So we had our IVF appointment today and it looks like we are cleared to move forward with IVF! The plan is for me to wait till CD21 this cycle and then take provera for 10 days to induce my period (since I most likely won’t ovulate this cycle or get my period at an appropriate time since I am not taking Femara). Once I get my period I will call the clinic and start taking the pre-IVF birth control and K and I will both take an antibiotic. Once I have been on the birth control for ~2 weeks I will go in to make sure I don’t have any cysts. I will continue on the birth control for a total of 19-30 days so that my cycle syncs up with several other women who will be doing IVF with me. Then I will stop the birth control and begin stimulating with Follistim and Menpur. I don’t remember the exact protocol the doctor wants to use, but I will be getting a copy of it at my next appointment. After reviewing my previous ultrasounds (antral follicle count over 30) and history of irregular periods he feels that I do have PCOS, so given my PCOS and age (24) he feels I am high risk of OHSS. He is going to try to prevent OHSS by using a certain protocol the clinic has been using on PCOS patients with good results. It involves using a GH antagonist after any follicle is greater than 12 mm and then using a GH agonist to trigger when the follicles are >18 mm instead of beta-hcg. After retrieval we will do ICSI due to K’s poor count/motility/morphology and I will start Progesterone injections. The plan is to do a 3 day transfer of 2 embryos if we have 6 or less fertilized eggs, and do a day 5 transfer of 1 blastocyst if we have 7 or more fertilized eggs.
So the general schedule looks like:
Start Provera: Feb 16
Periodand begin pre-IVF birth control: ~Feb 28
Begin Stimulating: ~March 31
Retrieval: ~ April 13
I really liked the Dr. even though I will be working with several of the Dr.s in the clinic depending on who is on call. We were in the clinic for over 4 hours and they were very thorough. We were able to meet with a financial advisor and we qualify for the warranty, which means we can pay a lump sum which will cover IVF and as many FETs as it takes to get pregnant and carry that pregnancy into the 2nd trimester or we get our money back. I am hopeful we will get pregnant, I just don’t know how many rounds of IVF or FETs we will need so it’s nice being able to just pay this once. (If we don't get pregnant and have no frozen embryos to transfer we get our money back and can choose to reapply for the warranty and do IVF again). For those interested the lump sum is $16,000 of which $14,500 is refundable for someone my age. The $16,000 covers everything but meds and our initial consultations/tests, which we already had done.
The Dr. said our chances of success are:
74% if we have 1 great quality 5 day blastocyst to transfer
60% if we have 2 fair-poor quality 5 day blastocysts to transfer
56% if we transfer 2 3-day embryos
I am ready to get started. I know there are a lot of “ifs” still left to play out: A lot of ifs about timing, the protocol working correctly, getting a good number of eggs, fertilizing a good number of eggs, have the eggs develop and grow healthily, and not developing OHSS (if I do develop it they will freeze everything and have me do a FET). I really hope that everything works out and that everything goes smoothly (although I’m sure it won’t since nothing seems smooth to a woman who really wants to get pregnant and is hopped up on a lot of hormones and drugs). Honestly, I won’t care as long as I can get my baby in the end!