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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