Day 3 IVF Cycle

Yesterday I started the hormonal stimulants. Up until now it’s been the hormonal antagonist Lucrin (blocks the pituitary gland from releasing hormone making messages to the body).  Now they put back the hormones in the quantities that they want them for optimal egg production.

Lucrin is an easy injection.  Fostimon, which is the follicle stimulating one, is also been pretty easy, but every time the meds change I get a knock out headache.  I am trying not to take any medication.  Usually a headache comes on, tension or sinus induced, and I just knock it flat with prescription pain pills (myprodol/tramacet/synap forte).  This has always been my modus operandi – and something my GP has instructed me to do the last time I ended up in his casualty with a migraine.

So bring on yesterday’s Fostimon induced headache, nay Migraine! – This is how it all went down.

I arrive at 6am for my day 2 blood test at Morningside Medi Clinic who have a 24 hour Lancet lab, and are just up the road from work.  The sister, who withdraws a shed load of my blood, refuses to give me the injection – they are not insured for that.  I injected myself at 6:30 am in our office basement, in my car.  I try playing it cool, but by 9 am I pop my first panado, thinking lets nip this in the bud.  1 pm rolls around and I am really in a lot more discomfort so I pop 2 panados and eat my lunch.  2pm and I want to die, but not on the roads, so I excuse myself from work and head home while I can still drive myself home. I am thinking a heat pack and a sleep will sort this out, and I will be able to work on the couch tonight while hubby is at tennis between the neighbourhood barking dogs and the burglar alarm going off next door I didn’t get ANY sleep and the heat pack didn’t help either.  5pm I can see, but I have to pick up a set of keys from a friend down the road who is off to visit her sister in Asia. Off I go, hold baby drink tea… even baby cuddles from the cutest aren’t helping. I drive home.  I cry.  I ring my husband who is supposed to have a tennis game tonight and ask him to please please come home first.  He tells me to have a hot bath – I do.  The head rush from the bath makes it worse when I stand up. I can’t walk or move or bend down without the pain searing through my brain. I am so miserable and curl up on the bed in the dark trying to manage the pain by praying in tongues. 7pm Hubby arrives, takes one look at pathetic me and puts me in the car and off we go to Sandton Medi Clinic. I pull my hoodie over my eyes all the way – the lights form the passing cars are excruciating and when we arrive I huddle in the darkest corner I can find while hubby fills in the damn paperwork.

The triage nurse is learning how to operate the computer system and the super modern blood pressure machine.  He has to leave the room and ask for assistance once or twice, but he is a good medical practitioner.  After what felt like too many questions I get taken through to the ward, find a bed and see a doctor almost immediately.  The doctor prescribes a migraine IV, and I have a small freak out.  I don’t know, with all the injections I have been having what I can take or not.  I make him phone the after-hours emergency number on my BioArt meds schedule and he comes back saying it’s all good and the nurse hooks up the line and gives me an oxygen mask.  A bit later he comes back to say he has decided to add another pain killer – IV paracetamol to the mix.  

It took about half an hour before I felt any pain relief, and when we left the hospital at 10 pm I still had a minor headache behind one eye.  So today, although I woke up pain free - I took myself off to see my trusted Physio, Wendy.  Oh the wondrous touch of trained hands – she is amazing.  Possibly the most painful session I have ever had with her. But really do feel like she sorted out some of those troublesome knots.

So my conclusion is that the Fostimon induced a minor headache but tension in my back and shoulders caused it to spiral out of control.

I start the Menonys tomorrow.  I am seeing my friend, a Dentist, to give me the first one, and we will take along an orange for hub to practice on.  We have been given the use of a house at the Vaal dam for the long weekend – so he has no choice – he has to inject me in the butt with that big huge flippen scary needle.

Oh… and I decided not to go on with reflexology treatment, but that’s a whole other post all on its own.

Day 21 BCP Cycle

We started the Lucrin injections this weekend.  On Sunday morning we set the alarm for 6am, and hubby jabbed me and we went back to sleep again for 2 hours.

