IVF for PGD: Cycle protocol and update

Since I’ve been doing my own share of Googling other people’s IVF experiences over the last several weeks, I think it’s time that I document my protocol and experience with my current IVF cycle.

We’re doing IVF for PGD (pre-implantation genetic diagnosis) to screen embryos for the BRCA gene mutation. I inherited this gene mutation from my mom, and each of my eggs is 50% likely to be positive, too. BRCA 1 radically increases the risk of ovarian and breast cancer, so while I’m doing what I can to reduce my own cancer risks, we decided to pursue this option to try to avoid passing this on further. (Read more about our decision HERE)

So, my IVF protocol involved taking a birth control pill for 2 weeks. This ensures that my ovaries aren’t doing anything before we get started. After those two weeks, I started on Gonal F to stimulate follicle growth. I was to do that for 6 days before adding in Luveris and Cetrotide.

Ok, I actually totally messed up and thought I was supposed to take Luveris + Cetrotide instead of Gonal F instead of in addition to Gonal F. The next morning at my appointment, I was so devastated when I found out that I’d missed a dose because I was worried everything had been ruined and my cycle would be canceled. Fortunately, the nurse explained that my follicles had still grown so all was ok. Of all the meds to miss, the Gonal F was the least tragic at that point. So phew! I still was anxious about it for the rest of the day and just so upset that with all the uncertainty that already exists with this process even when you do everything 100% correctly, I hated to think an innocent mistake could mess up a cycle. When a cycle runs many thousands of dollars, eeek!IVF for PGD

Anyway, from then on I took them together. Luveris works with the Gonal F to stimulate follicle growth and the Cetrotide prevents ovulation to keep all those eggs up in there until they’re mature enough for retrieval. While Gonal F comes in an easy-to-use pen, the others required mixing dilutants and powders and swapping needles and instructions with 17 steps. I got the hang of it though and am now pretty much a doctor 😉

I’ve had to go to early morning monitoring appointments every couple days for ultrasounds and blood work. I’m so lucky that the clinic is a 5 minute walk from my office. I know there are other ladies that drive in from 2 hours away, and probably even further. With appointments between 7 and 8am every day or two, I really lucked out with being so close by!

My appointments showed that I had a decent number of follicles in each ovary and they were growing steadily although slightly slower than expected. This just meant that I had to “stim” longer (10 days total).

After so many injections, my belly is now feeling quite tender, but otherwise my only symptom has been major bloating, which results from big swollen ovaries full of growing follicles. The bloating started about 4 days in and has only gotten worse. I constantly feel like I’ve eaten a huge meal, and feel like I’m waddling around. I even have to undo my pants!

IVF for PGD

I’m also a bit more irritable, which isn’t surprising with the hormones flooding my system. Hearing people (Mike) making a noise while yawning has suddenly become the #1 most annoying thing ever. I have no idea why this of all things nearly triggers rage within me. So random. Fortunately I’ve managed to keep myself in check since I know that’s hormone-related craziness. Ok, so maybe I’ve become very irritable, but only a bit more than normal 😉 Otherwise I’ve been going about with business as usual for the most part. I’ve stopped running at my doctor’s recommendation, since swollen ovaries + vigorous activity can lead to twisted ovaries, which I guess is as awful as it sounds. I’ve been walking/waddling, but avoiding doing any more than that.

Tonight I’ll be taking Ovidrel to trigger ovulation, and then my eggs will be ready for harvesting in a couple days. I’m so happy that I only need to take one injection tonight instead of 3.

Since we’re doing IVF for PGD to try to find our healthiest, BRCA- embryos, it really is a numbers game and kind of crazy to consider how they drop off at each stage. Right now it looks like I have at least 10 good follicles, maybe more. Hopefully eggs can be retrieved from all of them. Even then, who knows if we’ll end up with any or one or two or more at the end. It goes something like: # follicles > # of eggs retrieved > # of eggs fertilized > # of embryos that grow into blastocysts > # of embryos that are BRCA- and chromosomally normal. And that still doesn’t guarantee anything when it comes to the success of the later frozen embryo transfer. For now I’m hoping for a successful egg retrieval in a few days and for the rest we will have to wait and see!

 

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