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What is IVF?

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What is In Vitro Fertilization? Seems like a silly question to me. But that’s because it’s been part of my life for 4 years now. And now that we’ve had to talk about it so often with people I start to wonder…how many people really know what it is? When I tell someone we went through IVF to conceive our children they kind of look at me like, I’ve heard of that, but I really have no idea what you’re talking about. And I think most people have a misconstrued idea of what it is…like a doctor magically makes babies and makes you pregnant. Four years ago when we started on this infertility journey I had no clue what it was. When I was told that was our only option to have children I still wasn’t really sure what it was. We had to do a fair amount of research and learn a lot from our doctor. Plus just learn as we went along. Now that we’ve been through 3 fresh IVF cycles and 6 IVF transfers I have a pretty good idea of what IVF is and what it is not 🙂  And I thought it would be good to share with others. What is IVF…through a patient’s eyes.

First off I want to say IVF is NOT a “sure thing” by any means. I’ve heard that term used (even on a real food blog!). Some people think that it is the “easy” way to conceive…to be able to have your children exactly when you want. I think celebrities/media/tv shows have caused this. In reality it is quite the opposite. IVF is never guaranteed to work. It can be a very long, tiring, difficult, emotional process. And so unpredictable. Some couples go through years of treatments and never conceive.

Also, doctors do NOTcreate babies/life via IVF. Only God can do that. A doctor helps a woman mature her eggs with drugs and monitoring and puts them with the sperm. Then if an embryo forms (naturally) it is placed in the woman’s uterus. The doctor can NOT implant an embryo (despite what you hear on tv shows/movies). That is a natural process that only God can do. An embryo is transferred into the uterus…and nature takes its course. If you ever hear someone say they had an embryo implanted they don’t know what they’re talking about. That is physically impossible.

That being said, I’ll get on with what IVF is. In Vitro simply refers to any biological procedure that is performed outside the organism it would normally be occurring in. The egg and sperm are joined outside the woman’s body. I’ll start with the basics of IVF. There are basically 3 steps in the process. First the woman’s uterus is kept quiet…meaning prevented from ovulating/producing eggs. This often means taking birth control pills. Or in my case means doing nothing since I don’t ovulate without drugs 😛  Then comes the stimulation/retrieval phase. The woman is given hormones to make her body mature some eggs. Once the eggs are the right size/mature enough the doctor removes the eggs from the follicles (via a needle guided by ultrasound). The eggs and sperm are then joined. This can be done just as it would in nature (egg and sperm put in same place and let nature take it’s course). Or a single sperm can be injected into each egg (called ICSI – intracytoplasmic sperm injection) if the sperm is improperly shaped (this does not make the sperm fertilize the egg…it still has the same odds of fertilization as if it were not injected). The final step is transfer. If any of the eggs have been fertilized some of them are transferred into the woman’s uterus when they are anywhere from 3-6 days old. Any remaining embryos are frozen. If one or more of the transferred embryos implants into the woman’s uterus she becomes pregnant.

Sounds pretty simple and straight forward. But of course it’s not really that simple. There are so many factors that go into each part of the process. There are so many reasons a couple goes through IVF in the first place…unexplained infertility, female factor (anovulation, PCOS, only one ovary, blocked tubes, cysts,…), male factor (low sperm count, poor movement, bad morphology (shape), vasectomy reversal,…) and a combination of these and many other factors. So each couple has a unique treatment and odds of success/failure (just because you “know someone that got pregnant naturally after their first round of IVF” it does not mean anything to someone else going through IVF. They have completely different situations and obstacles to overcome). And even every doctor has different methods/ideas. It would take way too long to go into that much detail. So I thought the easiest thing to do would be to share my story/path. Even that is quite long and complicated. So I’ll just go through our most recent IVF cycle. Show you what a few months in the life of an IVFer are like 🙂

