NeyNey

Could you summarize in your own words the process of IVF.
As I'm seeing a new Gyno soon I'm wondering if I should bring
it up with him or not? There is many tests that can be performed
as my old Gyno was a slacker. Should I try IUI first? And what
is the difference?

We wont be covered with my health care until February, but after
that I got 100% coverage for IVF treatments.


Thanks Darl.

FJL

Hey sweety, no probs!

What is DH's sperm like?

I highly recommend going to the 'big guys' in that I mean having an appointment with a FS from an IVF clinic and I would extremely, highly without a doubt recommend our FS...he is just fantastic in everyway and right now he is the ONLY person I would see and that I trust.

Reason I say this is that we fucked around with a regional IVF clinic and the guy mainly is an ob/oyn but does IVF and he just didn't take our situation seriously.

I also think the country type FS's don't know as much...our current FS makes the other guy we saw seem like a GP. Sure, you have the added stress of travel, time, time off work etc but I am just so glad that we took the step to see the best of the best.

Our IVF clinic (like others) does IUI as well so don't feel daunted by going there thinking that they only do IVF.

If you're interested, we go to Sydney IVF and see Dr Derek Lok (there are full profiles of all Dr's) www.sydneyivf.com

Ok...now to the 'what really happens part'!

I'll start back from when we saw the dickhead at the regional clinic.

At our first appt he looked at DH's sperm tests and even though his lates test showed a motility of 1% he basically said that we can still get pregnant naturally (which I did NOT believe to be true) and that something was probably wrong with me. So I had the lap/hyst/dye test/uterine biopsy/lots of bloods/pelvic u/s and when all of that came back fine and wanted to put me on clomid because 'we're only young'. Well I wouldn't stand for that!

So I emailed our current FS telling him about that all and if he could give me his opinion. He emailed me back very quickly and with detail which I was very impressed by (perhaps you could do the same thing??) saying that with the info I gave him that clomid was a waste of time and that we would most likely need IVF but that he'd want to do more tests first.

I then told my then FS to shove it (in so many words!) and got them to send all my info to new FS. Had a phone appt with FS and immediately felt so comfortable with him.

We then went to Sydney to meet him in person, meet with the nurses and for DH to have the SCSA sperm test. I think they'd want to do this with your DH as they also test for anti sperm antibodies, DNA damage and a few other things that general lab tests don't show. I think they'd want to do a pelvic u/s on you or at least see images of a past one. On that day we also got blood tests (both DH and I) which were basically to make sure we didn't have HIV or other STD's.

After that, I had to wait for AF to come to start my cycle.

Now there are lots of different protocols available for an IVF cycle. I'm not very familar with them but it basically determines what drugs you have and for how long. I was put on a long down regulation cycle. This meant that I had to go on the pill for 21 days (sounds strange since you want to get pregnant!) and on the 21st day I started lucrin. The main drugs used are lucrin OR synarel and both of them acheive the same thing of shutting off the communication between your brain and reproductive system. Synarel is a spray and lucrin is a shot. I didn't find these shots painful at all. The first one was a bit 'oh shit, i'm really doing this' moment but they were fine. I then had to stop the pill a few days later and then you wait for AF.

About a week later I had a BT to make sure everything had shut down which it had. After around 2 weeks on lucrin I then had to start FSH shots (generally gonal F or puregon, I was on puregon). I think it was around 6 or so days into it I had to start having BT's and ultra sounds and I had to do that every 2nd day up until I took the trigger shot. I had to continue on lucrin at the same time as FSH as that prevents you from ovulating and losing all your eggies.

The U/s's were to check follicle growth and endometrium lining. I found this time VERY hard emotionally as I was a slow responder I had no idea if we were going to make EPU or not. I got the phone call late friday arvo to tell me to be at the clinic at 7:45am on Sunday!! Took my trigger on the friday night.

Now for EPU...it wasn't nice thats for sure! I was very nervous but my fave nurse was there and Dr instantly made me feel better when I saw him and spoke with him. For this (some clinics do a GA) I had a mild sedation, then a pelvic u/s to check everything, then a local anaesthetic...now that quite hurt but the good side of not having a GA is that DH can be in there with you holding your hand. The actual collection of eggs isn't so much painful but VERY uncomfortable...to me it felt like I was absolutely the most busting to go to the toilet and someone was punching and sitting on my bladder! We also got to see my eggs on the screen monitor so that was pretty cool.

Then they helped me into a recliner and I got wheeled back into recovery (which I giggled about, being wheeled out hehehe) and I sat there with heat packs on my tummy for about an hour while we waited to see how many eggs we got, DH then had to do his bit, we had to find out if the sperm was able to be used etc. As time went on I felt more pain. By the time we left I was really quite sore, shooting pains up the front and back door and very bad cramping.

So then we had to wait till the next day to get our first fert report. The next one was 2 days later, then we got a call the day before ET to confirm everything.

ET was fine, we were mostly anxious to hear how many embies we had. The scientist spoke with us to tell us about our little ones. We also got to see the embryo on screen that was about to be transfered. The ET is = to a papsmear only more uncomfortable...I swear the spec is bigger!

After that the nurses went through with me what to take for support (which for me was crinone - progesterone) my ovaries were very big and close to slight OHSS so they couldnt' give me anything else.

Then you pretty much walk away and you're stuck in the worst TWW of your life!!! They give you a BT form for a pg test on a certain date which is generally 16 days after egg collection.

Overall it was a very traumatic experience for me and totally not what I had expected even though I thought i'd read it all and had prepared for the worst. But I am more than willing to go back for more at the same time.

Let me know if you have any other questions!

Every clinic varies. Some only do day 2/3 transfers while our clinic only does day 5. Some clinics always put 2 embies back, ours will only do 1 unless its an exceptional circumstance (eg multiple attempts).

