The roller coaster starts

I definitely have a love/hate relationship with this Mother Nature character.  After 2 full days of examining calendars, discussing our holiday options and weighing work stress – Hubby and I decided to move forward with starting injections this month, on day 2 of my period.  This would mean canceling our trip to visit his family the day after Thanksgiving – something we would offset by visiting them during Christmas instead.  Our other options were pushing the stimulation start out 2 weeks (big projects at work near retrieval day) or pushing it out a month with my natural cycle (retrieval would fall like, ON Christmas day).  We also could have waited until January but we just didn't want to keep pushing this out – the whole idea is to "get sh*t done", remember?!

So – we were feeling comfortable with our decision.  Talking about what we'd tell his family and when we should tell them.  Trying to psych ourselves up for the idea that we'd be starting injections in just over a week!  Eeeks!!

And then….

AND THEN…..!

My period arrived…ONE week early (I'm usually like clock-work.  WHAA?!!)  

This was – mostly good.  It meant stimulation would no longer fall right DURING the Thanksgiving holiday and weekend afterward, and would therefore not disrupt our travel plans (good thing we hadn't told anyone they were changing yet!)  But it did obviously move everything up about a week.  That meant there was a chance (tho teeny-tiny) that the retrieval would fall on Thanksgiving Day.  It also meant that the scary injections that I was trying to psych myself up to happen in a week – would be happening TOMORROW!  Good thing we didn't have plans to be out drinking, clubbing and dancing like we usually did on weekends(…8 years ago).

The week ahead looked light - that was good.  Nothing needed to be cancelled - no excuses made.  I really had no idea what to expect in way of side effects from the injections over the next 10 days.  I'd heard exhaustion and a lot of bloating/bruising which would get worse the farther into Stimulation one was.  But obviously I had no idea how I, personally would react.  But better to have a clear week and fridge full of leftovers, just to be safe.

Since I haven't mentioned it before - allow me to share the overall IVF schedule we will be following as per Dr. A's program.  We are opting to do PGS (Pre-implantation Genetic Screening, also known as Pre-implantation Genetic Diagnosis) which is the genetic testing you've heard me mention.  This is an additional cost and something very new to mainstream IVF, but a game-changer.  This also changes the schedule we follow where there is a large break between retrieval and transfer - different than most traditional IVF schedules people are used to.

Our IVF Schedule:

• Stimulation - starts the 2nd day of your period.  Consists of injections each night to stimulate your ovaries to mature all the eggs.  Stimulation typically lasts about 10 days where you're taking injections to mature the eggs while holding off ovulation.  Numerous ultrasounds and bloodwork are scheduled throughout in order to see how the follicles are growing and check your estrogen levels in order to know the best time to go in and retrieve.
• Trigger - around Day 10 of Stim the doctor will prescribe a "trigger" shot which should provide final maturation for the eggs and help ovulation along.  Retrieval should happen within 36 hours of this trigger shot.
• Retrieval - roughly Day 11 or 12 of Stimulation.  An outpatient procedure with either general anesthesia or heavy sedation.  The Hubby will need to provide the swimmers (and be there for moral support, help you home, clean the house, cook you dinner, give you a massage, buy you a new handbag etc.) so it's an all day commitment for both of you.  The doctor will go in and suction out the matured follicles in the hopes that they contain mature eggs.  They are immediately whisked away to the embryologists who will fertilize them.
• PARTY!!! - at this point you can kick back and relax.  Take a vacation, go out and party, run a marathon etc.  You get a break for about 5 weeks.  Essentially you have to wait until your body is ready for implantation and your body essentially just ovulated.  Typically a body is ready for implantation about 1-2 weeks after ovulating.  But we also have to wait for the genetic testing which takes about 2 weeks AFTER the embryos have aged 5 days.  At this point, your body isn't in the right phase of the cycle to do a transfer so it takes another 2 weeks after that before transfer can happen.  Hence ~5 weeks after retrieval.
• Embryo maturation - "meanwhile, back at the lab..." your fertilized eggs are (hopefully) growing and splitting and doing so beautifully.  The best eggs were chosen to be fertilized by the best sperm and now they're being monitored by embryologists.  If they don't look promising, they're discarded.  The hope is that there are great looking blastocysts by Day 5.  If so, a micro-section of cells is removed in order to be biopsied as part of the genetic testing.  A couple weeks later we'll get a "report card" back for each of the embryos.  And thus the whole parent-judging-their-children begins!  "Why did you only get a B+ instead of an A?!?"  We'll hang the report card on our fridge if our "kids" have performed well enough...
• Transfer - ~5 weeks after retrieval (if doing PGS) the chosen embryo(s) will be transferred during another out-patient procedure.  This one is without any sedation or general anesthesia and is a very fast and painless procedure in the big scheme of things.  Go home, lie around for a couple days, and keep your fingers (and legs?) crossed that the kid with the great report card is continuing to excel in there.

It can be a long and complicated process with many possibilities for disappointment along the way.  But here we were, about to get in, sit down, shut up and hold on - the IVF journey was about to start!