IVF after 5 day embryo transfer timeline

this is what happens in a 5 day transfer :

-1day pt ..embryo is growing and developing
0 day pt... Embryo is now a blastocyst - (embryo transfer day)
1day pt....Blastocyst hatches out of shell on this day
2day pt.. Blastocyst attaches to a site on the uterine lining
3day pt.. Implantation begins,as the blastocyst begins to bury in the lining
4day pt.. Implantation process continues and morula buries deeper in the lining
5day pt.. Morula is completely inmplanted in the lining and has placenta cells &
fetal cells
6day pt...Placenta cells begin to secret HCG in the blood
7day pt...More HCG is produced as fetus develops
8day pt...More HCG is produced as fetus develops
9day pt...HCG levels are now high enough to be immediately detected on
HPT

amazing

Today, August 21, 2011, I had 2 (grade A) embryos transferred into me. It was painless (unlike the IUI where there was intense cramping during and days after the process). Also, the doctor told me that I had 5 grade A eggs, 5 grade B and the rest grade C. We got rid of the grade C embryos and kept 3 grade A and the B's for cryopreservation. I can home to rest and was unusually tired. I have to still continue my pills and suppository and go back to the clinic for bloodwork on Tuesday.

Egg retreival

On August 16, 2011- I had my eggs retrieved at the doctor's clinic. Since I was going under anaesthesia, I couldn't eat or drink past midnight the day before. The appointment was 6:30. I had to change into a gown, cap and foot covers. The anasethesia worked fast and I was under (best sleep ever). I couldn't feel a thing. The next thing I knew I was awake and the nice nurse brought my husband in to sit beside me. I was groggy, but that's to be expected.


The doctor came in and told me that he retrieved 27 eggs. He and I was impressed.  I attribute that amount of eggs to my diet and lifestyle. I didn't need that much gonal F and menopur. The thing that worked for me was: 

• going to acupuncture for one year
• last 3 months I was on a mostly vegetarian diet
• was doing yoga a couple times a week. Also, the last 4 days before the egg retrieval
• I was only eating hot soups, warm foods, and no dairy. 
• The chinese believe not to ingest cold foods and salads while going through IVF 

I was in pain, nauseated and could only eat liquids the day after. The next day I could only eat limited solids. It was time to take it slow.
 
I called two days later and they told me that I have 17 embryos that formed. Now I have to wait a couple more day to see the quality of the embryos. In the meantime, there's alot of medications I have to take - dostinex, doxyxcline, medrol, and prometrium (oral & suppository).  


I want to keep my body clean for the insemination of the embryos, so no caffeine or cold stuff. Just warm soups, lots of fruit and greens and no dairy either. I'll try to eat an egg a day too.

Freedom Pharmacy

When Freedom Pharmacy confirms you prescription that is given by your doctor's office. Always make sure everything is on the list by looking at the prescription list that the nurse/doctor gives you during a meeting. Yesterday, one prescription wasn't on the list and I had to call my doctor's office back to ask them to fax/email the script to Freedom Pharmacy. Sometimes things like this happen but it best to be aware.

IVF schedule

IVF Financials:
My GHI (City of New York) covers 80% of the cost. I'm allowed 3 IVFs. This is my first. My out of pocket cost is about $2000. The medication cost of Lupron, Gonal-F and Menopur will probably be around $200-400. The birth control pills cost $5. Now, I have dual coverage from my husband's healthcare. I'm also allowed 3 IVFs under his healthcare, covered by 80% of the cost. So all together I can do 6 IVFs, which is alot. But to lessen our out-of-pocket cost, we can give up an IVF cycle of my husband's coverage to cover the $2000 we will have to pay.

We also elected to freeze our embryos which is not covered but worth it. If I freeze my embryos (if I have any good viable ones to freeze), I don't not have to go through all these shots again. I just have to defrost the embryos and have them inseminated. It's also good, if I'm thinking about having additional children, later on down the road. Oh, GHI allows 3 IVFs and 3 frozen embryo transfers. To freeze my embryos, it will cost around $1200 and $600 for every year afterwards.

Here's is my IVF schedule, which spans 2 months:

Preparation Cycle for IVF

This is a preparation month to prepare my body. During this month, I will take birth control pills to regulate my period. Then around the 3rd week of my period, I take Lupron. It suppresses the pituitary and significantly reduces estrogen levels to prevent ovulation. It prevents the eggs from releasing because when they go retrieve the eggs, they want the eggs to be there. I will take the Lupron for a month. Then stop the birth control around day 22. In about 3-4 days my period should come again.

This is the crazy month now!

crazy month

This month is like an IUI cycle. After my 2nd period starts, I have to schedule for a baseline blood withdraw and sonogram. I will keep on going for blood withdraw and sonogram for 2-3 weeks, every other day. On my 2nd day of your cycle, along with the lupron stomach shot in the morning, I have to give myself a shot of a mixture of Gonal F & Menopur at night. Around the 3rd week, it will be time for my egg retrieval. I have to give myself a trigger shot and 36 hours later, I will be taking anesthesia and will be under. My husband will also need to give the sperm on the same day and will have to drive me home.

During 5 days, they will combine egg and sperm. Then watch the embryo grow. They will pick the best graded embryos to be inseminated, which will be the end of 5 days. After insemination, I will be given progesterone suppository to help with implanation. Suppository is great as oppose to the 6 inch needles, they previously used. I think I have to  give myself the suppository for awhile. I will probably be hormonal and my body will feel some pains and cramping during this month. But  it's to be expected. I am hopeful!