I moved the Menace into a Tupperware box in the fridge - there was a block of cheese sitting on top of the little boxes of medication and it just didn’t look right.  What if the cheesy fumes in my fridge penetrate the box and have some kind of effect on my menace??? Oh the mind is a wonderful thing.

I woke up this morning with a headache - mild hangover quality, and am wondering if I am going to have a Lucrin hangover for the next 21 days.  It would seem that almost all the meds cause headaches as one of the side effects.  I am a headache sufferer - if the side effects say headache, then that’s the one I will get - I couldn't even take the pill for contraception back in the day when that was a concern. I hope this is as bad as it will get and they won’t all build on one another,

And slight dizziness, about 2 hours after the injection that only lasts a minute.  I shrugged it off yesterday, but it happened again today so I am thinking it’s related.

Hubby is still wading his way through Easter eggs that I can’t eat.  So I made this chocolate pudding from a recipe that my dietician gave me - it uses avo for the creaminess and dates for the sweetness. I will be deadly honest here - it’s not Geldhof chocolate but it is a substitute that works and satisfies the craving.

Avo and Date chocolate "mousse"

Half avo
3 fresh pitted dates
1 tbsp. good quality cocoa powder
Water as required
2.5 ml vanilla essence

Blend the avo, dates and cocoa powder.  Add water a tablespoon at a time till a good consistency, add vanilla essence.

Blend Blend Blend till smooth.

It is super rich, but doesn’t keep too well, but if you do refrigerate do it in as small container as possible, only for a few days at most, and scrape the top layer off before eating.

So each time you pop a chocolate Easter egg into your mouth say a little prayer for my eggies - lots of and good quality is waht we want, and say a prayer for my self discipline!

IVF Long Protocol - The good, the bad, and possibly ugly

My Purple IVF kit is complete.  I picked up the last of all of it yesterday and it has blown my mind somewhat.  The Huge big fat needles for one of the injections are also freaking me out a bit.  In order to restore my sanity and sense of control, I researched what each one of the things I will be taking is, does and may do to me.

So here it all is, more for me than for you                

The Pill (BCP) Femodene - start on day 1 of the cycle the month before IVF treatment

Dosage – 1 tablet a day

What it does - Femodene  is a low-dose monophasic oral contraceptive with estrogenic (stops ovulation ie the body doesn’t release the egg) and progestogenic (changes cervical mucous conditions to inhibit the implantation of a fertilised ovum)peripheral effects.

Why do I need it? – To regulate my ovulation and make my period predictable before we start this IVF cycle.  I was on Clomid which was making me ovulate more than 1 egg at a time.  This will get everything back to normal before we start with the heavy injectable stimulants.

Side Effects -  breast tenderness, pain, secretion; headache; migraine; changes in libido; depressive moods; contact lens intolerance; nausea; vomiting; changes in vaginal secretion; various skin disorders including pigmentation; fluid retention; change in body weight; hypersensitivity reaction.

Ok, that one isn’t so bad…. What happens next?

Lucrin – Start on Day 21 of the cycle the month before IVF treatment and continue until Aspiration Day

Dosage – 20 Units per day, Injected Subcutaneously in the belly area at 6pm

What it does - Lucrin  causes the pituitary gland to release high amounts of FSH (Follicle Stimulating Hormone) and LH (luteinizing hormone) for several days until its stores are depleted. Since continued use of Lupron prevents the pituitary gland from producing new supplies of FSH and LH, the amount of these hormones being released per day becomes very low after 7 to 10 days. The goal that we achieve with Lupron is to ensure that blood levels of LH are low during the last few days of follicle growth, since we know that high levels of LH can lead to poor egg quality and stimulate progesterone production by the ovaries. A premature rise in progesterone may cause inappropriate maturation of the uterine lining and lead to a lesser chance of embryo implantation.

Why do I need it? My egg quality is in doubt, so the Lucrin helps, alongside diet and reflexology, to get the best eggs possible out on Aspiration Day.

