Tag: stimulation

Final Cycle – Day 11

Final Cycle – Day 11

Ok so today is the last of the stimulation meds, ive had to do 3!!! This is because im stimming an extra day and i only had 100ui of gonal f in the pen (1 jab) so i had to draw from a vile to top up to 200iu (2nd jab) and then the med to stop me ovulating (3rd jab). 

Later tonight ill do my trigger/hatching shot (10pm local time) this is the med that NEEDS to be done on time pretty much to the minute as it signals your body to mature and release the eggs, 36 hours later, Dr F will collect my eggs.

Tomorrow is totally drug free!!! Woohoo! 

Sunday is egg collection. Ill pick up my post EC meds from the clinic same day but no more jabs until egg transfer now.

Mr Me goes home tomorrow 😢 which is very sad. He will need to go up to clinic to provide a sample tomorrow before he departs.

Im meeting up with some fellow TM patients on Sunday which im excited for.

Until tomorrow then…

Love, Little Miss PMA xxx

Final Cycle – Day 9 (yesterday)

So day 9 was travel to Cyprus day. We were up at 4.30am and hit Kyrenia about 6.30pm local time. After only 4 hours sleep, we were all exhausted so we had a quiet night in.

Ovaries now feeling very full. Arrived to a whatsapp informing me to be at clinic at 11am on day 10 (today) 

Ok less graphics from here on in out as dont always have wifi!! 

Love, Little Miss PMA xxx

Final Cycle – Day 8

Final Cycle – Day 8

Day 8!!! Only 2 more days of stims (hopefully) huzzah! 

Physically, apart from my sore ovaries and few headaches ive felt fine. Ive also not had the obligatory ‘i hate my life, i hate ivf’ day so perhaps gonal f agrees with me more than menopur did.

On the whole im still feeling pretty calm. I must be a bit stressed as my eating has dropped, not to scary levels but enough to make me lose a couple of pounds. Im aware of it and trying to tackle it without getting myself whipped up about it. 

We fly tomorrow! If my Mum ever arrives….

Love, Little Miss PMA xxx

Final Cycle – Day 7

Final Cycle – Day 7

So carrying on with the 2 jabs tonight. Im VERY aware of ny ovaries now. Cannot wear anything tight round my middle anymore and if i have a full bladder, ouchy! 

I was like this in May which resulted in a freeze all. Im seriously concerned this could happen again but im putting ny faith in the team and in gonal f. All being well i should collect plenty of eggs but my E2 (estrogen) levels will be within tolerance.

Did the last minute shopping today as well as having my eyebrows threaded, meeting a friend for coffee and packing.

Nails are all ready for holiday…

Ive got rainbow toes as im trying to make a rainbow baby and i love paint party on my fingers. This is my latest obsession by the way….Jamberry. I was introduced to it in May and im in love. For more information please click here. They are heat activated vinyl wraps that come in over 300 designs! 

2 days until we fly…

Love, Little Miss PMA xxx 

Final Cycle – Day 6

Final Cycle – Day 6

So today we added in a second drug. Cetrotide – this stops ovulation. Ill be given a trigger or ‘hatching’ shot in Cyprus to signal my body to ovulate but we dont want it happening before egg collection.

This one involves a bit of mixing, the syringe is prefilled but you have to add it to the powder, wait for it to dissolve and draw it back up into the syringe.

Then you swap needles, get the air bubbles out and jab.

Ill continue on this regime until i have the trigger shot, then a drug free day before egg collection! 

3 days until we fly! 

Love, Little Miss PMA xxx

Its the final cycle dede deerr duurr…dede de de deerr! 

Its the final cycle dede deerr duurr…dede de de deerr! 

So back to me….

I started spotting Sunday afternoon meaning i was expecting AF in full Monday, but instead, more spotting.

Still nothing today so ive come to the conclusion that 42 days on the pill = no period for me.

However after YEARS of tracking my cycles and knowing that my 4th pill free day is usually cd1, im pretty confident today is cd2 and i did my 1st shot of the last ever cycle earlier.

And oh my god, it was sooooooo easy. Its a prefilled pen so you attach a needle, set the dose, stab and plunge. The needles are super fine too so no pain!! Took all of a minute even without my glasses on! 

