INFERTILITY / IVF TALK
My Infertility Journal, Part 5: IVF Preparation and ALL THE SHOTS
Megan Tansom | June 5, 2019
January – March:
After some much-needed sunshine and rest, fast-forward to end of March and our IVF medical outline Wow. It was over $5,000 of medication in the first shipment (with more needed later). I laid out everything on our dining room table to make sure we were good to go. I am anal. I didn’t want anything to go wrong because I wasn’t paying enough attention. I read on an IVF blog that it is so important to stay organized. I have a huge tub of supplies, a calendar to check off every medication and shot, and have taken over our guest bathroom.
March – Start of Meds:
The shots started on a Sunday at the end of March (2016). They are shots of course, but not terrible. The ones in the stomach at least… I was able to give them to myself. I mean, they suck, but looking back now they are nothing compared to the intramuscular progesterone and oil shots that came later. Intramuscular is a fancy way to describe in the muscle…. of the butt in this case.
Intramuscular: An intramuscular injection is a technique used to deliver a medication deep into the muscles. This allows the medication to be absorbed into the bloodstream quickly (Healthline).
Progesterone & Oil during IVF: During an in vitro fertilization (IVF) cycle, medications are usually used to prevent you from releasing an egg early (premature ovulation). These medicines affect your progesterone levels. Therefore, your doctor may prescribe a progesterone supplement to make up for this decrease in your ovary’s ability to make progesterone. That way, an embryo can implant and grow inside your uterus (womb). Many scientific studies have looked at pregnancy rates in IVF cycles that used progesterone (ReproductiveFacts.org).
Every day for two weeks was dictated by the timing of my shots. I had to start Ganirelix Acetate injections which prevent you from ovulating on your own. Those shots were way worse than the Follistim and Menopur for sure.
Ganirelix Acetate: This medication is used by women having certain fertility treatments (controlled ovarian stimulation). Ganirelix is usually used in combination with other hormones (FSH and hCG). It works by blocking the release of a certain hormone (luteinizing hormone). Ganirelix stops eggs from being released too early and gives the eggs time to grow properly (WebMD).
Follistim: This medication contains follicle-stimulating hormone (FSH) and is used to treat certain fertility problems in women and men. In women, it helps stimulate healthy ovaries to produce eggs. This medication is usually used in combination with another hormone (hCG) to bring about the growth and release of a mature egg (WebMD).
Menopur: This medication is used to treat certain fertility problems in women. It provides follicle stimulating hormone (FSH) and luteinizing hormone (LH) that help healthy ovaries to make eggs. This medication is usually used in combination with another hormone (human chorionic gonadotropin-hCG) to help you become pregnant by bringing about the growth and release of a mature egg (WebMD).
At the end of March, I was doing four shots a day and going into the doc for ultrasounds every other day for monitoring. It is a lot and I obviously still had to work and try to have a life in between there. As I have mentioned before, we live in Stillwater and I made the drive to Maple Grove EARLY every other day to get checked out. We were that confident in our choice of doctor that this didn’t bother me too much. I was used to the drive at this point too.
My follicles were growing nicely and multiplying appointment to appointment – which was GREAT news! Every other day or so basically I went in for the doc or tech to measure the size of my follicles that had the potential of having an egg inside. They measured the size because typically the larger follicles, those greater than 15mm or more at the time of retrieval, have a better chance of yielding a mature egg. That is the reason for taking all the stimulation meds so that even if one follicle doesn’t contain an egg, you have many other chances. For those going through the process and know what this means in detail, here were my numbers by appointment date:
March 16: 9 on the left, 5 on the right
March 21: 9 on the let that were greater than 10mm and 12 that were less than 10mm // 7 on the right that were greater than 10mm and 7 that were less than 10mm
March 24: 18 on the left that were greater than 10mm and 9 less than 10mm // 11 on the right that were greater than 10mm and 6 that were less than 10mm
What does this mean??
That is LOTS OF eggs, y’all. (Follicles are not eggs but the more I produced, the more possibilities of eggs!) I actually sent a snapchat to some close friends who knew I was going through the IVF process with “lots ‘o eggs” as the caption. I actually had one sweet friend who thought I had a big breakfast – and was not phased by it – totally supportive of my intense egg eating sesh. 😉
Not that I knew exactly what these numbers meant but like the nurse said when I asked, “Is there ever a point when there is too many?” She responded, “Nope! We are greedy. We will take as many as we can get.” I was very excited and optimistic after these appointments. Things seemed to be heading in the right direction. After that last ultrasound, we received a voicemail telling us when to do our trigger shot.
The time of the trigger shot was 7:30PM on Friday, March 25. Then 26 hours later would be our retrieval. We had Ryan’s family over for Easter that Friday and my sister-in-law, Alex, watched me mix up my meds. (Pregnyl and Lupron trigger) and give myself these shots. (Ryan did offer in the beginning to help with the shots but after a couple of attempts, I decided it would be LESS painful to do them myself. Bless him. He hates needles).
Lupron: Leuprolide Acetate (often called Lupron) is used commonly to prevent premature ovulation. In my case, it was used as the trigger injection prior to my egg retrieval. Lupron carries a lower risk of hyperstimulation than other fertility drugs.
Pregnyl: This injection stimulates the final maturation of eggs in the ovaries during the IVF process.
REFLECTION TODAY: Many people ask about this part of the process – the shots. When I tell them it was two weeks, they seem to think it isn’t a big deal. Two weeks may seem like nothing but it seemed to be a curse during this process. EVERYTHING seemed to be measured by two-week intervals. The two weeks wait between the process and finding out you’re pregnant, the two weeks of intense meds for IVF, the two weeks or so you wait after you are done with one full cycle to start the next. Two weeks doesn’t seem to be a long time unless you are going through this. Being a human pincushion for two weeks was a lot… physically, emotionally, mentally… Not only that, but I had to continue the progesterone shots for months afterward. I got used to it. I can’t imagine doing this daily and am thankful and blessed I don’t have a disease that would make this a part of my daily life.
You really have to have a “let’s do this” type attitude during infertility treatments. Nothing about them is fun. I always had my mind on the end goal. A baby. ALL of this had to produce a baby, right!? My journey, pain, wait, would all be worth it in the end. I am one of the lucky ones that did get a baby (actually two!) at the end of all this. My heart goes out to those who had to go through IVF multiple times and maybe even move on to other things or other ways to grow their families. It wasn’t easy but I am thankful for our blessings.
I will dive a little deeper on the actual price of these medications and process on how to obtain them on a later post. Next infertility journal post – Our Retrieval – Coming soon.
If you are going through these treatments, the clinic where we had our treatment has some education on their website and show how to mix and inject some of these meds talked about above. If wanting to know more, check out this link.
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