At this point in your IVF journey the appropriate tests have been performed and you and your fertility specialist have set a course for your IVF cycle. Your ovulation has been charted and recorded on your individual calendar and you will be prescribed medication that will aid your ovaries in producing several mature eggs at one time. This hormone-based medication is usually delivered by self-administered injections.
The reason your physician wants you to produce several eggs at once is in order to boost your odds for success. Not all eggs will respond, or develop, after fertilization.
Immediately prior to starting your ovary stimulating medication you’ll come to the clinic to measure your uterine lining, check your ovaries for follicles and rule out any cysts. This assessment will be done by ultrasound. Once the “all clear” is pronounced your nurse will review your individual calendar and instruct you as to when to begin your medication.
Injections
For those who tend to shy away from needles you need to discuss your options with your IVF team. You’ll be instructed on how to mix your medication, if necessary, and how to inject yourself. Bring your partner along so they can learn how to inject you, if need be. Here are a few tips to make your injections easier:
- Ice your injection site area prior to taking your shot. This numbs the area and cuts down on the pain. Simply place an ice pack (a package of frozen peas or corn will work in a pinch) on the area and leave it there for about 5 minutes.
- Put together an injection kit and keep it with you. You’ll want to include alcohol swabs, band aids, tissues or paper towels (in case there’s any blood) and, if you like, a pain relief vibrating device called Buzzy (you can find them online). If you tend to have a skin reaction at the injection site ask your doctor if it’s safe for you to use a topical anti-itch cream.
- Embrace the injection for what it does. These ovulation stimulating injections, while they may be a hassle, are helping you achieve your dream of having a child. Keep your eyes on the prize!
Starting a few days after you begin your medication you will schedule daily appointments with your IVF clinic. At these appointments you will have blood drawn. This enables your doctor to assess your medication and make adjustments as necessary. As you draw closer to ovulation you will be monitored by ultrasound as well.
Somewhere between day eight and day fourteen your eggs will be ready for retrieval. Make sure you continue to maintain your healthy lifestyle during the ovulation stimulation stage of IVF, as well as after.
Egg Retrieval Process
When the IVF team has determined your eggs are just about ready for retrieval you will be given another medication. About 34-36 hours prior to egg retrieval you will be prescribed a medication to bring your eggs to final maturity.
Your eggs will be harvested at the clinic. The procedure usually takes less than 30 minutes. You will be given IV sedation and your doctor will use a needle guided by ultrasound to gather your eggs from your ovaries. Your doctor will tell you the number of eggs that were retrieved after you’ve recovered from the sedation.
Recovery
Due to the use of sedation you will need to spend time in recovery post procedure. After you have recovered sufficiently you will be released into the care of your partner, family member, or friend. Because sedation is used you cannot go home on your own. You’ll also need to spend the rest of your day resting and recovering.
Expect to feel minimal discomfort, possibly akin to menstrual cramping, and some pressure in your lower abdomen due to your ovaries being enlarged. You will feel a little bloated so loose fitting clothing is advised.
Common side effects are mild cramping, breast tenderness, feeling of fullness, or bloating, and constipation. Contact the office immediately should you experience bloody or painful urination, a fever over 100.5°, vaginal bleeding, pelvic pain.
You will continue to recover for the next several days, however you can return to work, providing physical activity is kept to a minimum. You should also refrain from intercourse for the next two weeks.
Fertilization
At some point, usually during your egg retrieval, your partner’s sperm will be collected. The sperm will then be used to fertilize the eggs which have been retrieved. Over the next few days the embryologist will observe your fertilized eggs for development into embryos.
Once the embryos reach a stage known as blastocyst, typically 5-7 days after fertilization, the embryo(s) will be transferred into the uterus or frozen for transfer in a subsequent month. You can decide to genetically test the embryos for chromosomal abnormalities using the technology called PGT (preimplantation genetic testing).
Pregnancy
Within 2 weeks (usually 9-11 days) of transferring your embryos you will be given a pregnancy test. This can be a very emotional time for couples, or individuals, awaiting good news. Try distracting yourself by spending time doing those things you enjoy. Practice meditation to alleviate stress, try gentle yoga, or get out in nature.
Once you test positive you will be scheduled for a blood test to assess your HCG levels. You will schedule an ultrasound at six weeks. You will continue taking your prescribed medications as your doctor determines.
If you find you aren’t pregnant at this time, you will discontinue any medications you’ve been taking and await your period. You, your partner, and your doctor can discuss next steps. The average number of IVF cycles to successfully conceive is three. You can choose to move forward now, or pause for a bit.