Begin life at forty

Tag: Birth control pills for IVF

  • Canceled IVF Cycle 5, July 2023

    ​​​Two weeks before my baseline ultrasound and blood tests, I was nervous and anxious about my upcoming cycle. It was the first time I found myself emotionally and physically unavailable for the treatment, feeling negative and doubtful. I wasn’t certain if I could proceed with the treatment.

    My immune system was badly affected by allergies, despite it not being an allergy month. While helping S build two flower beds in the backyard, I might have exposed to allergens or fungi when touching the old soil and decayed leaves. I ended up with constant runny nose and relentless sneezing, which forced me to take Clarins even though I didn’t want to. Additionally, I experienced swelling in one spot of my gum for unknown reasons, slow healing of a scratch on my hand caused by Sam, and sudden pain in my left knee joint. My muscles were stiff and my entire body tensed up.

    S took me to a spa for a massage, which provided temporary relief. However, I still felt exhausted, and deep down, I sensed that my body wasn’t fully prepared for the treatment. I hesitated to order stimulation drugs, unsure if the baseline ultrasound and blood tests would provide the green light to proceed. It was the first time I mentally prepared myself for the possibility of failure right from the start.

    The test results revealed active cysts in both ovaries and a high estradiol level of 128 pg/mL, surpassing the expected 50 pg/mL. Therefore, the doctor decided to cancel my cycle and put me on birth control pills, Norethindrone Acetate and Ethinyl Estradiol (1.5 mg). I started taking these pills on 6/26 and will discontinue them on 8/7. However, I am not fond of being on birth control pills, especially for an extended period. I had expressed my concerns regarding the risk of ovary over suppression multiple times to the doctor, and while she understood, it seemed she didn’t weigh that risk as heavily, considering the benefits it provides in preventing cysts and facilitating the clinic’s scheduling.

    I felt trapped, unsure of how to strike a balance between resolving the cysts and ensuring that my ovaries respond well to the medications. Given my age and the past negative experience with prolonged use of birth control pills in the second round, I worried that I would encounter the same outcome in the future. When I asked about an alternative to birth control pills, the nurse mentioned the possibility of using long Lupron, but she added without an explanation that the doctor might not want that option for me. I was advised to talk with the doctor to understand possible solutions she could offer. This means I would have to book an appointment with her and wait for at least a month for the appointment. I hesitated to do this because though we previously discussed how to avoid the development of cysts during the stimulation phase, we have never talked about how to resolve cysts that occurred before stimulation injections. This is the first time I’m experiencing active cysts before stimulation, so I persuaded myself to try not to overthink or overanalyze the situation and to follow the professional instructions without questioning, believing that the medical team is providing the best care they can.

  • Canceled IVF Round 3 – Feb 2023

    Paid $3,991.69 for the meds

    I was more nervous and cautious during Round 3 since it was my last chance to do IVF here. Also, I was worried if I could even start Round 3 because I got an ovary cyst during the stimulation phase of Round 2. Fortunately, the baseline ultrasound and blood tests showed that I was good to go. The ultrasound technician told me that my right ovary had 12 or 14 follicles (I didn’t bother remembering the exact number or asking my nurse for the precise count). I was trying to relax this time and avoided stressing myself out with too much information. I just did what the nurse told me to do. Basically, here is how Round 3 went for me:

    Sun, 01/15/23: Started BCPs – I hated BCPs. I told my RE at the post-retrieval visit of the last Round that I preferred not to be on BCPs, especially for a long time considering my age. Despite this, I still had been on BCPs for 31 days.

