Hello bleeps. My journey continues with the visit to the IVF nurse. She was a very nice lady who has worked at a government hospital, then Vitalab and now Medfem.
It is helping me to write this all out and digest it.
She first of all described how the cycle would go.
At the beginning of the cycle estrogen is low, you menstruate, and estrogen gradually increases – FSH (follicle stimulating hormone) helps in this. Then in the middle you have an L H (luteinizing hormone) surge and that’s where you get ovulation. Then you get progesterone which stabilizes the lining and gets it ready for implantation.
Menopur is like FSH and it will help to stimulate the follicles. This is what I will be on from CD 3 for five days. Concurrently they will also put me on two other drugs to counteract those immune antibodies they picked up in the blood tests. I can’t read the nurses’ handwriting so well, but it looks like Ecotin and Meticonlen. Could be totally wrong on those.
At the same time as all this, on day 4 and 5 of having the menopur I will also have Cetrotide which will block the pituitary gland and prevent the LH surge too soon, so that they will have control over when I ovulate.
The scans pre egg collection will be on day 3, 8, 10/11 (or not, or more, it all depends on my ovaries).
The trigger will happen 48 hours before aspiration (egg collection). I hope I got that right. That will happen in the morning, you are there around 9. It takes about an hour and you go home around lunch time. I will be asleep but not under general anesthetic. I do need a ride home. Have to start thinking about that as well.
Once I’ve done that the day after I will be on intragam, and this will carry on weekly for 12 weeks (again to fight the antibodies) (assuming I’m pregnant).
Transfer (at lunch time) 5 days later. You then phone the first, second and third day after transfer to see how things are going.
I then go on Cydogest (to aid progesterone).
Pregnancy test 13 days after transfer.
I chatted to her a bit more about my dilemma with test week. She said that ovaries can be unpredictable, wait until I get my period and then make the decision. I am tending right now towards doing it now in October, particularly because they shut the place down towards the end of December (summer holidays here) and I don’t want to be stuck, start rather sooner than later.
It looks like the Day 3 scan is the biggie: you go in, and also have to pay the deposit, get your meds from the pharmacy and then go for instructions on how to use them. This (according to my rough calculations) will be the week before test week which should be fine. The balance of the money is paid with the egg aspiration/collection. On this day they also need the sperm sample.
Some other stuff I have just been made aware of: the sperm test came back good but right at the bottom it says: Comments: Pos Mar Teratoz. This was not explained to us before and it is the first time we are hearing about it. This apparently means anti sperm antibodies. The sperm like to clump too much together.
So what they will do is put a fluid in the container before the sperm is even added. Hopefully this will help them separate. They will do a h.b.a. test (which tests sperm binding ability) to see. If not, if the worst comes to worst, we have to go the ICSI route which will be an extra R11 000. But the nurse seemed to think not. She just said it is good to be prepared for the worst.
Also: if my egg’s embryo “shell” is too thick and the sperm cannot get into the egg, then they have to do “assisted hatching” which means they will break a little piece of the “shell” so that the sperm can get in. This is routine for all patients over 38, and being only 5 months away from 38, I need to be prepared for that as well. That would be an extra R2662.
She has also given me a dvd to watch on how to mix the powder and water for Menopur. Haven’t watched that yet.
Well, I know that was all a bit technical. But I hope I got it all straight. Feel free to give me some comments and give input. I am still digesting all this information, and I’m sure the questions will start coming soon. That’s why I took down her email address.