Side effects - hot flashes, vaginal dryness, etc.; however, these often go away after stimulation begins since estrogen levels start going up with gonadotropin treatment.

Fostimon –Only on day 2 and 3 of IVF Cycle

Dosage – 2 powers to one water ampule

What it does - Fostimon injections contain the active ingredient urofollitropin, which is a form of follicle stimulating hormone (FSH).  FSH directly affects the ovaries in women, where it increases the number of growing follicles and stimulates their development. Within the follicles are the developing eggs. FSH also increases the production of oestrogen, and under the influence of this hormone, the largest follicles continues to develop.

Why do I need it? Because this is an IVF cycle we want to get as many eggs out, of good quality, at one time as we can, so that if the cycle doesn’t work, there is a chance of having some embryos to freeze.  In tht way you don’t have to go through the stimulating process again.

Side Effects - Over-stimulation of the ovaries (ovarian hyperstimulation), causing the production of many eggs (see warning section above); Headache; Constipation; Bloating of the abdomen; Pain at the site of injection; Disturbances of the gut, such nausea, abdominal pain, indigestion; Lethargy; Dizziness; Changes in mood; Difficulty in breathing (dyspnoea); Increased activity of the thyroid gland (hyperthyroidism); Nosebleeds (epistaxis); Flushing of the skin due to widening of the small blood vessels (erythema); Itching (pruritis); Breast pain and enlargement; Hot flushes; Fatigue; Urinary tract infection (cystitis).

Hmmm – that’s a lot of side effects.

At the same time as that I also start taking a tablet calledMeticorten

Meticorten – Start on day 2 of IVF cycle and continue until 3 months pregnant

Dosage – 2 Tablets in the morning.

What it does - prevents the release of substances in the body that cause inflammation.

Why should I use it - In patients in which one suspects implantation problems based on an immune tolerance or auto immune basis, Meticortin is extremely valuable to promote implantation an maintain early pregnancy

Side effects – sleep problems (insomnia), mood changes;acne, dry skin, thinning skin, bruising or discoloration; slow wound healing; increased sweating; headache, dizziness, spinning sensation; nausea, stomach pain, bloating; or changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

Menonys - the Menace -  Start on Day 4 of the IVF cycle and continue till day 8. Doc will advise if to continue after day 9 scan.

Dosage – 3 Powders to 1 water ampoule, injected with a HUGE needle into the upper half of the buttock

What does it do - has the equal activity of FSH & LH. its helps in the maturation as well as rupturing of Graafian follicle (in which the egg is developing), hence it helps for Ovulation.  This stuff gets the eggs to maturity – seeing as there are so many maturing at one time, they need a little bit of help getting there.

Why do I need it?  So the Lucrin is suppressing ALL the hormones but I need the LH and the FSH to actually mature the eggs.  So this stuff puts back the FSH and LH in equal quantities to help the eggs along.

Side Effects - Injection site pain; Lower abdomen tenderness; Fluid retention; Headache; Emotional irritability; Breast discomfort; Fatigue; Multiple births; Severe pain or swelling in lower abdomen or extremities; Shortness of breath; Vomiting or diarrhoea

Day 9 Scan

At this point we see how may follicles are developing on each ovary and wether or not we continue with the injections, and how much to change the dosage.  This is a critical time in the process – if there aren’t enough eggs then the whole cycle can get cancelled.  

Day 11 Scan

We check the eggs again to determine how much they have developed on since the last scan, and decide when the Aspriation Day (the day they remove the eggs) should be based on the size of the majority of the follicles.

The Trigger – Ovidrel

This is an injection used in fertility treatment cycles to help follicles mature and trigger the release of mature eggs from a woman's ovaries following treatment with stimulants prior in the cycle.  Aspiration day will be 24 – 36 hours after The Trigger injection.

So that’s the next 21 Days or so mapped out.  We start with the Lucrin injections this weekend.

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