I suppose I ought to document our IVF process for posterity. So, here goes.

Last Friday I had my screening ultrasound to make sure we were good to go this month. The ultrasound lasted all of three minutes, and the doctor counted a total of 34 follicles in my ovaries. This seems pretty good, but it also makes me a little nervous about potentially developing OHSS – ovarian hyperstimulation syndrome. Which apparently could result in hospitalization and/or death if it isn’t handled correctly. Fortunately, our RE, Dr. Johnstone, has put me on a low dose of stimulation medications to try to prevent that from happening.

After the ultrasound, I met with a nurse for our “injection training” class. I was expecting a little hands-on experience, perhaps practice mixing the medications and injecting them into an orange. (Why an orange? I don’t know.) Well, for one thing, I was a little peeved that she started with the demonstrations before Jacob arrived in the consultation room. He had been on the phone with American Express, trying to sort out payments so we could pay off our cycle ($18,500), and no one told him to come in once he got off the phone until after the nurse had started her spiel. And the “class” was not what I expected. She basically showed me how to twist the needles on and take them off and how to set the dose for the Gonal RFF pen. I had watched the injection videos online prior to this, so it wasn’t anything new, but she went so fast that I could barely process what she was doing.

Then she asked if we had any questions. I knew that starting day 8 of the injections, I’d be expected to come in for morning blood work to check my hormone levels. I mentioned I might have a slight conflict because I have work training from 8 to noon on July 16^th. She didn’t seem sympathetic to my plight at all and gave me the impression that I was just going to have to skip it, too bad, so sad. I guess she did say it was a possibility that I could come in at 7:30 or 7:45 so I wouldn’t be so late that day, but the vibe she sent off just rubbed me the wrong way. After that, I didn’t feel like asking any more questions, of her at least.

After the appointment we drove to the pharmacy to pick up our medications. We had two big bags waiting for us, but they didn’t have a sharps container or alcohol swabs, so I’m glad I asked for them before we paid. I forgot to ask for gauze, so we’ve been doing without for now.  The medications cost a little over $1,200 and apparently included everything we’ll need except for the trigger shot medication. I was pleased the price was relatively low, because I was expecting it to be closer to $2,000. I suppose it might be after we pay for the rest, though.

I started the injections two days ago, on Monday. The first day wasn’t so bad. I told Jacob he was in charge of giving me the injections, because while I don’t necessarily have a phobia of needles, I can’t watch them enter my body (or anyone else’s, for that matter). I pulled up the training videos on my laptop, and we would watch for a few seconds, pause the video, and then follow the steps. And repeat. Over and over again. All told, it took probably 30 to 45 minutes to prepare and administer the two injections.

The first injection we do is the Gonal RFF pen, which isn’t so bad. The medication is already inside the pen, so we just need to set the dial and pull out the button and it’s ready to inject. The second injection is a little trickier. We were given five vials of Repronex powder and five vials of a diluent. First, we take a giant mixing needle and insert it into the vial of diluent. We withdraw a milliliter of diluent, which we then inject and mix with the vial of powder. Each dose is only half a milliliter, so the idea is that one vial will last two days. The Repronex also burns when going in my skin, so that’s less than pleasant.

So, the second day we had a little drama with the Repronex. We had put the vial back in the fridge inside the bag of medications, but when I pulled it out in the morning it was tipped on its side. Then, when we were withdrawing the remainder of the medication, the needle slipped out prematurely and some of the medication sprayed out. We were left with only one fourth of a milliliter, or half of a dose. So then we weren’t sure what to do next. I was afraid of screwing things up if I only had half a dose, but I was also afraid of running out of medication and needles if we mixed another vial. I told Jacob to inject what we had, which he did, and it burned really badly while going in. That, coupled with the stress of the spilled medication, led me to crying in the hallway while Jacob cleaned up.

After a few minutes, I calmed down, and then I suddenly decided that we needed to administer the other half a dose, lest we adversely impact the cycle. So we opened another mixing needle (after a brief debate about whether it would be okay to just reuse the one from that morning) and mixed up another vial of medication. So I ended up getting three injections that morning instead of just two. I called the IVF nurse hotline later once the office opened (we’ve been doing the injections around 6:15 in the morning to accommodate Jacob’s work and sleep schedule), and the nurse said I could get more needles at my appointment tomorrow. I’m still hoping we’ll have enough medication, but I guess we can buy some more if necessary. I just hope they come in smaller packages, because I certainly don’t think I’ll need an extra five vials – one should be sufficient.

Today the injections went fine and didn’t hurt quite as badly, but my stomach is pretty sore. From day one my stomach was a little tender if I rested a book on it or while wearing a seatbelt, but now it even hurts to bend over. So far I don’t have any bruising, so that’s good. I’m nervous about what it’ll be like once I start the intramuscular injections – those needles are an inch and a half long, and have to be jabbed in my bum in a “dart-like motion.” I cringe every time I watch those training videos. I shouldn’t need one of those injections until sometime next week, so I guess I should be grateful that I’m only doing two injections with half-inch needles a day for now. Tomorrow, I’ll find out if we’re ready to add a third medication! Yippee!