10/6/2022: Post-Round 1 visit
Free of charge
The appointment turned out well, much better than I thought. It was the first time I had ever felt care and attention from my RE, whom I had previously been nervous, anxious and stressed about.
I had excitedly wished to see her at first. I had hoped the visit would tell us more about what happened to our Round 1, what else we needed to do to better prepare for Round 2, and clear information on the protocol to follow for that round. However, I had lost my enthusiasm for the appointment after waiting for a month. Moreover, during that time, I had already started taking birth control pills as directed by the nurse in preparation for the stimulation phase of Round 2. (I was unsure if it was a good idea for me to take birth control pills for an extended period of time at my age.) But surprisingly, the appointment ended up going well.
This time, instead of injecting various drugs with doses adjusted as needed, I would only be using Gonal F for stimulation, Lupron for ovulation suppression and a trigger shot. The doctor would not be adjusting doses; she explained that if my body responds poorly to the drugs, increasing the amount would not be very effective.
During the appointment, the doctor seemed surprised when I mentioned that in a few days it would have been 41 days since I started taking birth control pills. Answering my concern if it was ok to take the pills for that long, she assured me that it was not a problem. I had also asked the nurse about this before and received the same assurance.
We left the clinic, feeling more positive about our next treatment.
10/20/2022: Baseline ultrasound and labs for Round 2
19 follicles (11 left, 8 right)
Lab tests showed normal results.
Stimulation Phase
Day 1 (10/20/2022): Took Lupron (40 units) at 8:30 pm.
Day 2 (10/21/2022): 225 units of Gonal F (x2) and 20 units of Lupron (x2) at 5AM and 8:30 PM.
Day 3 (10/22/2022): Same time; accidentally took extra 75 units of Gonal F. The nurse instructed to subtract that amount from the PM dose.
Day 4 (10/23/2022): Same dosages, same time
Day 5 (10/24/2022): Same dosages, same time
Day 6 (10/25/2022): Same dosages, same time
Got the first ultrasound, showing 8 follicles (6.5-9.5mm). Sad!
Day 6 (10/26/2022): Same dosages, got injections 30 mins late in the evening.
Day 7 (10/27/2022): Same dosages, same time
Day 8 (10/28/2022): Same dosages, same time
The ultrasound showed a 25.7mm cyst on the right ovary; as well as 3 follicles (15.7mm and 13.7mm on the left, and 12.7mm on the right) and 2 small follicles (8.6mm and 6.3mm). So sad!
Day 8.5 (10/29/2022): Same dosages, same time for the AM dose
The nurse called me and said my progesterone were elevated, so I would not be receiving any more stimulation injections. Instead, I was to take a trigger shot at 10:30 PM that night.
In Round 1, I had used the trigger shot Pregnyl, but this time I chose Novarel, even though it was more expensive, in the hope of getting a better result. Each box of Novarel comes with one vial of 5000 units of powder and one vial of bacteriostatic water. I bought 4 boxes, 20,000 units in total.
To ensure that we were not rushed while administering a new drug, we began preparing 45 mins before the scheduled injection time. To administer 10,000 units, I would need 2 vials of powder. S diluted one vial of powder with 1cc of water, then injected the mixture into the other vial of powder and swirled it to dissolve the medication. Next, he drew the resulting solution into a syringe and replaced the needle with a smaller one, 27Gx1/2″. The prepared syringe was then placed in the fridge until injection.
Mon, 10/31/2022: Egg Retrieval
Procedure time: 9:30 AM
We were required to be at the hospital 2 hours before the procedure for admission registration, medical history checking, and pre-surgical instructions, etc.
2 eggs were retrieved (…) – I was at a loss for words to describe my feeling.
Tue, 11/1/2022: Zero embryo. Failed.
The embryologist called me and said one of the eggs was abnormal and the other was mature but didn’t fertilize. He was unable to determine the exact cause, but suggested that the sperm’s low binding rate (30% versus the normal average of 60%) could have been a contributor.
….
I began writing this post more than 2 months ago and didn’t finish it until today. It was just too overwhelming to think about how things had happened, what would be possible paths my life would take, and what I could and should do to improve my chance of success in the next round(s). We had a follow-up appointment with the doctor on November 10, 2022 ($157) to review the result of our Round 2 and discuss a new protocol for Round 3. While we exchanged a lot of information during the visit, much of it was not particularly helpful. We still don’t know which factors mainly caused the failure, as there were so many variables at play. However we all know that there is no guarantee of success in this IVF journey, despite our best efforts.
Round 2 was truly a nightmare to me both mentally and physically. I broke out in pimples all over my face and part of my neck. More terribly, I suffered a significant change in my mood. I wasn’t myself anymore. I felt extremely low during the stimulation phase. I became tremendously vulnerable and sensitive. I got easily irritated and couldn’t let it go. I cried everyday until the retrieval day. The doctor later said these mood changes may have caused by Lupron, which lowers estrogen levels in the body, triggering menopause-like symptoms.
Though S has been with me just as he always is, IVF is still a lonely journey for me.
Begin life at forty 