IUIs ins & outs

So here's what I needed to do so far in getting pregnant.

Last 2 years - IUIs

GHI (City of New York) required me to go through 3 IUIs before starting IVF. To start the IUI cycle, I needed my period to begin. Once my period begins (I got a progesterone shot to stimulate my period because my cycle is so irregular), between the 1st - 4th day, I needed to go in to the fertility clinic and have blood withdrawn (you'll get use to this) and a baseline sonogram of my ovaries. I picked a clinic close to my workplace because every 7am, before work for 2 weeks, I have blood withdrawn and did a sonogram of my ovaries.

To multiply my eggs, I have to take Bravelle. Around  the 5th day, I was told to give myself (my husband actually administered the shot) a shot in the stomach for about 2 weeks. During this time, every other day for two weeks, I got blood withdrawn and was sonogrammed in the mornings before work. My clinic was good. I got everything done in 15 minutes and off to work I go. Emotionally & mentally, I was drained. Sometimes I cried because of the stress but I think it was due to the extra hormones I was given. Some woman don't have to take medication for IUIs. Depends what the doctor prescribes.

The Bravelle shots, even with insurance covering most of it, cost me $198. When I went in to withdraw blood and sonogram, the co-pay was $30 ($15 each procedure).

After about 2-3 weeks, they told me to give myself a "trigger shot" and that releases the egg.  The trigger shot in the stomach isn't painful at all. The needle is finer. In 36 hours, they inseminated me with my husband's sperm. Oh, on the day of insemination, my husband was driving with me holding his sperm in a sterile cup (clinic provided the cup) under my arm an hour before insemination. They had to wash his sperm before inserting it in me.

I'm on the table and the insemination feels like a pap smear. I rested for the rest of the day. On all tries, an hour afterwards, I had intense cramps for 7-8 hours afterwards. On the 3rd IUI, the trigger shot gave me flu like symptoms and I had a fever but still went through with the insemination.

I was pregnant on my first IUI, but the embryo didn't have a heart so I had a miscarriage. The other two IUIs were unsuccessful.  All this time, I was seeing an acupuncture for fertility once a week. Between IUI treatments, I also managed to get pregnant naturally (probably due to acupuncture) but all of them ended in miscarriage.
So now onto IVF...

Journey into my 4 circles

Yoga Circle: 

Wow, I finally finished the basic 200 hour yoga instructor course at Three Sisters Yoga http://www.threesistersyoga.com/200hr.htm. It's been tough. I work full time as a NYCDOE teacher, IUI  and acupuncture treatments and living in another borough and traveling to class was tough. But staying with it and making it through, feels like a huge accomplishment. 

 One day I was teaching my 4th grade students some yoga moves. The next day they asked for another yoga session. Then again the following day. I finally realized that I need to be certified because I want yoga to be fun & safe for them. That is why I became a yoga instructor. I did my research and found Three Sisters Yoga to be the cheapest yoga teacher trainer program in NYC. But when I joined, I found their philosophy admirable. Jen Whinnen, one of the founders of Three Sisters Yoga, said that Yoga should be accessible to everybody at every social level. This is great. Also the people that joined this program at really grounded and believe in karma yoga - giving back to the community. This was a wonderful group I joined. Positiveness radiated at every session we meet. 

I thought I couldn't make it through the program because of the long hours, professional life, and mental exhaustion. But I did. Woohoo!

This is the a video of my instructor speaking about how her small business is a success.

http://www.thestreet.com/video​/index.html?bcpid=673439667001​&bckey=AQ%7E%7E%2CAAAAAEBQhPI%​7E%2C35stD

Professional Circle 
I am a NYCDOE Special Education Teacher. I am Dual Certified with a Special and General Ed License. Now that I passed the Gifted Test, I will be taking my last course in Gifted Education, and be certified by the end of the summer. What will I be doing with my Gifted License? I don't really know. Why did I become a teacher? Because I was accepted into the Teaching Fellows Program. Did I feel a passion for teaching when I was younger? NO. What about now? I still don't feel the passion for teaching but I have met some wonderful people and kids along this journey. Does the salary allow me to live a lifestyle that I like? Yes. I don't think I will leave teaching for yoga. Yoga will be a part-time gig for me. Great health benefits like the one NYCDOE gives us is hard to come by. 

Fertility Circle 
My husband and I were trying to have a baby for 3 years. Going through 3 IUIs and 3 miscarriages, you would think I would give up. Nope. Why do I want a baby so badly if I had to go through these crazy things? Take bravelle shots in my stomach every night for two weeks for 3 IUIs? Had one bad D&C where I felt like I was stabbed with a dull needle in my uterus because the doctor only believe in local anesthesia. Going through a whole year of acupuncture needles and drinking bad tasting herbs. I believe that my husband and I will get a baby that we can shower with love. If my body still has viable eggs, I will not stop, because giving up, is not an option in my book. 

Support Circle

Everyone has a support system. My support system is truly my husband. I always have an idea or project on the horizon. I talk it over with my husband, well actually tell him that I'm going to do it. But I have to convince him why my project or idea is a logical move. He's a very logical guy.  If he agrees, which he usually does, he commits 150%. We coordinate our schedules. He makes dinner, run errands, does laundry for us, etc. My projects usually affects both of us and he is very supportive when he commits. I think I'm very lucky to have him...very lucky!

My friends also have been so helpful in listening. They don't pound advice on me that my parents (both sides) and sister does. I hate that. My friends just listen and joke which makes the mood less stressful. Friends are the best!