A Difficult Journey: Infertility- In Vitro Fertilization (IVF)

Now that I feel like I can breathe again I think I can write this post. I’ve only tried to write something that makes sense about a million times now. I’m going to skip over the detailed lead up to IVF for us and just get right into how the process has been for us. Before I do I have to say that when we first started our journey down the road of infertility I was against doing IVF. I felt like it was an extreme measure but as they years went by I began to look at it differently. I started to feel that not even considering IVF was silly and I couldn’t go on without knowing that we truly exhausted all of our options. (Thank you Tess for opening my eyes to this.)

That’s when we decided that IVF was our last option that we needed to exhaust it. It wasn’t until after a lot of thinking, discussing, talking with doctors and 4 failed IUIs (inter uterine insemination) that we came to our decision. My new doctor (we changed doctors back in March) referred us to a fertility specialist in St. Louis, MO after we had a DNA fragmentation done on Andrew’s sperm and the results came back with an abnormality. That opened the door to more of why the IUIs weren’t working. We had a phone consult with Dr. Alhering at the Missouri Center for Reproductive Medicine (MCRM fertility) in St. Louis in May or early June I can’t remember. We were happy with all the medical advancements that MCRM offers and that they specialize in male factor infertility (even though we have both female and male). For us most importantly we were looking for a doctor who is confident in what they do and could lay out a very clear plan of action for us. We found exactly that in Dr. Ahlering. After our phone consult with him we decided to start making the final decisions to move toward IVF. We had a lot to figure out, timing, financing, and wrapping our heads around how big of a deal this entire process is. It took us a few months to get everything in order but by August we were set for an IVF cycle in September.

We got ourselves all set for our September cycle but for me it seemed like it was going to be forever before September got here. I still remember running a race with my friend Megan at the beginning of August and us talking about how far away September seemed. Then all of a sudden September was here. Sometimes time flies and other times it drags.

I had been on birth control since the beginning of July because of a cyst on my right ovary, which by the way throws a big kink in fertility treatments. I was given a calendar at the end of August telling me when exactly to stop the birth control and what to expect for the month of September.

September 8th – I had an initial ultrasound here in Tulsa to determine my AFC (antral follicle count) and blood work including testing for infectious diseases. AFC measures a woman’s ovarian reserve. That ultrasound showed 18 follicles on the right and 12 follicles on the left. Those were good numbers so I was happy to move on with our process.

September 12th- I started stimulation medication. The medications I was on were to stimulate my ovaries to grow mature follicles, inside each follicle there is one egg. The medications I was prescribed were Gonal-F, menopur, and cetrotide. I also did a dual trigger but that wasn’t until right before egg retrieval. The medications were all injections and I did them every night or morning in my abdomen. There were days that I only had one injection and days that I had four.

September 16th- I went in for blood work here in Tulsa (estradiol and progesterone were what they were monitoring) to determine how my body was responding to the medication. The results of the blood work also determined how my medication would change for the next week.

September 19th- We had our first face to face meeting with Dr. Alhering as well as another ultrasound and more blood work in St. Louis. During this ultrasound he counted my follicles and measured the bigger ones. He stopped counting out loud at 20 and told us it looked like he would retrieve 20+ eggs. After this appointment I had another change in medication and was scheduled for another ultrasound and more blood work so Andrew and I stayed in St. Louis for a few days.

September 21st- ultrasound and blood work. They counted and measured all 20+ of the follicles. It seemed like that ultrasound was never going to end; oh and since I forgot to mention before all these ultrasounds are transvaginal. After this appointment we had a date and time set for egg retrieval. We would retrieve Saturday September 24 at 12:45. Andrew and I went home for a few days before the actual procedure!

September 23rd- 12:45 AM I had to wake up and do my dual trigger and by wake up I mean I fell asleep at midnight and woke up every 10 minutes until my alarm went off at 12:30. It had to be done exactly 36 hours before egg retrieval. My dual trigger was lupron and hcg. It was so simple and I celebrated my last shot by going for a pedicure with my friend Brooke at a normal hour later that day!

