I’m not going to sugar coat this as I want you to know as many facts as possible. Everything listed is based on both my personal experience and that of friends who have also undergone IVF. There is a lot to cover so I will split this up into sections.
What is IVF?
In-Vito Fertilisation (IVF) is a form of assistive conception used by couples with fertility problems. You will also soon discover its a procedure full of abbreviations and lots of medication.
IVF is a long wonder process and definitely not for the faint hearted. It takes some research and thinking before deciding to commit. Definitely don’t jump in with both feet especially if you are self-finding.
Just waiting to get to the start of the treatment programme involves a lot of paperwork and that is before you’ve even spoke to an IVF nurse or consultant. You will find this part of the process the most frustrating. Sometimes you sit in that waiting room for an eternity (especially if they are running behind schedule) listening to other people children running around wondering if it will be worth it only to find that that says appointment was to tell you you’ve been accepted for the programme and now need to complete some more paperwork.
Should I tell people that I am having IVF
This is an entirely personal choice and no one can tell you the right or wrong answer. My advise would be to think carefully about who you do tell. It’s amazing how many people suddenly have a friend of a friend who went through the same thing and they know how you’re feeling.
It is a terribly lonely experience if you do not have someone to talk to even just about how you’re feeling. You don’t need to share all the details and if like me you are going through the procedure with your husband don’t always rely on them to support you. Some men just can’t handle seeing their wives in pain and try to distract themselves in work. It’s not that they don’t care it’s just they don’t know what to do and that helpless feeling makes them vulnerable.
Meeting the nursing team
That first meeting with the IVF nurse is a bombardment of information and tests. First up is some blood tests (get use to this because you have plenty more to come over the duration of your programme). You will then have an intravaginal ultrasound. This is a painless procedure and again plenty more of these to come.
Finally, you will collect a massive bag full of medication, needles and a yellow sharps bin. Hopefully the nurse has shown you how to do the injections. Which are in the stomach. If not a quick easy guide can be found below
Depending on whether you are in short protocol or long protocol will determine the exact timings of the below however both generally follow a similar process.
You will likely have been requested to take the contraceptive pill for a month or two. This is too help control your menstrual cycle and hopefully activate a period if you have irregular ones.
Step 1a: Scan 1 (pre-stims)
So you’ve had you’re medication for a few days whilst waiting for your period to start. It is he only time your probably glad to see AF.
Once it arrives you call the IVF nurses who book you in for scan number one. Yes, you will be scanned internally whilst still on your period. I dreaded this part I thought blood would go everywhere but it honestly doesn’t.
Little tip: pop a pad in your panties just before you go in for your scan so when you pop your panties back on there’s little risk of staining your clothes. Also note you cannot use a tampon until after the scan.
Step 1b: Stimulation (Stims)
So this is the part you’ve been dreading. Self injection to help stimulate your ovaries into producing more follicles than normal.
You will have been told when to start your medication and given a handy checklist of types and dates when to take. Depending on which programme (short or long protocol) will depend on the medication and timings. You will have regular blood tests followed by scans when your hormones reach the right level. The scans again are internal and this is to check that the lining of your womb is forming and that the follicles on your ovaries are maturing.
Once ready you will be given the date for egg retrieval. You should prepare yourself for visits to the hospital every other day for blood tests.
This is a very tiring part of the process and it is worth checking if you can purchase a monthly parking pass it will save a lot of money for your trips over the coming weeks.
Step 2: Egg Retrieval / Collection (ER/EC)
Approximately 48-hours prior to your procedure you will need to self-inject with the HCG hormone. This basically gets your eggs ready for release without releasing them into your Fallopian tubes. The exact timing depends on the time of your procedure and will be written down for you.
On the day of your procedure you and your partner (unless using donor sperm) will attend the IVF ward. You will be given a hospital gown and popped into a nice private cubicle. This will be your home for the next few hours. At this point you will be so hungry (and nauseous) as you’ve been nil by mouth for the last 12 hours.
Your partner is in attendance as they provide a sperm specimen whilst you’re in theatre. Also it’s nice to have someone to talk too before and after the procedure.
The procedure itself is done under sedation. You will be awake the entire time! You will likely feel most or all of the procedure but not at the pain levels without sedation. I won’t lie though even with the sedation it hurts like hell and you will feel every needle jab.
You will be taken into theatre and asked to climb onto the bed and place legs in the stirrups. You will then lay back and the anesthetist will inject you with some anti-sickness medication, pain relief and a sedative. You will have had your cannula inserted in the private cubicle before you attend theatre.
