Fifth appointment for my IVF #2

We have spotted an additional follicle! I have now 5 so far with sizes 12-21mm. Since the biggest one is more than 18, my doctor is thinking that I may be scheduled for the final trigger shot this evening. She told me that they will call me this evening as soon as my blood test result is out. They wanted to confirm my Estradiol level. Although my nurse who gives me the injections told us that it is very likely that they will ask me to take the final trigger shot because my previous Estradiol level from my last appointment is a bit more than 1000. She said that they are usually looking for >1000 level. She told me that my lining is a bit thin though. It measures 9.4mm now. She said that the ideal thickness should be 10-12mm. Although based on my internet research, it says that more than 8mm is good enough. Besides, after my OPU, I would be taking medicines which will make my lining thicker. Therefore, I’m not so worried.

Just before 9.30pm, I received a call from the clinic instructing me to take the trigger shots at exactly 9.30pm today. It’s good that the nurse gave us the medicine so we didn’t need to rush back to the clinic. The medicine is the same as what I took in my IVF #1. It is called Ovitrelle 0.5ml. This injection 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 (Ooctyte Pick Up) or Egg collection should be done 34-36hours after the trigger shot. Mine is scheduled on Thu 9.30am. 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 after 12am.

Compared to my previous IVF, I didn’t feel too much discomfort during the course of my stimulation this time. Probably because my ovary is still inflated from my previous cycle. The reduced number of injection also made it feel lighter. Though I still experience mood swings, sudden twinges in my abdomen, a bit tightness in my belly, frequent urination, mild headaches, and the feeling of being thirsty all the time.

We are also more optimistic for this cycle compared to the previous one. I remember having a dream of just giving birth to twins. We are in the hospital room and I am breast-feeding them. My husband also had a dream of us having twins. We are really excited for our-soon-to-be God’s Bundles of Joy. We are really claiming that this time is God’s time for us to have our family complete! I can’t wait to see a BFP (Big Fat Positive) on my first post hormone blood test!

I like ANC’s final word tonight that is posted in Facebook. It goes: "Nothing is impossible. The word itself says: I'm possible." Good vibes!

Fourth appointment for my IVF #2

My follies are growing fast! We have seen 4 of them with sizes 9-14mm. I am still on the same medication, which is actually a relief because in my IVF #1 I think by this stage I have around 2 or 3 injections per day.

Third appointment for my IVF #2

I’ve got 3 visible follicles seen in my ultrasound which ranges from 8-10mm. I hope that in the next few days they would continue to grow more and that more follicles will be spotted. My doctor recommended the same medication (Pergoveris 300 IU) for 3 days. I also did my blood work after.

Second appointment for my IVF #2

Days before this appointment, I observed that my period became heavier (it started to be so light). But on the day of my second appointment (D6 of my period), it was reduced to almost spotting. After my TransV, my doctor said that I can start my ovarian stimulation. She prescribed Pergoveris 300 IU for 3 days. Pergoveris injections contain the two active ingredients, follitropin alfa and lutropin alfa. Lutropin alfa is a synthetic version of a natural pituitary hormone called luteinising hormone (LH). Follitropin alfa is a synthetic version of a natural sex hormone called follicle stimulating hormone (FSH). In the ovaries in women, FSH and LH increase the number of growing follicles and stimulate their development.

After taking my routine blood test for my baseline hormone levels, I went to the basement floor to take my injection. The Filipina nurse was not there. Instead, there was the Indian nurse that I’ve previously met during one of my operations. She insisted on giving the shot because she wanted to show me how to prepare the injection. One box of Pergoveris contains two vials— powder and solvent solution for injection. The powder vial contains 150 IU (equivalent to 11 micrograms) of follitropin alfa and 75 IU (equivalent to 3 micrograms) of lutropin alfa). Since my prescription is 300 IU of follitropin alfa, I need to take 2 boxes of Pergoveris in one shot. The nurse inserted the syringe (with big needle) into the solvent vial and took out the liquid. Then she injected the solvent into the vial of powder. After the powder is dissolved, the solution is taken back into the syringe. She then injected the solution into the second vial of powder (second box of Pergoveris), which completes the 300 IU of follitropin alfa. As soon as the powder is dissolved, the solution is taken back into the syringe. The big needle is then replaced with a finer one and then injected in my tummy below the belly button. I’m glad that the other solvent was spared because it would mean more liquid injected! The drug was a bit painful but it doesn’t linger.

First appointment for my IVF #2

The problem with my breakthrough bleeding (see previous post: Summary of IVF#1) is that I had difficulty in assessing the start of my period. After having a failed IVF cycle (IVF#1) followed by a hysteroscopy, my doctor prescribed birth control pills before I could start IVF#2. I read that menstruation period usually comes 3-5 days after the last pill. Since I was constantly having spotting, I found it challenging to determine if it is the start of my genuine period or just the usual spotting (a side effect of taking the pill). Three days after my last pill, I got bright red spotting that is more than usual (but not yet enough for me to wear a pad). The next day was more blood but still very light. After reading some posts in the internet, I decided that this should be it! I called the IVF clinic and asked for an appointment for that day since it is D2 of my period. Fortunately, they squeezed me in Dr. M’s busy schedule.

After my TransV ultrasound, my doctor said that I am ready to start my treatment. She changed my medications though. She prescribed two days of Gonapeptyl 0.1 mg injection which is for hypophysary inhibition or blocking of pituitary gland in order to prevent premature ovulation during ovarian stimulation. Just like in IVF#1, I took a shot of Ceftriaxone 1g antibiotic injection. I was also advised to take the same set of drugs as my previous IVF cycle: Vibramycin 100mg (taken twice daily) and Folic acid 5mg (taken once daily).

 

We took home the Gonapeptyl injections. This injection is the easiest one to administer because it is ready to use.. no need to mix, measure, or transfer to the syringe. The needle is also small and thin. As usual, my home nurse (my husband) gave me my shot. Perhaps it’s because I am now used to injections that I’ve become more prick-tolerant.. or maybe my nurse has become a pro in giving the shots!