    Wed, 02/14/23: Stopped BCPs

    Fri, 02/17/23: Baseline ultrasound and blood tests: 12 or 14 follicles on the right ovary

    Sat, 02/18/23: Day 1 of stims: Took 300 IUs of Gonal F, 150 IUs of Menopur and 100 mg of Clomid (PM)

    Sun, 02/19/23: Day 2: Same dosages (PM)

    Mon, 02/20/23: Day 3: Same dosages (PM)

    Tue, 02/21/23: Day 4: Same dosages (PM)

    Wed, 02/22/23: Day 5

    – Ultrasound and blood tests: only 4 follicles grew, one of them was dominant (15 mm): Disappointing

    – Same dosages and 0.25 Cetrotide – ovulation suppress drug (PM)

    Thur, 02/23/23: Day 6: 300 Gonal F and 0.25 Cetrotide (AM) and 150 Menopur (PM)

    Fri, 02/24/23: Day 7: Same dosages as Day 6

    – Ultrasound and blood tests: Still only 4 follicles measurable (3 on the right ovary – 19.5, 14.3 and 12.8 mm and one on the left – 10 mm): Disappointing and considered canceling the treatment. Emailed the nurse and the financial counselor asking about the potential cancelation and whether this would be counted as Round 3 or not. If not, how much more we would have to pay to continue Round 3.

    Sat, 02/25/23: Day 8: 300 Gonal F and 0.25 Cetrotide (AM) 

    – Ultrasound and blood tests: Again, still 4 follicles (3 on the right ovary – 21mm, 16.8, 13.2 mm and one on the left – 11.1mm). At first, the largest one was thought to be a cyst. The nurse later clarified that it was a follicle. The nurse also assured me that they could still do the retrieval with just two follicles but my RE supported my decision to cancel if that’s what I wanted.

    We canceled the treatment. I was disappointed when no one from the IVF team had suggested that I should cancel when I only had 2 or 3 follicles until I asked them.  If I hadn’t mentioned this to the nurse, I would have had another bad retrieval again and lost Round 3 without the chance to try a different protocol to increase the number of follicles. 

    Looking back, I wish I had canceled my retrieval in Round 2 as well. Doing so would’ve saved me so much emotional, physical and financial pain. My Rounds 2 and 3 were quite similar. Like Round 2, I hadn’t yet started the period when I began Round 3, and had been on BCPs for a long time. Also, I had the same number of follicles with similar sizes as in Round 2. At the time, I didn’t think of canceling the retrieval in Round 2 as I trusted my RE’s instructions completely.

    Since I canceled the treatment, I have some drugs left over but I can still use them for my next cycle. My friend, D, wasn’t that lucky. Her treatment was canceled on day 5 of stims and it was her last attempt after the 2 failed cycles. She spent a lot of money on the unused meds. If she had been advised not to buy the meds for the whole cycle from the beginning, she would’ve saved a lot of money. I was grateful when she offered to give me the unused meds for free. However, I still haven’t got them yet as my car is currently broken and I’m not sure if S is willing to drive me for 2 hrs to get the drugs that we may not use since the protocol for my next cycle might be different.

    Throughout my IVF journey, I haven’t got enough guidance with the team. While my nurse and RE were polite and professional, I didn’t feel much support or care from them – it’s probably how a clinic works. However, I really like the ultrasound technician. She took the time to answer my questions and explain things to me carefully. I didn’t feel rushed when talking to her and felt a human connection between us. I also like a nurse (not mine) who helped me extract leftover drug fluid, and she did it with great care. She placed a note with my name on my drug box and another note inside to let me know which syringe didn’t have enough dosage. Overall, the clinic’s atmosphere was nice and supportive, but I received all my instructions only from the nurse over the phone. I didn’t talk directly with my ER. I only met her during consultation visits before starting the treatment, and since then, everything was through my nurse. Also, my ER didn’t retrieve my eggs – a different doctor did. Once you sign a multiple cycle package, you will be immediately put into the next cycle after a failed cycle without an appointment with the RE to understand what goes wrong and what new protocol will be applied unless you ask. This has happened to me in my first 2 Rounds. In short, I didn’t feel the ER’s presence during my treatment.

    But I don’t intend to switch clinics. There are only 2 in my area, and starting treatment at a new one would take months, or even over half a year. I’ll try one more time at this clinic and if it doesn’t work, I’ll continue seeking the opportunity in VN where I believe there are more resources to support me.