What Exactly Are You Doing?

Over the past few weeks I've been getting a lot of questions about what exactly is is that we are doing with this whole In Vitro Fertilization thing (take two?) These have come from friends, family members, and from some of you wonderful readers. You asked, so I'll answer... here is the quick and dirty of what IVF is (as told by me, using my understanding of what is going on, in no way insinuating that I am an expert/ medical professional.) Also, as requested, I will end this post with a quick update on where we are at in the process now.

• The process begins by trying to stimulate as many follicles as possible turning them into viable eggs. Typically only one egg is created per cycle.
• This is done using synthetic gonadotropins, which are injected daily, at varying dosages, with a goal of maturing as many follicles as possible, without overly stimulating them to avoid hyperstimulation. 
• During the period that the injections are being administered, daily, I am also undergoing blood work and ultrasounds to keep tabs on what is happening in the ovaries, and what the hormone levels are. The ultrasound detects how many follicles are growing, and what size they are. The blood work tells them if you get too close to ovulating naturally, so you can administer another set of injections to keep this from happening prematurely.
• Once the lead follicle reaches about 17 or 18mm a trigger shot is given. Exactly 36 hours from the trigger the follicles are retrieved. 
• At retrieval, general anesthesia is given and I am out for about 30 minutes to an hour. The retrieval is done in a hospital like setting and simultaneously, my hubby is (ahem depositing) his sperm in another part of the building, and after the eggs are retrieved (last time I had 17) they are then joined with the sperm to create embryos (hopefully.) 
• At this time I am able to leave the center, and 3 or 5 days later we return to have the desired amount of embryos placed back in my uterus (for us this number is always 1.) The decision to wait 3 or 5 days is one that is carefully made with your doctor, and there are major pros and cons to each choice. Last time we waited until day 5 to implant what ultimately was a frozen embryo. At day 3, we had 6 fertilized embryos, but our doctor thought that if we waited to transfer a day 5 embryo we would have had a much higher chance of implantation. Well, we didn't which is why we are now back to square one, which is why this time around we will definitely transfer 1 embryo at day 3, and freeze the rest for possible later use. (Later as in, we didn't conceive this time, not later we want a baby #3.)
• After the transfer you anxiously wait 2 weeks for a blood test to determine if you are a knocked up lady or not. This, for me, was the worst part of the whole process.

I get asked a lot if it hurts. It doesn't hurt per-se, it is just very uncomfortable towards the end. I feel very full all the time, and as the follicles grow there is a lot more pressure. I don't mind the injections, and I have found, this time around, that I like doing them better myself. To be honest the repeated doctor visits are what I find way worse. For me, the hardest part is the anxiety over whether or not I will hyperstimulate like last time. We have already decided that no matter what we will be transferring a live embryo (vs frozen) so I am either going to have a lot of pain, and bed rest, or everything will be gravy. This is still TBD. Of course, my biggest concern with this is childcare, but luckily this time around my saint of a mother-in-law (cue the heavens) is coming in with a one way ticket on Friday. Can you say sigh of relief?

Today I went in and we have 7 follicles that measure 13mm, and 29 that are still babies. We are hoping for 12 to get to 18mm. This would be just enough to ensure a good number of embryos, but not too many to cause as many problems as last time. It's a delicate balance, and I just hope this time it works in our favor. So, that is where we are at now, just waiting to see what happens.

Obviously, I will keep you updated as things progress. There will likely not be any action until the end of the weekend.

I hope I didn't bore you all too much, but you asked.... ;)