Day 4 of Ovarian/Egg stimulation - IFV #2

So today is Day 4. My ultrasound and bloodwork looks fine according to my nurse. But my Puregon dosage is being increased from 300 IU to 350 IU.  This means I have stab myself twice because I have 300 IU cartridge.

The next ultrasound and bloodwork will be on Friday (Day 6).

Day 3 of Ovarian/Egg stimulation - IFV #2

Today is day 3 of ovarian stimulation.  Had been taking subcutaneous injections daily and my belly is already starting to hurt.  I'm not complaining at all.  I'm so thankful to have an opportunity to get through this treatment.  I’m more relaxed the second time but I have headaches and feeling nauseous.  As expected these are side-effects of Puregon (to grow multiple eggs) and Menopur (to improve size of eggs).  Puregon contains FSH (follicle stimulating hormones) and it helps ripen the follicles in which the egg cells develop. In IVF, it is important to have as many high quality and matured eggs to retrieve.  Menopur contains both follicle stimulating hormone (FSH) and luteinizing hormone (LH) and stimulates the ovaries to produce eggs.  I’m taking 300 IU of Puregon and 150 IU of Menopur daily.

I’m also taking Saizen (growth hormone to hopefully improve quality of eggs), Elthyroxin (to treat my slight underactive thyroid) and Dexamethaxone (to suppress immune system). 

Day 1 was last Sunday, May 28.  I’m glad I’m on top of my records (so I thought, I’ll explain later) because my nurse told me my Day 1 was Saturday, May 27.  And I had to tell her it’s Sunday based on the original paperwork I was given.  I’m not impressed this time the nurses are not careful and told me the wrong start date for taking the medications.  At the end of the day, I had to almost be my own advocate.

Anyway, I was so excited to begin my Day 1 medications and I was looking over records, double-checking things, but unfortunately, I took one medication (Saizen) too soon on Day 1.  Ooops, my mistake!  It’s supposed to start on Day 2.  It was very difficult to get a hold of my nurse to ask for advice over the phone.  Eventually I managed to talk to her after calling the receptionist so many times.  She said not to worry about it and just take the next dosage on Day 4 and to continue taking it every other day as per my protocol.  I'm quite relieved.

Tomorrow (day 4), I go back to the clinic for bloodwork and ultrasound to see if any adjustments will be needed in my medications.  I hope my eggs are growing fine.  During the baseline ultrasound scan 2 days before my day 1, there are 13 follicles visible (8 on my right ovary and 6 on my left).  I hope they all contain eggs and will grow big and healthy for retrieval in about 9 days.  Ideally, there should be around 20 follicles but given my age, I'm lucky to have 13.

Puregon and Menopur I took today.

This is the saline solution for Menopur. It's in glass because this is the European Packaging I ordered online, unlike what I used before which was in a vial with a rubber seal.



And this is how the saline solution for Menopur is opened. I was scared at first because it is made of glass.

Administering Menopur.

Administering Menopur

Puregon is easier to administer because it comes in a pen. Unlike Menopur, I don't need to mix the powder with the saline solution.

 

 

 

To PGS or not to PGS

Today is the last day of my pre-IVF down regulation.  I took Androgel (testosterone) once daily, Prometrium (progesterone) 200 mg twice daily and Estrace (estrogen) 200 mg twice daily for 23 days.  My body will be resting for about a week.  Some of the side effects for me were nausea, fatigue and feeling down for no reason. 

My down regulation hormone medications

If the ultrasound and bloodwork looks normal on Friday, the ovarian stimulation (which involves several daily injections) will begin in exactly 7 days.  I’ve also purchased the most expensive fertility medications (Menopur, Puregon and Cetrotide) I will need for the ovarian stimulation from ivfmeds.com which saved me a couple thousand dollars.  They don’t carry everything I need so I will still buy the rest from the clinic.  I was hesitant at first to buy online but the savings is incredible.  I wish I had done that the first time.  They ship from UK and but charged US $99 express shipping.  It arrived in 5 days.

I’m having a hard time deciding whether to have PGS (Preimplantation genetic testing) or not.  It is supposed to prevent early miscarriage but it didn’t work for us the last time.  We had 2 chromosomally normal embryos in the last cycle, but one ended in early miscarriage (just short of 6 weeks) and the other one didn’t even implant.  Our doctor recommends it because we’re older and my husband’s sperm DNA fragmentation is not so good (even though it improved in the last 3 months after he took a lot of supplements).  Anyone over 35 years old has more than 50% chance of having abnormal chromosomes, and about 90% abnormal by age 40.  Those abnormal embryos usually end in early miscarriage and if it does become a successful pregnancy, has a higher chance of having a baby with Down Syndrome or birth defects, so it’s pretty scary.

Here are the reasons why I’m hesitating against PGS testing:

1.  Not covered by OHIP and it costs around $5000 and we can no longer afford this.

2.  The test is maybe 98% accurate but cannot test mosaicism. 

3.  Biopsy is taken on day 5 (blastocyst stage). But I’ve learned that abnormal embryos can self-correct themselves after day 5.

4.  At almost 40, my own egg(s) is more fragile and of low quality that the biopsy process can further do damage to the embryo.

I guess the only outstanding issue is to PGS or not to PGS.  If I don't do PGS testing, it's where my faith comes into play.  I need to decide in 7 days…