In Vitro Fertilization Intro (IVF)

Welcome to my first real post about our latest in vitro fertilization (IVF) journey. I have mentioned it during my last few monthly posts, but there really wasn’t too much to say back then. Some of you reading this may have followed our journey the previous times, others not. Whatever the case, I am going to brief you (or maybe not so briefly) about the whole process of in vitro fertilization. I will provide the details of where we are at in the coming months or so, because I know a lot of you want to pray specific prayers for us, and it is also kind of therapeutic for me to share. So keep checking back! Needless to say, our heart’s desire is to have another child, but as we have been praying about the direction to go over the last few months, we hopefully have our hearts okay with the end result of this attempt even if it is unsuccessful. We know God is in control!

IVF is “performed” over 2 cycles. In a woman, each month one egg (sometimes 2) starts maturing at or even before the start of her period. With IVF, the whole purpose is to get a bunch of eggs to mature at once. So, in order to do that successfully, there needs to be a “suppression” cycle to not have one egg already maturing, and thus ahead of the others. Birth control pills are used to suppress. So, at the start of a cycle, active birth control pills are taken for about 3 weeks or so to suppress.

Then, with the start of the next period (2nd cycle), the stimulation cycle begins. The woman gives herself injections of hormones a couple of times a day for an average of 12 days. This is done with small needles in the abdomen. This isn’t as scary as it sounds. I was nervous about doing it before I got started the first time, but then found out it wasn’t bad at all. The needle is just like an epee pen, if you are familiar with those. Ultrasounds and blood draws are done every other day starting about a week after the birth control pills have ended to watch the growth of the follicles and determine when the eggs are ready for retrieval. An egg matures inside a follicle. The follicle is visible on ultrasound. The size of the follicle determines the maturity of the egg inside. One to two dozen or so eggs are hopefully matured with this process. In a woman, every month a “batch” of eggs comes up and one matures. The rest are discarded by the body, so this process doesn’t have any effect on the number of future eggs because they all are coming out of the current “batch”. Didn’t know you would be learning so much about a woman’s reproductive system, did you?

Then after the ultrasound that says the eggs are almost ready, the egg retrieval is scheduled for the day after next. The egg retrieval is done under “conscious sedation” (basically out and don’t remember). The doc goes in through the vagina and pokes through to the ovaries to retrieve all the eggs. The eggs are handed over to the lab. The eggs are analyzed and determined if they are of good quality. The good ones are then fertilized. Then the embryos are watched as they hopefully grow for 3-5 days.

Then on either day 3 or 5 the best 2 embryos are transferred via catheter into the uterus. That is a simple procedure that basically is like getting a pap with a full bladder (for ultrasound guidance of placement). The number that are growing and the quality is what determines if the transfer is done on day 3 or 5. About 9 good embryos are needed in or to wait until day 5 (we didn’t have that many on either of the first 2 times). Any other good embryos on day 5 can then be frozen for future transfers. Progesterone shots are also started on the day of the transfer. These are a little bit harder because the needle is bigger and it goes in the backside. But I have done it myself for 3 periods of time, one being for about 10 weeks! If a pregnancy happens, then the progesterone shots are continued until about 9-10 weeks gestation to make sure the body has "caught on" to the pregnancy.

Then the waiting game begins. About 2 weeks later is the first blood test. HCG levels are measured. 5+ is considered positive, but they like to see 25+. If positive, then there are 2 more blood tests, 2 days apart each. The HCG levels need to at least double to continue to be positive. If all three tests are positive, then a pregnancy has occurred. A few follow up ultrasounds are then done at the clinic to ensure that a viable pregnancy is occurring, and also to determine how many babies are in there! After that, it is on to the regular OB doc at about 9-10 weeks gestation. Got all that? Feel free to leave questions/comments on blog posts or send me an email at swhunter84@verizon.net. This is how our precious Shaun started life, so here’s to another little miracle baby!

Our tentative timeline is as follows:

January 15 suppression cycle began
February 11 stimulation cycle to start
February 15 Frequent ultrasounds and blood draws begin
February 22 estimated egg retrieval
February 25 estimated embryo transfer
March 9 first blood test