IVF #4

We started IVF #4 in May after having a cancelled cycle (IVF #3) in February. We waited for two normal menstruation period before we decided that we're ready for our next IVF cycle. Going through our fourth IVF cycle feels like a routine already. The staff especially the Filipina nurses seem like old acquaintances. I was booked to a new doctor because my doctor's schedule is full. Since I already know the protocol, I agreed to see her.

The doctor performed an ultrasound scan and saw 3 small follicles on my ovary (a good sign!). I had my blood test and then received my first injection (Ceftriaxone antibiotics). I took home the Gonapeptyl injections (once a day for 2 days) because I want to take the shots at around the same time each day. I was also prescribed to take folic acid 5mg (daily) and antibiotic (Duradox 100mg 2x a day for 5 days).

I went back on Day 4 and saw my original doctor. We insisted that we follow the same medications as IVF #2 since that was the cycle when I had a positive pregnancy. My doctor agreed. I will start Pergoveris 300 IU injection on Day 5 and be back for appointment on Day 6.

If you haven't read my IVF #2 blog entries, Pergoveris is used to increase the number of growing follicles and stimulate their development. Follicles contain the egg cells. The aim of stimulating the ovaries in IVF is to ensure the simultaneous development of several follicles instead of just one in order to be able to collect several oocytes (immature egg cell) and to thus obtain several embryos so that at least one of them with a good morphology can be transferred back to the woman's uterus.

On Day 6, my ultrasound scan is looking good. Four follicles are seen, the biggest measuring 10mm. My endometrial lining is 6.3mm. My blood test results are also good. My doctor prescribed the same medicine (Pergoveris 300 IU) for 3 days.

On Day 9, 5 follicles are seen with the biggest measuring 14mm. My lining is 10mm. My blood test results are still great. It's good that we decided to stick with the same medication as IVF #2. My doctor prescribed the same medicine (Pergoveris 300 IU) for 2 days. I met with the anesthesiologist before leaving the clinic. They now require the patients to see the anesthesiologist before the Egg Collection procedure (also called OPU - Ooctyte pick-up). The doctor took note of my height and weight (if you're curious, I'm weighing 55kg that time). She also asked about medical history, etc.

On Day 11, 5 follicles are seen with the biggest measuring 17mm. My blood test is still good. My doctor prescribed the same medicine (Pergoveris 300 IU) for 2 days. 

On Day 13, 5 follicles are seen with the biggest measuring 19mm. I need to take one more shot of Pergoveris tonight and then the trigger shot (2 injections of Ovitrelle 0.5ml) will be the next day at 10:20 PM. 

The trigger shot is used for the final maturation stage of the follicles. I took 2 injections – left and right tummy. Timing is very important when taking this medicine. The OPU or Egg collection should be done 34-36hours after the trigger shot. Mine is scheduled on Sunday (Day 16) 10.20AM. I was advised to come to the clinic an hour earlier for the preparations before the procedure. Some precautions were also advised such as: no perfume, lotion, nail polish and feminine wash before the procedure and fasting for at least 8 hours before the procedure.

My OPU or egg collection procedure is the same as what I had described on my IVF #2 blog entry. I will leave out the details regarding the procedure so please refer to my earlier post for more information. The entire procedure is painless because I was under general anesthesia. Seven follicles were collected (this is a good number!). I was prescribed to start taking Cyclogest suppositories thrice daily. By the way, on the same day, my husband gave his semen sample in the clinic.

The next day, the embryologist called me and gave me an update. Out of 7 eggs collected, 5 are matured and out of those, 4 are successfully fertilized.

My Embryo Transfer is scheduled on Day 19. I was initially booked with another doctor but when my original doctor recognized my name on the list, she asked to be assigned to me instead. My doctor showed me the picture of my "babies" on the monitor while I was lying in the operating theatre. She asked me how many embryos do I want to be transferred. During my previous IVF cycles, they transferred 2 embryos only. But my doctor is saying that 3 embryos are still safe so that I would have a higher chance of getting pregnant. At that time, I was thrilled to have twins and very much okay with having just one; but the idea of having triplets terrified me! She said that the probability of having 3 is very slim. I never really thought that I would have to decide on this alone. Even if I wanted to consult my husband, I wasn't given enough time ask him. So, I gave the okay to transfer 3 embryos while praying that God will give us at least one but not all 3. I was prescribed with the same medications as my previous cycles - Cyclogest 400mg suppository (3x daily) and Progyluton white tabs (2x daily). Being aware of my previous miscarriage (after IVF #2), my doctor prescribed additional medicines that are believed to have helped other patients with similar case. So in addition to my usual medicines, I have to take Aspimed 75mg (once daily), Prednisolon 5mg (2x daily), and Clexane 20mg injection (once daily).

So, here comes the agonizing two-week wait (waiting till we find out if we are pregnant or not).