Day one of stims for IVF#2

13 09 2012

So, today begins FSH stims for IVF#2.  Whooooooo!!!!!


Actually that’s a lie– I really am excited.  Excited but terrified.  I just googled “excited face” and this kind of gave me a little giggle.  (And now I know how to generate a “meme”– go here.)

But you know what I’m talking about if you have ever heard your spouse (or your bank account) say “This is the last time.”  Whether you’re doing IVF, donor egg, donor embryo, surrogacy, IUI, or “just” timed intercourse… there’s a feeling of intense desperation that comes with that last effort. It’s that happysad line you have probably been riding right along with me in one sense or another.

I don’t blame him (a lot) for feeling as he does… it is expensive, stressful, and ridiculously NOT FAIR that we can’t get pregnant by making sweet, unhurried, loving love.  Even timed intercourse gets to be a pain in the ass, metaphorically speaking.  I always thought I’d get knocked up and we’d look back fondly, trying to guess– was it that night on the carpet in front of the Christmas tree? was it in the shower? and so on!  Instead we got to a place where if I had gotten pregnant, I could have told you exactly the day I ovulated.

It’s not so funny… but when we want to talk about sex as opposed to making a physical connection (as in, extending an invitation, request, or demand for lovin’) our little “euphemism” is usually “the business.”  As in, “Honey, how ’bout some bidness?”  Sorry if that is TMI, and sorry if it sounds stupid, it works for us.  I have no idea how we started using business to mean sex, but we did– and consistent with both of our personalities, 95% of our “invitations” are made very playfully.  We’re just not hot-and-horny heavy-breathing sex machine people.  It’s just that, once sex became such a functional-yet-dysfunctional thing, it really did become business.  I was always calculating– sperm live 5 days, but you shouldn’t deplete them, and yet you shouldn’t try to store them up, and even if you’re like a metronome in the regularity of your ovulation (as I was, before all this stim/IVF stuff) it can be challenging to decide the perfect dates and times for “deposits” even if you’re not dealing with real life things like work demands, long days, physical fatigue, travel apart… and oh yeah– my husband is a person too, and he might like to be less a mailman and more a lover….

So poor baby, he’s happy to be a daddy, but he’s less and less happy about being a mailman who writes fat checks to doctors for no return.

Before this, I did one unmedicated IUI… one injectibles+IUI, and then one “embryo banking” cycle with Dr Sher in Vegas.  That’s where you do (theoretically) several cycles of egg retrieval and embryo freezing, so that you can “bank” several embryos… which you have biopsied, so you can test a bunch of cells at once (as that costs less than testing two cells this cycle, two cells next cycle.)  The theory being you will end up with a bank account empty, and an embryo bank full of frozen, chromosomally-normal blasts… and then you can have not just one baby, but even make siblings down the road.

Ahem.  I’m apparently not so good with theories. This was the embryo report generated by SIRM-Vegas from our ER there.


As I didn’t make any blasts, we didn’t bother with any testing.  And I wasn’t so happy with Sher’s approach to immunology, after I did more reading and research.  (Though I was deeply grateful to the concept of embryo banking because it’s what turned my husband around on IVF.  He was originally adamantly opposed to it because it was too much a crap shoot.  The embryo banking plan sounded so… sure. HAHAHA!)  Back then, hubs gave the go-ahead for 3 cycles.  He wanted to stop when we didn’t make any blasts the first time but I persuaded him to give it another shot (and he was okay with a third try if we make blasts on the second.)

In the back of my mind I’m thinking if somehow I don’t get pregnant this time– ie we do a 3-day transfer and it doesn’t stick, OR we do a freeze-all and the later FET doesn’t work– but we still somehow make a blast in the lab… then I can probably fairly request another cycle since we did, after all, make a blast.  So much thinking.  And this is why, although I am truly excited to get the show on the road… I am also absolutely dreading the beginning, because it’s the start of the end of the adventure in which I can too-easily see a no blasts, BFN, sorry, you lose kind of situation in which hubs insists we stop the madness and remain perpetual DINKs.

Enough moaning and groaning, amirite?  Shut up and get moving.

So here we are… today is day one.  My protocol is one Sher developed– the short name is LA8-e2v.  It’s an agonist/antagonist conversion protocol designed for older women and low responders that actually turns out better egg quality for young women and good responders too.  I’m a decent responder for my age– but I am old.  Dammit- since when is 40 years one month OLD?!  Anyway, this protocol will minimize any tendency to bathe the eggs in androgens because of too much LH, and it primes my ovaries to be sensitive with lots of estrogen.

If you want to read more about the varying IVF stim protocols out there and why Sher advocates the A/ACP for most women, go here.

I was on birth control, layered with lupron, then off BCP, then off lupron, and on ganirelix.  Now, today, in addition to the ganirelix, I added lovenox this morning, and prednisone, and baby aspirin.  And this evening I start my FSH — 600 units of Gonal-F.  (I feel relatively experienced– I can read some new-to-me blog and already tell the approximate age or PCOS status of the author just by their stim dosage.  Or at least I think I can.)

My first injects+IUI cycle, I started with 225 units of Gonal F for two days, then ramped down to 150.  I stimmed for four days total and my lead follicle was already 20mm so I triggered then, and probably got two eggs because the second largest was something like 17mm on the day of trigger.  My first IVF cycle, I did the long-lupron (no ganirelix, only BCP and lupron) protocol L4, so I started with 300 units for 2 days and then down to 225, stimmed 8 days, got 11 ripe eggs, 9 fertilized (with ICSI), and no blasts.

I’m really, really hoping that (as Dr Saleh at SIRM-Dallas told me) the doubled amount of FSH in my current protocol translates to double the number of eggs… and that they’re not fried or hurt by the higher amount… I’m hoping that Dr. Braverman will give me good feedback on whether to do ICSI or not… at the moment I’m leaning towards yes, because:

  • Older eggs have thicker shells
  • Once you leave the eggs and sperm alone in a dish, “rescue ICSI” isn’t really good because the egg is so old.  Sucks to spend all this money and time and basically have a cycle fail because you didn’t get enough eggs to fertilize.  (Of course this assumes that ICSI-fertilized eggs might not have fertilized on their own and that they’re still okay if you force them along.)
  • Sucking the egg out of the follicle sometimes affects the cumulus layer of cells which are necessary for appropriate sperm interaction, and ICSI bypasses this
  • The studies that talk about increased risk of birth defects, miscarriage etc with ICSI were done on cases involving MFI (male factor infertility)– where allowing natural fertilization means the normal sperm do the work (in ICSI, you might fertilize with an abnormal sperm, which looks normal to the embryologist’s eye.  Assuming you’re not doing IMSI of course.  And not all labs have the high powered microscope you need for IMSI.)  If you don’t have an MFI case, then ICSI doesn’t produce those problems.  See Sher’s article on this debate here.
  • Regret management.  If this really is our last cycle of IVF (i.e. it fails but Mitch wins and we don’t try again) then I want to know I did everything possible short of drinking kombucha.  One must have limits.

Hope your day is going swimmingly so far 🙂



2 responses

16 10 2012
Liz Raptis Picco

I’m cheering for you! I teared up and laughed as I read your post. Keep writing! Please visit

16 11 2012
Everyday Mom Style (@EverydayMomStyl)

Good luck to you! Both of my sisters went through this, and I know it’s extremely difficult. Try some yoga to control stress!

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