For this cycle, as its my last, im going to blog pretty much daily. Many of the posts will be short and sweet this week as when stimming you tend not to feel anything until the 2nd week.

I had reflexology this evening and a massage yesterday, im all about keeping the zen feeling going! 

Until tomorrow then….

Love, Little Miss PMA xxx

IVF – a basic guide

IVF – a basic guide

IVF is a complex process that takes months to set up and then weeks/months to execute. If you are new to IVF its very daunting as there seems so much to get your head around and understand. So ive put this together for my non ivf friends and those just starting out.

Easiest way to do this is a timeline:

Within 6 months of starting treatment youll need a number of tests performed on days 2-4 of your menstrual cycle. These tests include:

  • AMH – this looks at your egg reserve
  • FSH
  • LH
  • Oestriodal
  • Prolactin
  • Thyroid stimulating hormone

Youll also need a scan in the same time frame to check you antral follicle count (AFC) this is simply the number of follicles on each ovary before treatment. This number is NOT the number of eggs you will get at collection.

Some clinics also run STI blood tests for HIV and Hep A, B, et all aswell.

The good thing about these results is there is no bad or good. They are simply to help the Doctor prescribe the right stimulation drugs. Do not read too much into these results, you may be above or below average but thats not what is important, what is important is that Dr has the most current info possible in order to stimulate safely.

Its worth noting that many UK clinics see the 1st attempt as a trial run to see how your body responds (even with all the test results Drs have no clue how you as an individual will react) and that is why many 1st cycles fail and drugs are tweeked for the 2nd cycle.

So, now we have all the tests done, what happens next? Well your clinic needs to fit you in. This usually involves calling on day 1 of your cycle and awaiting a call back for availability (and this is why i dont cycle in the UK – the waiting lists are absurd at some clinics) 

Once accepted, youll be given a drug teach appointment. If cycling abroad you dont get this but there are loads of youtube videos that you can watch!! 

Ive only ever done short protocol on a fresh cycle (fresh means eggs are collected and replaced in same cycle) so im going to focus on short protocol.

Short Protocol

Period starts = day 1. If your period arrives after midday the NEXT day is CD1.

Day 2 = stimulation medications start (usually gonal f or menopur)

Days 3 – 6 = stimulation meds

Day 7 = add in medication to STOP ovulation (dont want all those eggs being let loose) and its usually Cetrotide.

In the UK you will be monitored via bloods and scans but nothing really starts happening until the 2nd week.

The scans are to look at FOLLICLE development…they will be counted and measured. Usually they need to be around 18mm to be considered ready for collection. During this time, your stimulation meds can be adjusted accordingly during monitoring.

Once the follicles are ready youll be given a trigger or hatching shot. It basically tells your body its ok to ovulate in the next 36hrs. When you take the trigger Egg Collection will be EXACTLY 36 hours later.

The day after trigger is a DRUG FREE day, woohoo!!! Its the only one in the cycle mind, but its welcome as youll be quite battered and bruised.

Egg Collection

This is a medical procedure and the majority of clinics sedate you meaning nil by mouth from midnight the night before. Its light sedation but youll not remember the procedure which is nice…plus the after affects are funny (see ‘Time for a laugh’ for details)

During the procedure the Dr will aspirate your ovaries. Remember not every follicle will contain an egg.

After collection IVF/ICSI or IMSI will be performed

IVF – the sperm and eggs are placed in a petri dish and left overnight to fertilise

ICSI – used when sperm count is low or of low quality. An embryogist looks through a microscope, physically selects the best looking sperm and injects it into an egg (its actually a lot more complex than thar but unless you are a science geek like me, its probably not of interest) 

IMSI – very similar to ICSI but with a stronger lens in the microscope i believe. 

Embryo Development

Over the coming days the embryos will be placed in an incubator and cultured in a medium. The embryologists check the embryos daily to monitor cell division and growth. During this time some embryos are likely to arrescyc

During this time you will be prepping your body for transfer. You will most definitely be given pessaries, waxy bullets containing progesterone that is inserted vaginally or anally. You may also be given estrogen support to thicken your lining, antibiotics, steroids etc. All clinic and protocol dependent. 

