemination. My dh's sperm was insemintated using a cathether (same as ivf) into the uterus after i'd thad the injection to release the egg.

CD, there is a higher chance of MC due to the treatment I think. I'm sure you'd be fine but still. I think they usually put back 2, they dont tend to put back more these days as it's more risky with multiples. If you really didn't want twins then you could always ask them to only put back one but the chances of both taking, well I don't know the stats, you'd have to ask. I mean to say iui stand for intra uterine insemination. My dh's sperm was insemintated using a cathether (same as ivf) into the uterus after i'd thad the injection to release the egg.

I was also worried about twins. If it works then there is about 25% risk of twins if two embryos are transferred. It is usual practice in this country to transfer two embryos if possible, but other countries are moving towards single embryo transfer. The clinic will transfer one if that is what you want.
For ds1 I only had two embryos and both were put back. I think they both implanted briefly (I had a v strong positive test and the clinic were expecting twins) but then an early bleed that I think was the demise of one embryo. with ds2 I had only one embryo and incredibly it implanted. I have been very very lucky with the outcome. i ahve to say that there is a strong relationship between maternal age and success rates (because of the deterioration of quality of eggs).
how far have you gone in being investigated? It might be worht persuing a really expert semen analysis and also having your FSH level checked. Although we were unexplained, I think we may have had subtle sperm problems (dh's last test came back with a slight abnormality) and we had poor fertilisation rates (hence the small numbers of embryos to transfer).
I have to say it is a hard decision if it is not something you really really want. I definitely knew I WOULD be gutted to only have an only child. Now I still think I would quite like another, but not enough to go through it all again.

Ok thanks

Did you all tell your employers?

Yes dh's sperm is fine (has had tested twice)

Not sure about me but they did all tests last time and there was no problem

I do have a retroverted uterus or whatever tis called so don't know if that might be an issue

I did but that is the kind of person I am - hopeless at hiding things. Not everyone does but I would imagine that could add to the stress - making up excuses for absence etc. Guess it depends on your workplace and how hard it woudl be to have non-negotiable time off.

Just thought i'd also mention my success, though it has no relevance to your situation as we're all different.

Was told that I was peri-menopausal when I was 35 but I think this may have been due to the stress of dh being ill. My fsh was high and I nee4d an awful lot of drugs to get me stimulated. I had far more to produce 1 egg, than my sil had to produce 27!! Anyway, I had 1st treatment at 36, failed (but it failed 10 days after dh died so expected)

2nd treamtent at 36.5 failed.
3rd at 37, missed m/c at 11 weeks
4th at 38, m/c at 5 weeks
5th at 38 have gorgeous dd who's 10 months

I agree with Elliott, it's not something i'd want to go through if I didn't want to.

You never know, you might not need such invasive assistance. They can scan you and see when you're likely to ovulate and then be told to go home and shag for England!

Everyone knew at work, i'm hopeless! DH worked at the same place as me so they were all keen to know.

Wow delgirl, congratulations!

I do want another it's just I am not totally desperate IYKWIM. I have a gorgeous dd after thinking that maybe I would never have any and feel very blessed. Dh however is feeling sad as he wants another (having been fairly lukewarm to the whole idea of having kids in the first place - typical!)

Have been using OPKs - is that different to what they would do?

Delgirl, that must have been really really tough. Iknew you had some kind of complicated history but never followed enough posts to pick it all up. Fantastic that you have your dd now!

I have to say I quizzed a lot about whether I could try IUI rather than IVF - tried to locate relevant research and basically there's not a lot of hard evidence either way for unexplained infertility. But my clinic were much keener to go straight for IVF as they thought the chances of success would be greater and in hindsight it obviously was a good choice for us.

well they'd monitor you, possibly for more than one cycle to see how you are?? You could still have the drugs, like I did, but just have sex as normal when you're ready to ovulate.

If you think you'll be happy with one but not your dh, why not consider ivf, just once, and see. It would hopefully work, but if it didn't your dh will see what it entails and may not press for more treatment. Sorry if i'm talking bo**ox but hope it helps At least you'll know you'll have given it a shot.

Yes that is what we had discussed in fact. Looking into it and if we agreed go for it once.

Do I go to my gp or contact a clinic privately?

CD, if you have one child you wouldn't be eligible for NHS treatment but you still have to be referred by the GP

OK - how much does it cost?

And which is the best place?

DH could prob find out as he is Medical Lawyer

I would probably go to your GP for a discussion intially - in case any further tests/initial consultations need to be done that could be done on the NHS. Some GPs will prescribe drugs for IVF on the NHS so might be worth exploring that.
There are loads of clinics in London - the HFEA website would be a good starting point. Have to say I'm glad I didn't have much choice! Personally I felt more comfortable with the local unit that also provided NHS treatment than with a purely private clinic.

I went through several IVF and FET's. I acutally packed in my job, went to Australia for 4 months and then when I got back started the IVF process. I wanted to keep it a secret and there is no way I could have done that whilist still working. Also, my clinic wanted lots of blood tests so for a couple of days I was going every day. Bit hard to have fitted in with work as my work was 2 hours away from the clinic. If work can be flexible and you dont mind people knowing then I wouldnt imagine it would be a problem.

Elliott went through the process very well, just want to add that I was an emotional wreck. Firstly, the drugs played havoc with my emotions and then just the stress of it all.

Personally for me, it was something that I'm not sure I could go through again. My 3rd IVF resulted in the birth of my daughter, I also had 2
FET's. It put an enormous strain on our marriage, it was worth it. We always wanted 2 kids, and before we started we were quite prepared to go through it twice, but after experiencing it never again. However, thankfully we had a little miracle born 18 months after my 1st dd.