Nicole, I've been meaning to ask you about your second EPU since I first sound out that you didn't have sedation or anything... Just wondering what they gave you so that you couldn't feel the procedure? I'm guessing you have something so you couldn't feel the needle? I'd like to know what to discuss with my FS to see if I can do the EPU without a GA.
Mylitta - I'd imagine EPU under light sedation would require local anaesthetic. Fancy them forgetting to tell you about the stitches. I really don't know what to say about that. I'm a nurse, and that is major. Major, major, major. I'm not quite sure what you mean about the last stitch hasn't dislodged yet. Do you mean disolved? Sorry, not up with all the gynae. Yes, and as for the needles, I watch patients give themselves insulin injections, and I find that most of them do it nice and slowely, so I did it that way and it was pretty OK.
Nicole - that sounds great that you didn't need anything. I wonder why they encouraged me to have a GA on my first cycle. It wasn't even really suggested that light sedation was an option. I will ask tomorrow about that option.
Dreaming - I'm in the same boat as you. The cycle in November only produced one embryo. So this time they will have me on Gonal-F 225 units injections instead of 150 units and hope for more follicles this time. Only had 5 last time.
Southaus74 - , I hope everything is working out right as you would be close to egg pick up now. Hope the trips into town aren't too much trouble, it would add extra cost as well.
Kitkat72 - as well. this is probably my 3rd or 4th post. The forums have been very informative. Could you tell me what low AMH is? I hope the cycle is turning out for you.
Babydownunder - I hope your first cycle goes well.
As for me - I've had one cycle in November and now on a second cycle, going for first scan tomorrow to check whether uterus lining is ready for Gonal F injections. On my first cycle my concern came 2 to 3 days after embryo transfer when I thought I had a UTI. I ended up going to the emergency department at 1am, just in case I needed antibiotics, after all that effort, I didn't want a failed transfer because of a UTI. It turns out that it was just my body still healing from EPU and the pain happened when I voided and the bladder deflated. It got me really worried. I realise they must do a bit of poking around to aspirate each follicle. Anyway, within a few days it wasn't an issue.
Mylitta, I think they only used some type of local in the area where they draw up the eggies.
I think that was the worst of the pain I felt, the rest was like really bad period pain.
I'll be honest it did hurt and I just talked to DH and just watched the clock but being awake for the 20min it took for the procedure I can live with that as when I had the light sedation when I woke up the nausea feeling was something I didn't want to re visit....oh yeah and going home and sleeping for 8 hours too!!
It was also really exciting counting eggs with the nurses
Oh yeah they did put a cannula in just in case and there was a anaesthesiologist there and I had to pay for him but never needed it.
Some FS will not do the EPU unless you have at least sedation, but all you can do is ask.
timeforafamily, how scary for you going to hospital!! I guess don't take any chances hey.
Best of luck on your second cycle....fingers crossed for a second time lucky
Timeforafamily, AMH is the Anti-Mullerian Hormone. My doc tests AMH (it's a pretty new test, only around for the last couple of years, apparently) instead of FSH to measure ovarian reserve. Essentially, all of the eggs that are still sitting in your ovaries emit AMH, so by testing AMH, they can tell how many eggs you have left. (Higher AMH level = more eggs.) One benefit of the AMH test is that it can be done at any time of the month, not just on days 2-3. In addition, it supposedly does not fluctuate the way that FSH levels can, so it's supposed to be more accurate. Furthermore, AMH levels can start declining before your FSH starts to rise, so some clinics say that finding out you have sub-optimal AMH levels acts as an early warning system that your fertility is waning and that you should get started on pursuing more aggressive treatments if you want to have a child.
That is all the theory. In practice, since it is such a new test, it seems that there is some disagreement over what the measurement actually means, as far as what the cutoffs are, what is normal, and how likely you are to respond to fertility treatment. Apparently people with normal fertility will have an AMH level between 14 and 44. Higher than that apparently indicates PCOS. According to my FS, lower than 14 indicates lower than normal fertility (I think this means that you have a diminished ovarian reserve). But I've read somewhere (on the website of that Indian doctor, Dr. Malpani, I think) that 7-14 can be considered "low normal", and on the Repromed website (they processed my test), I found a chart showing that for women my age, my score is right on the borderline between normal and low for women my age, even though it is still, objectively, a low score. So some doctors might interpret the result more strictly or more optimistically than others. The other thing is that if your ovarian reserve is low, you would apparently have a higher likelihood of being a poor responder to stimulation meds. But that is not always the case. So while the test is a useful tool, it's not perfect.
In my case, since I've been on my first cycle but am 38 -- not a spring chicken! -- my doc was going to start me on a low-ish but not super low Puregon dose of 225. When my AMH results came back a few days before I was to start injecting, he decided to increase my dose to 275. That's higher, but still does not seem to be as high as some of the poor responders require. I just got back from my EPU a few hours ago, and am happy to say that mid-range dose fetched me 6 eggs. So my poor AMH level did not destroy my chance of having a successful IVF cycle. Now we just need to see how the eggies fertilize. Go eggies go!
Hi all,
NIcole - thanks for your wishes, yes all legs, fingers and toes crossed.
KitKat72 -
I hope your 6 eggies are getting on well.
thanks so much for all the info on AMH. I hadn't been told about that, and I'm 39 y/o. I see some of their methods as a bit hit and miss. I was surprised they didn't adjust the Gonal F (follicle stimulating hormone) after they found a low number of follicles. Increasing it may have given me a few more eggs and maybe an embryo to freeze. they had me on Gonal F 150 units on my first cycle, tonight I start on Gonal F 225 units. I suppose each place or FS have there choices in what to test for. Gosh, maybe they did test me, I'll ask them next Tuesday. I know when we started on this, they didn't even check my fertility, they just went ahead and said well the sperm is behaving badly, you need ICSI. Naughty spermies.
As for me - I feel a lot more relaxed going into this IVF down reg ICSI cycle. A lot less nervous. It has really helped reading the forums. my attitude last time was this must work or else I will be devastated. (yes and I was devastated ) Now I've learnt from all the girls that you take what you can from it, and what can you do with what's out of your control anyway. I think having 3 weeks holiday also helps.
Yesterday I asked the nurse about light sedation instead of having a GA this time round. She said that last time I didn't actually have a GA at all. It was sedation. No tube down the throat. Sedation good enough that I didn't even wake up while they do all their prodding around. Anyway, I need to take each step at a time. Follicles, EPU and fertilisation comes first.
as for Synarel, yesterday started to get some headaces after 2 weeks on it, so hopefully starting the Gonal F tonight might help balance that out. Maybe the headaches might go away.
Babydownunder and all the other ladies worried about EPU - i've had two, both with GA and had no problems whatsoever. I also required stitches after my first EPU as they nicked a blood vessel (my FS told me that's so incredibly rare and they if they tried to do that they wouldn't be able to!!), but I honestly felt fine, although there was some slight bleeding for about 12 hours afterwards. I had a several days off after EPU and just made sure I rested well and didn't over exert myself. My clinic does 2 day transfers, so I was back at the clinic only a couple of days after EPU for that, and although the advice is continue on with 'normal life' after a transfer, I also took a few days off after that just to be sure.
So for me it wasn't a scary, painful experience at all. I'd advise you to talk to your FS if you're worried, but you really don't need to be.
All the best girls xx
ps - i'm now 32 weeks pg so these stories do often have happy endings
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) Now I've learnt from all the girls that you take what you can from it, and what can you do with what's out of your control anyway. I think having 3 weeks holiday also helps.
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