Making Baby Sonne: IVF Part I- Stimming

Years ago, the very first day I was prescribed clomid to aid in conceiving a child, I knew deep down it would come to this. I knew I’d have to withstand this complicated and overwhelming process.

I have endured those crazy pills, a plethora of other medications, many procedures, and IUIs—each time putting all of my hope and positivity into the process and praying it would work, even though I’ve always known I would conceive only through IVF. And here I am in the thick of it.

I have been stimulating my ovaries to grow a whole bunch of follicles and maturing them in hopes that they will soon be embryos and that eventually one of them will be growing inside of me for nine months. This is all just so emotional and insane. Science can be so awesomely breathtaking.

The timing of this cycle’s stimulation meds was a little rough. Some might wonder why I didn’t wait until the craziness of this month dies down. Here’s the thing, though. I can’t keep delaying the process because of timing. If I wait for a perfect moment, that day may never come. We were ready, my body was ready, my doctor was ready, and the insurance kicked in at the exact moment we needed it to. Sounds like perfect enough timing to me. Regardless of my philosophy here, this month is nuts. On top of all my summer dance team coaching obligations that pop up throughout this month, I run the Eli’s Cheesecake booth at the Taste of Chicago summer festival. The Taste takes up only 5 days, but they’re long 13+ hour days.  I also have many family parties, showers, graduations, etc. And then there’s the main event— my “little” brother’s wedding. It’s extremely difficult to plan anything around IVF because everything depends on how well and how quickly you respond to the medications. I won’t know when my retrieval will happen until two days beforehand. I’ve been assured it will be scheduled days before Mikey and Chelsey’s big day, though, so hopefully I’ll be fully recovered. I’m living on a hope and a prayer that I won’t have to miss any of my other scheduled happenings.

Starting my shots the day before the taste began was intense. I felt like I was under immense pressure to get the hang of it immediately. I was reluctant. Would I have to do these shots outside? In front of a bunch of people? Is that even sanitary? It all worked out though, and I did not have to worry about any of that. I took my morning shots at the hotel before we left and my evening shots when we came back to go to sleep. I was worried about being away from home and having to go through all of these new processes. Again, I didn’t have to worry. I had great support from Jacob, Meghan and Haley, Cynthia, and my parents through the whole thing. Jacob calmed me down a few times when I felt like I just couldn’t be tough anymore. Meg and Hay were really great helpers during the Taste (and were actually pretty well-behaved and awesome), and then there’s Cynthia. My right-hand woman. My rock. She’s just the best. I mean, could there ever be a more helpful, genuine, reliable, and trustworthy person? I’m so incredibly lucky to call her a friend and little sister. And then there’s my mom and dad. Twice they had to bring me meds to the festival—one that the pharmacy forgot to send me and one I left at home in the fridge because I didn’t think I would need it yet. I was also able to call/text a close family friend (more like an aunt, really) with tons of questions because she’s kind of an expert on this stuff. I also relied heavily on my girls who have been through all of this before. Kristie, Heather, Nichole—thank you for putting up with me. How lucky can a girl be that she has so many outstanding people in her corner? #blessed

OK, so now for the nitty-gritty.

I’d like to preface what you’re about to read by saying this isn’t for everyone. Many of you probably aren’t too interested to read what giving yourself shots is like. Most of you probably don’t care to read a laundry list of side effects or my complications with mixing medications. And that’s ok. I am writing for women who are going through this with me and for women who are searching for answers. Maybe I can help or encourage another infertility or PCOS patient. That is my hope, anyway. It is important to know you’re not alone.

Below you will find a chronicling of my In Vitro Fertilization stimulation days. This is the beginning of my IVF cycle.

Protocol:

Menopur— combo of hormones that stimulate the ovaries to produce eggs

Gonal F— a purified form of follicle-stimulating hormone that is manufactured by extraction from human urine and then purified to remove various proteins and other substances

Cetrotide— can prevent premature ovulation in women undergoing fertility treatments with controlled ovulation.