September 24th- Egg retrieval day! We woke up SUPER early and drove to MCRM for our appointment. Egg retrieval goes like this, get there an hour early and wait, change into a medical gown and cute socks then wait. Haha if you know anything about infertility treatments its a huge game of hurry up and wait. Before I actually went back Andrew went back and gave them a semen sample so they could prepare it for the eggs that they were retrieving from me. We used sperm nanobead selection process offered at MCRM to help get the sperm that were malformed out of the sample. When they took me back to the procedure room I got sleep drugs in my iv and fell asleep quickly before I even remember seeing the doctor come into the room. Egg retrieval is done through a transvaginal ultrasound with a needle and hose attached to it. The doctor goes through the vaginal wall and “pops” each follicle individually sucking the egg and follicular fluid into the hose and into a vile. Then it goes directly to the embryologist lab right next door to be counted and determine if the eggs are mature or not. We knew before we left that he retrieved 22 eggs. I was excited but feeling crazy from the meds. Andrew wouldn’t let me just sit in silence after the procedure. He was prodding me so I was very alert even though I was feeling completely exhausted and like my brain wasn’t functioning quite at full speed. When the nurses felt I was ready we got back in the car stopped for gatorade and lunch then went right back home. Talk about a wild day!

September 25th- fertilization report call day. We had 17 mature eggs and 14 of them fertilized! The fertilized eggs were then watched as they grew for 5 days. Since we had a genetic abnormality we decided to do genetic testing.

September 30th- We got the phone call that of our fertilized eggs only 2 made it to freeze and biopsy. I was happy to have two that made it and called them my little fighting embryo! I was also terrified because results of genetic testing can be so scary. I mean the reality was that we could have both of them come back normal, neither of them come back normal or just one. I had to have reality check by a friend who has supported me throughout this journey since she just went through it herself, she said, “this entire time you have been saying all you need is one, focus on the possibility of one coming back.” Thank you Elizabeth for that reality check it got me through the week of waiting!

October 6th- (yesterday) I knew I was getting the phone call this day. I woke up sick to my stomach. I tried to out run my nerves and it helped for 30 minutes but once my run was over they were on top again. I cleaned our house, and took a longer shower than normal. I hoped that nobody would call me because it made my heart stop for my phone to ring. I kept myself busy until I had to get Blake from school. At this point I just knew that the phone call was going to come while I was there and it did. Luckily I’ve got some good mom friends at the school that didn’t mind watching Blake on the playground while I stepped away to take the call. We had ONE come back PGS normal! I cried and was shaking; I couldn’t speak. I was so happy! I think I said thank you 20 times and that was all I could get out. We have one frozen embryo waiting to be transferred in November!

Now we wait, again, for my calendar that details medication to prepare my body for a transfer! While we wait for that calendar I’m trying not to think about the possible negative outcomes of transfer but instead that we do get to transfer!

When we decided to go to MCRM Fertility in St. Louis there were many things that factored into our decision to drive 6 hours instead of using someone local. Besides the fact that Dr. Alhering knows his stuff they also offer so many different options to fit your needs. Here is what our treatment package included plus a few that we added.

  • sperm nanobead selection process
  • embryo biopsy
  • PGS/PGD/NGS embryo testing (Genetic testing)
  • intra-cytoplasmic sperm injection (ICSI)
  • Morphologically selected sperm (MSI)
  • embryoGlue
  • Cryopreservation of Embryo (freeze them or THE ONE for us)
  • ednometrial scrathcing
  • assisted hatching
  • Fertilization and culture of embryos through day 6
  • ultrasound guided embryo transfer

I have been sharing this journey not only to help myself get through it but also for all the girls/women out there that struggle with infertility but are too scared to talk about it. What I learned is that more people are struggling with the things you are struggling with in life than you could imagine. So if you are struggling with infertility know that you are not alone!

Now that the first part of our IVF process is finished we have to focus on transfer. This part is pretty scary but I am going to continue to trust the process and lean on our fantastic support group. It’s not over yet so please keep sending all the love, prayers and good vibes our way.

PS- I’m part of a wonderful FB group of ladies who all go to the same clinic and without those ladies sharing their hearts with me along the way this process would have been so much more scary and difficult!

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