Embryo Transfer 

This can take place 2, 3 or 5 days after collection. It all depends on the number of embryos and the quality. Only with high numbers will most clinics go to day 5 development. There isnt a best day for transfer. Pregnancies can happen from any day transfer 

It is thought that by day 5 only the strongest will have survived when there is a high number of embryos making selection for transfer easier

Embryo Transfer

Ita basically a smear with a full bladder. Uncomfy but not painful. The full bladder is for the sonagram thats performed during the procedure. It allows the Dr to see inside your uterus and place your embryos in the best spot. If youre lucky youll see a flash on the screen as your embryos are transferred by catheter. And thats it. You are pregnany until proven otherwise! On a short protocol the time taken matches your menstrual cycle so its all done in 4 weeks and that includes the 2 week wait.

2 week wait

I wont lie, its mental torture. You analyse every twinge, sneeze, cramp wondering what it means. There is no cure, just keep as distracted as possible until test day. Im not an early tester and would recommend you dont test until 9dp5dt (9 days past a 5 day transfer) or 11dp3dt or 12dp2dt as then the result will be accurate. I usually break at 11dp5dt as my clinic’s OTD (Official Test Date) is 12dp5dt.

Fingers crossed youll get a positive result but remember IVF isnt a gurantee, even if youve had children tradtionally before. Even when everything is text book, once transferred its all in natures hands and it can still fail (which has happened to me more than once) 

Embryo Grading

MEANS NOTHING!!! Its something the embryologists use to classify embryos but a high grade embryo doesnt mean a baby, nor does low grade mean a negative result. Its just luck at that point to be honest.

Ive only outlined a basic ivf cycle, these days there are loads of extras you can opt for and ill discuss the ones im going for in more detail in future blogs.

I hope that helps give an idea of whats involved but feel free to ask me specifics and ill do my best to answer them. Also feel free to share with family and friends so they have an idea if whats happening when and then hopefully they wont ask lots of questions whilst you cycle.

Love, Little Miss PMA xxx

The plan…

I realise i havent mentioned what is actually happening in cycle 9.

So instead of stimulating on menopur, im using gonal f for the 1st time

I asked my clinic why we were changing and i got an amazing explanation…

‘Yes it’s to try and keep E2 down but also because you have PCOS so you should have a better response using only a low dose of FSH rather than FSH/LH combination like Menogon.

There’s a scientific article that sort of explains the difference between Gonal F and Puregon:http://www.fertstert.org/article/S0015-0282(08)03820-X/abstract

Basically patients using Gonal F and Puregon had a similar number of eggs collected but the ones using Puregon had a lower pregnancy rate and much higher E2 levels.  Gonal F has a higher rate of pregnancy and lower E2 levels.’

So that’s promising as the reason for the freeze all was due to really high E2 levels and its our LAST EVER cycle, i REALLY want to get to transfer.

Im on the pill until 18th August, then meds start approx. 23rd August and we fly the 31st! 

I cant say im feeling very confident though. Nothing to do with the Team or anything, but lack of faith in my own body and embryos. Im young and relatively fertility healthy and yet we are struggling to get pregnant again. I thought we had cracked the GETTING pregnant bit and it was STAYING pregnant that would be the issue, but infertility isnt straight forward. And IVF isnt a gurantee.

Im hoping my PMA returns the closer we get, im sure upon seeing the team ill be boosted, they are a very inspiring and reassuring lot.

For now, im just managing my fears and keeping busy until the time comes to start yet another cycle.

Love, Little Miss PMA xxx

We’re here (ow my ovaries)

We’re here (ow my ovaries)

We arrived safe n sound late last night. Our apartment is massive and amazing, we love the complex and the pool and can see ourselves holidaying here in years to come.

Woke up mega early this morning so we had a stroll to the shop for essentials…ham, bread, cheese, milk…obvisouly

We then wandered down to the harbour where we had a lovely drink by the sea!

Afterwards we came back to the pool for a little sunbathe with high spf as the meds are making me very susceptible to the sun.

Im at clinic at 12.30pm tomorrow and i hope im ready to trigger because im getting pretty uncomfortable now!

So fingers crossed for large follicles tomorrow and a nice lining.

Love, Little Miss PMA xxx