Dexamethasone—treats inflammation

Doxycycline— can treat and prevent infections

Pregnyl— (trigger) used to cause ovulation and to treat infertility in women

Leuprolide Acetate— synthetic gonadotropin-releasing hormone

 Tuesday, July 5th

  • Stims Day 1- 225 IU Menopur, 300 IU Gonal F

 I had a great deal of trouble mixing my first shot in the morning. I’m going to try to link to a short video here, so you know what I’m talking about.

http://www.freedommedteach.com/eng/videos.html?play=menopur_draw_up_qcap%2Cmenopur_sq

I had to mix three powders in with one cc of sodium chloride and fill the syringe for injection. It doesn’t sound difficult, but it is definitely a process you don’t fully understand until you have to do it. Regardless, I made it through and I did it successfully. I wasn’t nervous at all when I was actually giving myself the shot— just a quick pinch and a bit of stinging after. The mixing is the tricky part and I didn’t want to mess it up. Pressure! At night, I had to use Gonal (Follistim) and that’s easy peasy. I’ve used it before in my IUI protocol, so I was familiar. It’s a cool pen-like thing that clicks to the desired amount, and then you just inject. I felt fine all day, so I was motivated to continue and to grow ALL the follicles!

Wednesday, July 6th

  • Stims Day 2- 225 IU Menopur, 300 IU Gonal F

 The second day of mastering the art of injections was much more successful. No nerves. However, I was starting to feel the effects of taking shots in the belly…. My abdominal and oblique muscles were cramping (like a middle-of-the-night-Charlie-horse-in-calf-muscle sensation). Horrible pain. And nothing really helps it go away. It just eventually eases up. Also, I felt bloated all day. Some of my IVF buddies thought it was weird that I felt so much so early on, so I put a call into the doctor. I was told that everyone is different and each cycle is different. Since I would be monitored on Friday, they were not concerned and thought my complaints were normal. Cool! Keep going!

Thursday, July 7th

  • Stims Day 3- 225 IU Menopur, 300 IU Gonal F

 No nerves! I was already a pro at this point. I was, however, becoming very aware of EXACTLY where my ovaries are in my body, their exact size and shape, and that they were working over-time. I felt like I could feel everything growing in there. Very strange! I was really bloated and just kept drinking water, which only made me feel more bloated, albeit hydrated. I tried to relax as much as possible, but managing a booth at the Taste of Chicago is not the most relaxing atmosphere. I put my feet up on a water cooler in the back of the booth whenever I could.

Friday, July 8th: MONITORING- blood work and ultrasound

  • Stims Day 4- 225 IU Menopur, 300 IU Gonal F

 I followed my Menopur protocol that morning and headed out of The Palmer House hotel off to the doctor at River North. I embarked upon my first solo Uber experience. My driver was uber friendly and followed that with a pleasant morning of blood work and ultrasounds. I would get the call later that I had grown 26 follicles!! Wowza. My estrogen was at 418, which was ok, but they want that number to go up. The doctor added another medicine (an antagonist to prevent ovulation) into my protocol and changed it up a bit. Later that night, I was feeling extremely bloated and uncomfortable… or so I thought.

Saturday, July 9th

  • Stims Day 5- 225 IU Menopur, 0.25 mg Cetrotide, 300 IU Gonal F

 I did not know I could be even more bloated and uncomfortable than I was the previous night. All day, from stomach to pelvis, I felt swollen, sore, bloated, bruised, and just worn out. I cried a little thinking about why it had to be so difficult, but then I stopped feeling sorry for myself and decided to change my outlook. My child is going to know exactly how much he/she was wanted and loved way before he/she was even growing inside of me. I think that is really something special. I really have to work hard for this— it’s going to mean the world when it all falls into place. All of this will be worth it, in the end.

This day was kind of a mess for me. The new shot was tricky. When mixed, it creates little bubbles and you’re not supposed to use it when bubbles are present. I waited for the bubbles to subside; I followed the instructions, but couldn’t get rid of one larger air bubble. I finally decided to use my Q-cap (an easy way to mix and transfer into syringe) and it worked out for me. It was nerve-racking. Again, you wouldn’t fully understand unless you’re actually doing the mixing and preparing the shots. It seems so easy, but it isn’t until you get the hang of it.