June 11 – June 23: take prometrium pill one time/day each day; take estrace pill one time/day each day (continue to take estrace through whole process) (prometrium is to induce a period, estrace is to prepare my body for stimulation)
June 15: one time injection of dep-lupron (done by nurse) to start maturing eggs
July 8: 1st ultrasound to make sure uterus is quiet; start follistim shot and menopur shot in PM (I do these shots myself in my stomach)
July 9 – 12: follisitim shot 2x/day, menopur shot 2x/day
July 13: 2nd ultrasound to check on eggs/follicles – over 10 in each ovary; follistim shot 1x, menopur shot 2x
July 14 – 15: menopur shot 2x/day
July 16: 3rd ultrasound check – 10-15 follicles on right, 10-18 follicles on left; follistim shot 1x, menopur shot 1x
July 17: 4th ultrasound check – 8-14 follicles on right, 12-20 follicle on left; follisitim shot 1x, menopur shot 1x
July 18: menopur shot 2x
July 19: hcg trigger shot – 1x shot to make my body think it’s time to ovulate and finish maturing the eggs – Justin gives me this one (in the butt).
July 20 – 23: antibiotics (pills) 2x/day
July 21: Egg retrieval – sedated while Dr. uses an ultrasound guided needle to remove every egg from the follicles. My total count was around 50 this time. Just to give an idea of how many that is, a woman normally produces/releases 1 egg each month. I did over 50 at once. Very uncomfortable.
July 23 – 26: progesterone shot 2x/day (Justin does this one for me…in the butt)
July 26: ultrasound belly check – confirmed OHSS (ovarian hyperstimulation syndrome). I look about 6 months pregnant. Ovaries are swollen. I’m severely nauseous and can barely get off the couch. Go to hospital for albumin infusion to balance protein levels in my blood. All embryos frozen, no fresh transfer due to OHSS.
July 22 – August 2: recover from OHSS

August 5 – August 14: estrace pills 2x/day
August 15 – 20: estrace pills 3x/day
August 17: ultrasound to make sure uterus is quiet/fully recovered and to check lining
August 21 – 10 weeks of pregnancy: estrace pills 2x/day, progesterone shot 2x/day (Justin does this when he’s home, else I do it myself…in the butt)
August 24: frozen embryo transfer (FET) – transfered 3, day 3 embryos (3 embryos put into my uterus via a small catheter, takes about 5 min. Then I have to lay down for an hour and a half)
September 2: beta 1 (pregnancy test/check hcg level) – blood test – 120 (positive!)
September 8: beta 2 – 1223 (hcg level increasing as it should…typically doubles every 48-72 hours)
September 14: beta 3 – 8220 (hcg still rising as it should)
September 21: 1st pregnancy ultrasound – one sack and heartbeat seen. Pregnancy confirmed.
October 12: 2nd pregnancy ultrasound – still to come :), estrace pills and progesterone shot go down to 1x/day
October 19: stop estrace and progesterone – released to regular OB

That’s what happened this cycle. This one thankfully turned out well. Our last cycle was much more grueling…a fresh stimulation cycle, OHSS, then 3 failed FETs. And having to start all over.

As you can see it is by no means easy. Anyone who thinks that has no clue what it is. It is expensive, physically demanding and extremely emotional. I would not wish for anyone to ever have to go through it. It disturbs me how the media portrays IVF as such a simple thing that guarantees a woman gets pregnant. I didn’t even mention in here all of the side effects of the drugs, the weight gain, emotions, inability to make plans, etc. It disrupts your whole life.

And no, it is not that common for women to get pregnant with high order multiples. But that’s all you see on the reality shows. Most of those couples did not do IVF (they did IUI…a much simpler procedure). And in my opinion had very irresponsible doctors.

So that’s IVF in a nutshell. At least my version. It’s hard to explain all of the details, but hopefully you get a small idea of what it is. Although I hate going through the process it has given me such a deep appreciation for children and the miracle of life. I hope you enjoyed reading more about our journey. Always feel free to ask any questions. I’m an open book. I pray that God will use my journey through infertility and IVF for his glory. Hopefully in a few weeks we’ll be done with IVF for a while and can feel somewhat normal again. But this will always be a part of our lives, even after we’re done having children. It’s part of our unique story 🙂

3 comments

  1. ProfessorMom says:

    Thanks for this detail – it is certainly one of those things that seems obvious once you have been through it, so that you quickly forget how unobvious it can be to others. On the other hand, it is also surprising to me that there is “life after IVF.” In other words, 7 years after my last transfer, it is becoming a dim memory of another life. Both good and bad, I suppose. But I appreciated the reminder of what it was like. Especially since, because of the Nobel announcement, I have been thinking about it a fair bit this week.

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