Once all meds and ECG pads have been placed on your chest and blood pressure finger clamp it’s time to begin. You will be covered up with only your lady parts on full display to the consultant (a bit like a smear). You will be clamped open and then all the uncomfortable parts begin. Small needles are used to extract the follicles (hopefully containing mature eggs) these are inserted into the vagina and through to your ovary. They do one at at time and depending on the number of follicles depends on how many insertions they do e.g. Could be 30 on one side and only 5 on the other. At this point focus on something on the ceiling and breath.
Afterwards you may become drowsy or even fall asleep, this is normal. You will be left to recuperate in your little your cubicle. You will be asked to rest until ready to eat and drink something then you will be allowed home. Despite them telling you how many eggs were collected you will forget so you will be reminded of how many eggs were collected before you depart.
Step 3: Fertilisation and Embryo Culture
Your eggs will have been mixed with your partners (or donor) sperm shortly after the procedure. One of the lovely embryologists will give you a call the next day to tell you whether any fertilised. This is an awful wait hoping, praying something worked. If you got fertilisation you will be kept up to date during the next couple of days and advised when / if you will have embryo transfer and on what day. Normally you receive your calls around 9am but definitely before lunch time. You feel like a child at Christmas waiting and waiting with the day feeling like a whole year.
Step 4: Embryo transfer (ET)
Take your partner for moral support and you also won’t feel up to driving to the hospital and back home again either. The procedure itself is once again done in theatre but this time no sedation. The procedure is quite uncomfortable more like a more invasive smear test but with a full bladder thrown into the mix. Try to focus on your breathing I found starring at the ceiling and counting in my head 1-2-3 as I inhaled and 3-2-1 as I exhaled. It didn’t take the pain away just make me refocus slightly to relax. The more tense you are the harder it is for the procedure to be done. Plus, you have a fullish bladder so you’ll want to think of anything but what’s happening down below.
You will be asked to confirm your name several times and even get to see your little embryo (embaby) on the screen before it is inserted. Afterwards you may feel like you’ve just emptied your entire bladder on the theatre bed but it’s the fluid flush that was inserted before the embryo transfer to check there are no blockages.
At the end you may even get a scan copy although you won’t be able to see much. At this point the nurse was talking and all I could think about was trying not to leave a huge puddle on the floor. Oh and I forgot to mention the consultant will also insert (rectally) your first progesterone pessary before you sit up.
The two week wait (2WW)
This is the period of time between embryo transfer and been able to take a pregnancy test. It’s one of the longest two weeks of your life. It’s also the first time you have no support from the IVF clinic – you’re on your own.
The first week is usually the quickest but most uncomfortable because you might still have some bloating from the hormones. You will also still be using the progesterone pessaries (or injections). You will be googling EVERYTHING and anything IVF related. Early pregnancy symptoms etc. Nothing online will be 100% and will even plant ideas in your head that cause more worry than necessary. In this first week you may feel exhausted from the recent procedure and maybe have OHSS.
From my personal experience the second week was the worse. I googled implantation bleeding, why am I so ill after embryo transfer, why am I still bloated etc etc. I even googled things like early early pregnancy symptoms to see if I had any. This really doesn’t help because you become obsessed.
Here is a short list of the uncomfortable and bizarre things that happen during the 2WW:
- Constipation from the fabulous progesterone pessaries;
- Feeling tired;
- Sore boobs and itchy nipples (yes this is a thing);
- Convinced taste buds have changed already
- Convinced sense of smell has enhanced
- Feeling unwell (cough, sore throat, etc)
- Implantation bleeding at about day 9 (doesn’t happen to everyone)
- Overwhelming desire to test early. You really shouldn’t test early as you may get a false positive due to the trigger shot (HCG). If you can’t wait 2 days before you test date is usually ok but better to wait until that full 14 days has past since your trigger shot.
- Metallic taste in mouth (again could be in your head)
- Desire to hit someone due to frustration of not knowing
- Desire to ignore the world because you’re fed up of waiting and not knowing anything.
As you can see some are common early pregnancy symptoms and some are just typical after a medical procedure. Either way remember the pregnancy feelings are due to your longing desire to be a mum, the HCG trigger shot and all the other hormones still circulating your body.
I had a terrible chest infection and generally felt awful. I couldn’t wait for test day so tested two days early and then again on test day. Reason for the early test was because I was convinced it hadn’t worked and was desperate for some relief from my chest infection. As you maybe aware from my other posts my test was a big fat positive (BFP).
If you get a BFN (negative) try not to worry. It will be very very emotional and you will try to blame yourself but sometimes the embryo just wasn’t viable. Still ring the ivf nurses because they will guide you through the next steps. It’s important to remember positive or negative don’t stop your progesterone pessaries (or injections) until you are told to do so.
If you are going through this procedure right now I wish you all the very best and have my fingers crossed for your BFP result 😊
BFP: welcome to the first trimester of pregnancy
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