IVF- APN Consult

I met with my IVF APN today. She was spectacular. She answered all 7001 of my questions and she was warm, smiling, and all around awesome. We went over my protocol, the schedule, the medications, and the overall plan-

Currently I am on the BCP and will continue them until January 5^th. On January 10^th I will return to the office and have an ultrasound and blood work and go over the medications.

My protocol is Antagonist using Menopur, Follistim, and Ganirelix. I should star the Menopur & Follistim on Jan 10^th.

From that point forward I will be in and out of the office for continuing evaluations of the follicles and their growth. I will also be placed on temporary disability from the ambulance. They do not want me lifting or twisting while I am stimming. This is a double edged sword. I’m glad that I will have some extra down time to just relax—but the extra income is a nice thing too. I’m going to do my best to use the time to just relax and relax and relax. My temporary disability starts 1/12 and will run until 2/17- at which point hopefully I am carrying a normal pregnancy and can return to work!

Retrieval is planned for around the week of the 19^th- however that is subject to change completely depending on how I respond. For retrieval to take place there must be at least 3 follicles over 18mm—this should not even be an issue. I need to be healthy—this I am combating with extra Vitamin C, Echinacea, and Airborne (no sickies for me!)

I will start the Ganirelix once the follicles reach 13mm, this will tell my body not to ovulate the follicles on its own. About 36 hours prior to retrieval I will take two Ovidrel triggers.

For retrieval they will provide anesthesia and remove the oocytes (eggies). After retrieval I will be out of work for that day and the next and not allowed to drive. I will be on bed rest basically. That day they will split my eggs and half will be placed with the sperm to hopefully become embryos on their own- the other half will be done with ICSI.

ICSI- Intra Cytoplasmic Sperm Injection is when they place an individual egg and insert an individual sperm. My insurance authorized it because we are considered unexplained infertility even though I have PCOS. Reason for the ICSI is in case there are any male factor issues that have been looked over. There is an 80% fertilization rate with ICSI.

I will start Crinone 8% Vaginal Gel (instead of Endometrin) for my progesterone supplementation 2 days post retrieval and continue it until 10 weeks into my pregnancy.

The day after retrieval we should receive an update on our embryos and then again to set up the embryo transfer. Embryo development for anyone that doesn’t know or is interested should look like this-- Day 1 zygote- fertilization, Day 2- embryos 2-4 cells, Day- 3 embryos 6-8 cells, Day 4 – embryos 16/32 cells "morula" and Day 5- embyros "blastocyst" and hopefully transfer day!

Embryo Transfer should take place about 3-5 days post retrieval depending on the embryos. Its advised to be on bed rest for 24-48 hours post transfer- I am hoping it falls on or near one of my 3 day weekends and I can extend this a little longer and take it easy!

Estrace will start the day after the transfer twice a day and continued until 10 weeks of the pregnancy.

The number of embryos transferred depends on the quality and number of embryos for us. We are open to a SET (single embryo transfer) and also not objected to transferring 2. It will all depend on the quality and how the transfer day goes.

14 days post retrieval is pregnancy test time- then blood work for betas and an ultra sound at 6 weeks and 8 weeks and then released to my OB.

Holy Moly. I won’t go into the other information we went over today. It was about FET (frozen embryo transfer) if our IVF fails... I won’t/refuse to think about that and will cross the bridge only if I must.

For now my focus is on a successful IVF. -Rainbows and Butterflies if you will.  Relaxing and taking my medications and being so very happy and blessed. 2014 is going to be our year<3

Thank you all for your support and your love- It means the world to us<3 Please continue to pray and think happy thoughts and do baby dances as we move towards a happy and healthy pregnancy :)

Happy New Year guys!! xo