For information on
website advertising,
please contact the PCOSA's
IT Department:
it@pcosupport.org

IVF - A patient's perspective

Part One

In the first of a multi-part series, one woman shares her experience with IVF - in vitro fertilization.
Please note - names have been changed for the sake of privacy.

Well, this is it...

My husband (Jim) and I just completed another cycle of fertility treatments. No success, though. I've had a hard time trying to conceive - three pregnancies, three miscarriages, and now I don't seem able to get pregnant at all. I was unlucky enough to have an ectopic pregnancy the last time, and it damaged my right fallopian tube so badly that it's completely shut now. After the surgery to remove the ectopic pregnancy, my doctor discovered that I might also have problems with my left tube due to scar tissue. So, we went into surgery again. She was right. Scar tissue everywhere. It took them an extra hour to deal with all the excess tissue.

I had the corrective surgery a couple months ago. She told us we had about a 50% chance that the scar tissue would come back. It looks like it did. We had a picture perfect cycle this time, but I still didn't get pregnant...

Why IVF?

Jim and I decided to try IVF for a number of reasons. I was tired of trying and getting no where, after being pregnant three times before. We both want to have a child that is a part of us, and this is the last option we have, now that it looks like my fallopian tubes are completely blocked. My doctor thinks I have an excellent chance, since I have a good history of conceiving. She also says that my eggs should be good, and I should respond well to the medication required, since I've shown a good response to the previous treatments we've tried. My age is also not a negative factor - I'm 29, so I'm still "young enough." We're also fortunate in that Jim doesn't have a fertility problem.

We talked it over quite a bit, and decided that IVF is our last, best chance of having a child of our own. Although our insurance won't cover it, we are lucky enough that, with help from family, we can afford it. We have also set a limit - we will only try three cycles, unless we do conceive or something unusual comes up. We just can't see spending huge amounts of money when the chances of increasing our success aren't that great.

The Consultation

Before we could start, we had a meeting with the nurse at our doctor's office, to talk about the scheduling, the medication involved, and how to administer the medication. I thought I knew how it would work, but my knowledge was just the beginning! She talked us through the whole process, explaining how the retrieval would work, and some of what to expect. It was really great to get a better feel for how it all will work, and how long it will take (You can click here for a calendar which estimates how long the cycle will take, and what medications I'll be on for each phase).

She told us about the different medications I'll be taking and showed Jim how to administer them (Click here for a list of ALL the medications, and how they're administered. It's quite a list!). Nearly all of them are given via injection, which is hard to do to yourself, so he had to learn how to give me two different types of shots - subcutaneous (like insulin shots - just in the skin, also known as sub q) and intermuscular (where you have to shoot the medication into a muscle). He's a quick study, and he actually knew how to give me intermuscular shots already, because I had taken B vitamin shots in the past.

The most disappointing fact we learned during the consultation was how long we would have to wait before we could even start. Our doctor likes to start the medication on day 21 of your cycle, and I was just about to start a new cycle! Because of my history of irregular cycles (as with so many women with PCOS), we opted to put me on birth control pills. This will also help to start the suppression process.

What is suppression?

The suppression phase of IVF is really important, because this gets your body ready for the rest of the drugs they will use to develop the eggs for retrieval. To prepare you for IVF, they suppress your natural hormone production by using a drug called leuprolide acetate - typically known by its brand name, Lupron. By suppressing your hormones, they effectively put you into chemical menopause. This prevents you from developing any follicles, or releasing follicles prematurely, or overstimulating once they start adding the drugs to encourage follicular growth. I've been told that I may have hot flashes, mood swings, and other side effects.

Money, money, money!

Well, we've started my birth control pills, and it's nearly time to start my shots (nearly all the medication you use for IVF is via injection!). We ordered our medication all at once, and BOY, what a shock! The injections are expensive! We also have to prepay for all of the other fees for the retrieval and transfer, because our insurance won't cover it. So far, the total is somewhere around $12,000. I don't even know for sure, because I just couldn't take the stress of reading the bills. Thank goodness Jim can handle it! He's been great. I told him I felt like the money pit, because we've spent so much money already with the surgeries and fertility treatments and this is just REALLY expensive. He told me to relax, that none of this is my fault, and that we'd both decided this is what we want to do.

Starting the process

I begin shots in just a few days. I'm really nervous. I hope I don't have a hard time with side effects. I had some hot flashes on higher doses of the other fertility drugs we tried, but nothing horrible. The suppression phase only lasts a week, and I'm supposed to get my period sometime during that part of my medication. At the end of a week of suppression, I'll go in for an ultrasound and blood work. Both are to be sure that I don't have any ovarian cysts or developing follicles that could cause problems once we start the induction phase. If I were to have any kind of cysts, it could cause the delay or cancellation of my cycle.

Wish me luck!

Diane G.

In Part Two -

More about suppression, and preparing for induction, as well as the induction procedures.