IVF Round 2

12/30/13: Started on birth control pills
I did not do this during Round 1 and the short explanation is "we're taking control of your cycle." It's all about controlling the timing, which is extremely important in fertility treatments.

1/10/14: Our in-service appointment is scheduled. This appointment is going to be another 1 1/2 - 2 hours even though we have already gone through it once. We have to sign new consent forms and they will go over our medication protocol in detail.

Friday I was pretty nervous and nauseous, but it was comforting going to the clinic again. I do love the staff, and I know they are pulling for us. It's a longer protocol (I got my wish on the delay) and a different mix of medications. One downfall is that the first round of meds was $2500, and this one is over $5K – out of pocket, not covered by insurance.

I've been dreading tonight for a while - I have to start the testosterone gel portion of my protocol. However, I did a little research on the "why" behind this recommendation and it makes me feel a little more confident. I can't find too much information on it, as it seems to be somewhat new in the realm of ivf treatments, but this is also another reason that I trust my doctor.

Another Infertility blogger (the infertile chemist) wrote about it in her post "Inspiration…and testosterone." Here is a snippet:
The thought is that in theory [insert head tilt and two-handed gesture] since DOR (Diminishing Ovarian Reserve) patients can't make as much testosterone, supplementation (through a gel or patch, or indirectly by taking DHEA – a testosterone precursor), will stimulate the granulosa cells to do their thing and prep those eggs. This is supposed to “enhance follicle recruitment” (more eggs) and “promote follicle growth and development” (better eggs).

I will be on this gel for 15 days, then onto the next. I actually made my IVF Google Calendar public if anyone wants to check it out! Some days towards the end of Stims will need to be flexible based on the results of my every-other-day bloodwork and ultrasounds, but I will be keeping it updated.

As a recap, I was on a contraceptive pill for a month & a half to control/suppress my cycle, and testosterone gel (blech) for 15 days, which is used in preparation for this next phase – Androgen hormones are used to improve response to stimulation medications (a non-FDA approved use of this medication). My last night of those two items was Monday night 2/10.

2/10 – 2/14: 
I wore an Androderm patch every day this week (also used to improve response to stimulation medications), ending on Valentine’s Day.  

I had my Baseline ultrasound appointment to make sure everything has been working as planned and there is no “follicular activity.” 

I started my “Stims.” The Stimulants are a combination of three injections I need to give myself every night for about 2 weeks. Two are hormones used to stimulate the ovaries to produce multiple eggs in a cycle, and one is a growth hormone used to improve response to the other two stimulants. I go in for every other day blood tests and then they will call me later in the afternoon to let me know if I need to adjust the dosage for that night.

  • Gonal F: 450
  • Menopur: 75
  • Omnitrope: 0.5

For me, it is not stressful giving myself the actual injections – it’s mixing them up in the correctly and in the right dosage. They aren’t all wrapped up and ready to go; most need to be refrigerated, and I need to add supplied water and mix with powder, and make sure the right amount is in the syringe.

Oh yeah, and the cost:

Here is a startling photo of all my meds for this 2 week period:

2/17 & 2/19:
Went in for a blood draw / afternoon phone call said no change to doses.

I will have my first ultrasound scan to check progress of the follicles. Nervous!

On Day 8-10ish, I will start adding in a fourth morning shot (Cetrotide) to prevent early ovulation.

2/28: Egg Retrieval
You can read about the Days 1 - 5 results in posts on the blog.

3/6: Day 6
Everyone's good vibes worked from yesterday's (Day 5) bad report - we have 2 embryos from this round that were able to be biopsied (1 bounced back from yesterday and 1 still not looking GREAT but good enough to biopsy) so we will be able to send a total of 3 for PGS testing. Those results won't be ready until 3/17 - another torturous waiting game.

No viable embryos to transfer. We will not be doing any more IVF with my crappy eggs. Here is Andy's post on Facebook from after the results appointment:
Well... not the news we wanted to hear. No viable embryos for implanting. Even though this journey has prepared us for days like this, it's never easy to go through or actually hear. Especially devastating for Pilar... mentally, physically and most importantly, maternally. For me, I AM STRONG and I am here to pick up the pieces and inch us forward. I'm not sad for me, I'm sad to watch the tears roll down Pilar's cheeks knowing our lives just changed once again. This one door has just shut, but I just kicked the shit out of the next one and it's already flown open. No looking back for now. I'll carry us down this new path and see what's down this road. And I will keep trying and trying because what I want more than anything is to one day see the smile on Pilar's face when she holds our baby so tight. That will happen one day and I know when it does, all this heartache and sadness will go away. Thank you to each and everyone one of you for your prayers, thoughts, kind words, and most importantly, for riding this journey with us. I would never regret letting you in our lives and sharing this with you. It has meant everything to us to have your support. But don't get off this wild ride yet... just when you think it's over, there's plenty more track ahead. This I've learned. There will be more tough days ahead, but just hang on. The only thing I know is one day we will all share the same tears of joy when you finally get to meet Baby Bower.

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