This was also the day that Jacob had to go to the IVF center for a semen freeze. These swimmers will be used for IVF only if the sample given on the egg retrieval day is of no use (which is unlikely). He’s being a trooper, but let’s be honest—his job his pretty easy. Ha!

Sunday, July 10th

  • Stims Day 6- 225 IU Menopur, 0.25 mg Cetrotide, 300 IU Gonal F

 Tired. All day. From start to finish. Just wiped out. This could have been because of the meds or because it was the last day of five consecutive 14 hour work days at the Taste of Chicago. Either way, Sunday was a rough one. The day was busy, yet it lasted forever. I was sure I had grapefruits for ovaries; I was really feeling them twinge and swell up. I was just feeling generally uncomfortable. I contemplated lying down in the grass behind the booth to take a nap, but thought that might be a little irresponsible as a manager. Around 3 pm we started to get a ton of business and became pretty busy. I didn’t have time to sulk or feel crappy, so I forced myself to get a second wind. We didn’t get home until 11 pm or so. Needless to say, I went right to sleep. Making follicles and slingin’ cheesecake is tough work.

Monday, July 11th: MONITORING- blood work and ultrasound

  • Stims Day 7- 0.25mg Cetrotide, 150 IU Menopur, 300 IU Gonal F

I woke up bright and early to go get blood work and ultrasounds. I felt really good this morning—maybe it’s because I was finally able to sleep at home…  or maybe it’s because I got to see my Norbert pup… or maybe it’s because I didn’t have to take Menopur this morning! Either way, the results looked really good. My 27 follicles (TWENTY-SEVEN) were coming in around 14-15 mm (well, many of them, not all). That means they are growing (last check-in they were around 10 mm). I also grew an additional follicle from the last ultrasounds, so that’s cool. The more, the merrier (to an extent). My estrogen was at 1,100, so that level almost tripled since the last visit. While it was supposed to go up, that is a big leap—this will need close monitoring because estrogen in excess of 6,000 can mean ovarian hyper stimulation. I was told to come back the very next day for more monitoring. I was getting a lot of twinges and pangs through the better part of the day, so I was very interested to see what the next day’s results would be. I was finding it really difficult to bend at the waist without feeling extra pressure on my ovaries, so I decided to keep relaxed for the day and went in the pool. Ahhhhh, summer. Both of my shots at night stung badly. I wonder why that is.

Tuesday, July 12th: MONITORING- blood work and ultrasound

  • Stims Day 8- 0.25mg Cetrotide, 150 IU Menopur, 300 IU Gonal F

 This day was a roller-coaster. After my antagonist shot in the morning (Cetrotide- the one I do not like), I felt really awful. I was super sore and having that feeling I might cramp up all over my abdomen again. That’s just not fun. I drove to my monitoring appointment feeling really hazy. The sensation that I may pop any moment was strong and it’s extremely uncomfortable. However, when I was having my ultrasound, the technician offered to print pictures of my ovaries to take home. This cheered me up. Later, after I received the results, I found out that I had 32 follicles growing (the biggest one being 20 mm) and that my estrogen was 1600 (so it did not double or triple, as we feared—which was great news). Hearing all of this and having the images to show for it made me feel much better, though. I have been responding really well and that keeps me going for now.