There is 1 nurse there that I REALLY like, the other 3 I don't care to talk to. They're nice but seem very vague and that makes me feel uneasy like they might fuck my drug dosage up or something!

FJL

Sorry, just realised I didn't touch on the difference between IUI and IVF. I don't know very much about IUI but basically the best sperm is transfered to your uterus at time of ovulation. Drugs and scans are also required.

With IVF, they hope to get multiple eggs so you have high doses and more frequent injections to acheive this. Eggs are then fertilised in vitro (outside of the body) which means that for conventional IVF the egg and sperm are placed in a petri dish to self fertilise. We had to do ICSI which is used for male factor infertility and this means that a single sperm is injected into each egg. Any left over embryos can then be used for a frozen embryo transfer. This is what we will be doing next time. The downside is that embryos don't always survive the thaw, but it is much cheaper and you aren't on a stim cycle so you don't have all of those insane hormones circulating your body!

For us IUI would never work because the sperm cannot self fertilize the egg let alone reach it! If your DH's sperm is very good then IUI could work for you guys. It is also much cheaper than IVF.

To give you an idea of costs, the SCSA sperm test is just under $500, phone appts are $120 (more for the first one) clinic appts are around $250 (I think, can't remember) and a full IVF cycle is just under $9,000 but a good chunk of that, around $4,000 medicare covers if you've reached the safety net. I think a FET (frozen transer) is around $3500. Also, Sydney IVF is the most expensive IVF clinic in Australia but also arguably the best. Other clinics are up to $3000 cheaper for a full stim cycle.

NeyNey

Oh honey thank you so much for that!

We got a SP down for DH with my old Gyno, he said it "wasn't as good as he'd like" whatever that means, but gave me no numbers. He told me that his sperm was slow? and not very active. I plan on asking my new Gyno to test Matt again, he has changed a lot of his habits and is now taking vitamins so I hope that is helping.

Does weight contribute to their decision to do IVF? I'm not sure if you'll know as you're a pretty fit lady! Me on the other hand...well not so fit

So, when you said cramping and sharp pains after the EPU? How long did that last? DH and I are willing to travel to sydney no worries...I mean whats a trip to sydney if it can give you a baby!. What kind of recovery time would you say it will take? Will I need a week off work? Or perhaps a few days only?

Thanks again Darl
Sorry to bombard you with Questions....I'm just really starting to think about this more and more as of late.

Also, the IUI thing? Will they tell me to try that first before IVF?

FJL

Ummm....i'm not fit anymore!!! Don't want to scare you but I have gained a whopping 13kgs since my tests in march...3 of those kgs were from our last IVF cycle!!! BUT...I have been sitting around depressed and eating way too much. So if you exercised lightly and ate well I doubt you'd gain. I don't know how restrictive they are with weight. If you're very overweight they might advise you to lose weight before starting but I don't know if they'd refuse or anything, I don't think so?

If you decide to go to Sydney, see our Dr!!! I say this because our first FS said if clomid didn't work we'd do IUI then IVF, then ICSI, where as our current FS told us flat out that he strongly recommends ICSI and that sure, we could try IUI but he would be very doubtful that we would be successful. I have a friend seeing a Dr with SIVF but he sounds not very good, doing bugger all tests even though she's had 4 consecutive m/c's (no children at all) where as I know another girl with the same prob going to my FS and he ran every test under the sun to find out why...he did end up finding answers too!

So I can't speak for other Dr's but I am positive that our FS would never suggest a treatment that he wasnt' confident. So if he thought IUI was pointless, he wouldn't put you through it.

Can you ring your old gynos office and get copies of DH's sperm results? A FS would like you to have at least 2 tests so they have a bit of an idea of what they're dealing with. Since your DH's results weren't really good i'd say he'd get an SCSA done for sure. On the upside, tell DH that their collection room entails a wide selection of porn, comfy chairs & a bar fridge full of an array of drinks - my DH was impressed

We go to the Liverpool clinic, its closer than going all the way into the city.

With the EPU, I won't lie, the pain was very intense for 3 days and I was so bloated that I was short of breath because it felt like I could not fit 1 more thing in my stomach...looked like I was a good 6 months pregnant. You can have panadol or panadine for pain and the panadene does help. By ET most of the pain was gone and
a few days after ET the pain had completely gone. Everyone is different though, I know of some girls who are completely fine after EPU and little to no pain. Its 5 days between EPU and ET and because we're 9 hours away we just stayed there until ET but if you planned on going back home i'd suggest you didn't go back to work. Its similar to a lap in that they say no lifting or anything strenuous at all for a week or so.

NeyNey

Thanks Hun.

Well I've certainly learnt a few things!
I got to run to work now, but rest assured I'll have more questions as time goes on lol

Thanks for sharing your knowledge, it's not always easy to find out about IVF from a personal point of view, most of the info I know it's medically written, and we all know how hard that is to understand!

FJL

No worries at all, feel free to ask any questions!

MissAma

It's not the same with every clinic and it's certainly not the same from continent to continent but typically in Europe the average maximum BMI that fertility clinics will accept is 28.

maz

Thanks FJL for that info.

I'm going to my new clinic on Wednesday for my pre-consultation appointment where I'll get my AMH blood test done and confirm my weight, height, and BMI, which needs to be less than 33 - think I should be okay from that point of view. I'm really looking forward to getting the ball rolling, but am also quite nervous and apprehensive. I guess it's more a case of not quite believing that we need help to do something that we always expected to come naturally.

I really hope you have been successful this cycle, and found your diary very informative.

xx

Arcanegirl

If anyone has any questions on IUI ill be happy to answer aswell