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Thursday, November 11, 2010

Round 1 (IVM): Step 1 Begins! (Steps Included)

“In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.”

Remembrance Day has always been close to my heart as both of my maternal grandparents were in the war and I grew up hearing all of their stories. My grandfather passed away when I was 12 but my grandmother is still alive today and I love her to pieces! I am hoping, though, that Remembrance Day of 2010 gives me even more to remember and be thankful for than ever before because today I officially begin my first attempt at IVM! I did not pick this day specifically, more so because it worked with our schedules, but it feels like a good day.

These are the steps and how things should go in an ideal world. Obviously, when dealing with the human body, anything can happen so this is not at all set in stone!

Step 1: Since I still do not have a regular cycle, I need to take Provera (a synthetic variant of the human hormone progesterone) in order to begin AF. I need to take 2 pills a day for 3-4 days and then I can expect AF shortly after, bringing me to CD1.

Step 2: On CD1 I call the hospital to schedule a couple of ultrasounds in order to monitor the growth of my follicles followed by an injection of Human Chorionic Gonadotropin (hCG) to mature the eggs 36-38 hours before egg retrieval.

Step 3: Egg retrieval. This will not be the most pleasant experience from what I have heard but it must be done. Once I know more about it and when I am scheduled I will post about it. The interesting thing about this day is that my pregnancy test will actually occur 16 days after this date. In the “normal” baby-making process, this would be the date of conception basically. At this time I will also begin taking Estrace and Prometrium (a combination of Estrogen and Progesterone to help support the endometrium - lining of the uterus), and Doxycycline and Medrol (an antibiotic and a corticosteroid to help create a favorable environment for implantation of the embryo) in addition to the other medications I am currently taking.

Step 4: My collected eggs are matured further in the lab, fertilized using ICSI, and then monitored for a number of days afterwards before transfer. Not all of the eggs will make it through this process but the hope, obviously, is that at least a couple of them make it through the process strong, healthy, and ready for transfer. The embryos that are not transferred will be frozen for a future attempt so that I can avoid repeating all of the previous steps. This could be a month after (if IVM is unsuccessful) or years later for a sibling.

Step 5: Transfer time! I will go in and meet with the Embryologist to choose the best looking, strongest, and healthiest embryo. They will then perform what is called “assisted hatching” on the chosen embryo and then transfer the embryo to me. And then we wait. I will be placed on a 2 week sick leave in order to give me the best possible chance of success; little activity, no stress, lots of rest, fingers and toes crossed... you get the picture. I will stop taking Doxycycline, and Medrol at this time but stay on everything else.

Step 6: The blood test. If positive, I schedule an ultrasound 2 weeks later to determine the number and position of any pregnancies (yes, twins are still possible) as well as an appointment to see the high risk doctor. If negative, I go back to my fertility doctor and schedule round 2 (using the frozen embryos) as soon as I am ready.