Wednesday, July 13th: MONITORING- blood work and ultrasound

  • Stims Day 9- 0.25mg Cetrotide, 75 IU Menopur, 100 IU Gonal F

 I was really not feeling well this morning. It’s hard to put my finger on exactly what didn’t feel well—it’s just a general sense of crappiness. I didn’t want to drink any water, I wasn’t hungry, I felt bloated and sore, and could barely keep my eyes open. Just blah. My veins didn’t want to cooperate and I had to have blood drawn from my hand, so now I have bruises on my belly, arms, and hands—all from needles. Fun stuff, you guys. My cetrotide shot went smoothly this morning and did not hurt, which surprised me. I usually hate that one, so that’s a plus! I awaited the call from my IVF nurse with baited breath. I was hoping she’d tell me to take the trigger shot tonight, so that my retrieval would be Friday, but that was not the news I received. She said my follicles were still growing, but only one is large enough at the moment. She said we will probably stimulate and monitor for two more days (Thursday and Friday) and maybe retrieve on Saturday or Sunday. We won’t know anything for sure until the next day’s results. My Estrogen level jumped from 1,600 to 2,751, which is quite a jump. So, even though we still want to stimulate growth, we have to back down on dosage. I’m dropping to 100 IU of Gonal and 1 vial of Menopur. My nurse said I must take it easy, stay off my feet when I can, limit stairs (I live up three flights, so easier said than done), and to keep replenishing electrolytes. I am extremely full and bloated. I cannot even wrap my brain around this feeling. I feel it when I’m sitting, when I’m standing or moving around, when I have to pee, when I hit slight a bump while driving, when I sneeze, cough, or laugh…. I feel like an over-stuffed pressure cooker.

Thursday, July 14th: MONITORING- blood work and ultrasound

  • Stims Day 10- 0.25mg Cetrotide

What a day. I woke up full. No desire to eat or drink anything, which is not good when you need to replenish electrolytes. As I drove to the doctor, I cried when James Bay came on the radio. Ha! Estrogen! While getting my blood taken, my veins were uncooperative. While getting my ultrasound, my ovaries were uncooperative. My body is just like, “please leave me alone, people.” Later, while trying to relax and not sneeze too hard, the IVF nurse called me to tell me the good news. I am ready to trigger. I have 36 follicles total! There are only ten small-ish ones, so the rest should be pretty good (mature). My estrogen jumped up again. Yesterday’s 2,571 is nothing compared to today’s 4,030! The danger zone is nearing (6,000). I hope I don’t have another jump tomorrow. Tonight (well, technically tomorrow), at 12:30, I will give myself the hCG shot in the butt. I will also use Leuprolide Acetate (which is a new shot for me). I must say I’m extremely relieved my retrieval is Saturday. I’m getting super-duper uncomfortable over here and that makes me antsy. Let’s hope for a bunch of eggs!

Friday, July 15th: MONITORING- blood work only

  • (No) Stims Day 11- 2000 units Pregnyl (hCG), 80 units Leuprolide Acetate (twice, 12 hours apart)

I got myself a little worked up about the trigger shot in the bootie. The needle is bigger and it is intramuscular instead of subcutaneous. However, I pulled up my big girl pants and got on with it. I was freaking out for no reason. It did not hurt at all. In fact, the smaller subcutaneous needle for the other new shot I had to take (Leuprolide) hurt worse because there was much more fluid going in and it stung a little (plus, that one was in my belly and the whole area is already bruised and sore). It is good to know now that the shots in the butt aren’t as bad as I thought. The needle is deceiving! I did it! Twelve hours later, I took my last Leuprolide shot at 12:30 pm and it stung, but I did it!  Stimming done! Now I have to hope, pray, and wish for a smooth retrieval that yields really great, healthy eggs that become grade A embryos (and brace for the supposed pain and suffering after retrieval)!

And that, my friends, is a first timer’s experience with IVF stimulation meds/shots and a wrap on IVF Part I. After I give myself a bit of time to lie around and heal after the retrieval, I will write all about it. I’m assuming it will be MUCH shorter than this post. Thank you for reading and thank you even more for your support and encouragement.

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About Nicole

I have my BA in English Education and am a lover of the arts. I’m part of a small, but fiercely devoted (and annoyingly close) family– and wouldn’t change that for the world. I'm lucky in love with the love of my life and am a step-mom to his two beautiful girls. I’m also a Paleolithic eater, a lover of all things organic, whole, and natural.

2 responses »

  1. Kathleen Orlando says:

    To this day it seems impossible to me that ANYONE can get pregnant, given the amount of science involved. Hang in there Nicole.

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