Help with IVF expectations/work

[dcrxcm]

Hi all, after some more in depth testing with the fertility clinic, IVF is being suggested as the next step for us due to age/circumstances/muddle of PCOS and sperm issues.

We plan to try naturally for another 2-3 months while we gather funds for this but what I’m keen to understand is what a typical cycle (and surrounding weeks/days) looks like. I have to travel for work once a month and while I can fortunately be open about my situation, I also don’t want to sign up to do trips/projects when I know it’s likely I’ll have to cancel if it’s a treatment cycle/month.

What might I expect in terms of injections at home/blood test visits/scans in the lead up to, during and following treatment?

Thank you in advance, this is quite new to me and I don’t know all the terminology so I apologise if I’ve missed some important details!

For me it went:

1. inital consult (30 min at clinic, internal scan, blood test)
2. follow up 2 weeks later to discuss blood and scan findings (30 min via zoom)
3. 1-2 months of choosing sperm donor/signing consent forms (didn’t need to go to the clinic for this as was online)
4. order our medication (needed to be home to receive this as temp controlled)
5. clinic told us to begin a tablet on day 21 of cycle (at home) for 5 days
6. period came 7 days after stopping this medication and then booked scan at clinic for day 2 of period
7. scan to confirm looks good, instructions on how to use injections (30 mins at clinic)
8. first injection started that night at home (temp controlled injection- needs to stay in fridge)
9. second injection started 5 days later in evening (not temp controlled)
10. 7 days after first injection started, had a scan to check follicle growth (20 min clinic)
11. had scan at clinic every other day after this
12. 10 days after first follicle scan, went in for egg collection (need 2 days off work as sedated)
13. 5 days after this, back to clinic for egg transfer (didn’t need the whole day off)
14. blood test later to confirm if pregnant or not
15. there are medications you may need post-embryo transfer but doesn’t really involve the clinic at this point.

thats probably really long winded but hopefully it’s helpful - in summary, I would say the 2 weeks after your first injection is the most clinic-heavy period of IVF.

It's all a bit uncertain really until you get going. Ours have been roughly:

• baseline scan towards end of cycle before you want to start (day 20/24 ish)
• start stims day 2
• scan day 5/6
• scans every other day or so from then on until trigger (usually day 12/13 can be more or less). You sometimes might need some blood tests during this time too.
• full day off for egg collection
• 5 days later full day off for transfer (you could work before/after but with the emotional burden I've preferred to take the whole day)
• test day usually 11 days or so post 5 day transfer, no scans or anything in between times

Meds wise you will usually start with daily stim injections, add in another injection to suppress ovulation around day 5. Then a trigger injection before egg collection. After egg collection most people start progesterone suppositories, no more injections.

I was fine with the egg collection to work the following day but some people need a day or so off depending on response.

Hope that helps a bit? I would definitely plan not to go away the month you're doing the cycle, it would probably add unnecessary stress. It's a pain juggling it all around work but if you have a good boss that will help! The other thing to say is just be prepared it may not work first time, it's very common it doesn't. It's hard when you go in with so much expectation but the reality is for most it takes several goes. Worth having conversations along this line with your boss too to help with expectations. Wishing you luck.

Thank you both so much, that is exceptionally helpful. Each attempt is a full month commitment from what you’re saying and I will simply decline all work trips ☺️

After a failed month, is it typical to take a rest/recovery month(s) or is it straight back on the horse as such?

I think most people would usually take a month in-between, to give time for a meeting with your consultant. It also gives you a break from the logistics and time to gather yourself emotionally/financially! We had a break for a cycle after our fresh transfer failed in May, then started a natural modified FET which didn't go to plan at all, resulting in no transfer, so we went straight into a medicated FET this cycle. I wasn't on any meds for the natural modified FET though so in some ways that was like a cycle 'off' too.

NHS round:
So initially scan/bmi weight check (20-30 mins) Consultation (30 minutes)

Consents - once they came through the portal got them done over 2 days. Waited about 2 weeks for clinic to sign them off digitally.

Protocol came through about 3 weeks after that. Could have started on my next period but waited an extra month (nhs bmi issue).

(November) Once called to say my period had started, bloods arranged and medication ordered ready for CD21.

(December) Bloods at clinic before stimulation drugs started (about 20 minutes for both of us).

(December) Buserelin injections (down regulation drugs) from CD21. Waited for period, about cd7 baseline scan (anywhere between 10-50 minutes for scans - most of time spent waiting) I hadn’t down regulated so continued with down regulation for another 4 weeks until next period.

(January) Baseline scan cd5 had down regulated. Stims started next day.

(January) Stims - scans started CD8 every other day until trigger.

(January) Egg collection

(February) Transfer.

Would have been all finished in January if I had down regulated like a normal person!

Second round (private)

Consultation after failed cycle took about 2 weeks. New plan laid out. We had a 4 month wait between cycles on purpose as we had extra tests on DH sperm and had new supplements. Consultant did say wait 3 months though before another egg collection. Once paid for cycle, more consents and then protocol was received. Received that in about 2 weeks after I’d paid.

paid for meds in May to start June so I had them ready.

June - started norethisterone for 10 days on cd18.

July - second day of cycle started stims. Scan from CD7 every other day. Trigger/egg collection/transfer all in July. Scans between 10-50 minutes (really did depend on how busy they were- also included blood tests and pre-op for collection).

So on short, at least a month while paperwork is sorted, but that shouldn’t interfere with work. Depending on if your short or long protocol expect the injecting/med/collection/transfer stage to last between 4-6 weeks.

Thank you both for your valuable insights, I really appreciate you typing it all out!