I'm new and am actually starting ICSI in Sydney in couple of weeks time.
Quite overwhelmed with it all at the moment, had our meeting with our nurse today to run through the cycle and the injections I'll be on. To be honest the main concern I have is the egg retrieval and am considering going under a general (had bad experience with my hy-co-sy ultrasound, was really faint and found really painful after). How have you guys found it?
A fellow newby here (in fact, this is my 1st post, although I've been lurking for a few weeks). I'm just starting my first ICSI cycle, after never using any fertility treatment before, so I'm in a similar boat to you. Anyway, I just did my first ever Puregon shot this morning. I'm happy to report that it wasn't bad at all. I'm not great with needles and I couldn't even feel the shot as it was sitting in my belly. Now it's been an hour, and I feel a slight twingeing at the injection site (not painful at all), and that's about it. So hopefully that will take away a little of the trepidation for you. I start Orgalutran the day after tomorrow (slightly bigger needle), so I'll re-post and let you know if I found the Orgalutran just as easy.
My biggest fear is that I just found out 2 days ago that I have low AMH (6.9), so now I'm concerned about whether I'll even respond to the shots at all. Before I got the results, my doctor had told me to start off with 225 units of Puregon, but, in light of the results, he bumped me up to 275. (I should mention that I turned 38 2 months ago and have never been pregnant. Before getting this result I had thought that the reason we hadn't been getting pregnant was DH's poor morphology (1-3%).) I was pretty relaxed until I got my AMH result back, but now I'm feeling pretty stressed. I won't get to talk to the doctor about it until I go in for my scan next Wednesday. Oh well . . .
Now I'm also wondering if I might have mistakenly given myself a larger dose of the shot than I was supposed to, but that's for another thread.
Good luck to you and to everyone else who's cycling this month!
I have just begun my first IVF cycle too. I started my injections on Thursday. I don't know about everyone else but I am over analysing my body to try and pick up any changes from the drugs! So far I have had a bit of abdominal cramping and feeling of nausea right after the injection and in the morning.
My biggest fear is the egg collection - I think I have read too much about how it can be painful. Some other members may be able to shed some light on this or give some advise!
As we live in the country trying to juggle work schedules and egg collection schedules makes life a bit more difficult but we are looking forward to our first try.
This is my first time using a forum. It would be great to hear how others are going and how they are feeling.
hi babydownunder,
it is all very overwhelming and extremly strange when u do your first cycle! i have done 1 cancelled cycle and 1 stimulated (icsi) cycle. unfortunatly my embryo transfer was unsuccessful and we had 0 frozen embryos so im about to start another stimulated cycle.
i was VERY concerned about egg pick up as well but i have to say i was pleasntly surprised with the whole procedure.
i know everyone is different though.
i considered a GA but my doctor uses sedation and has an anesthetist there who can "knock u out" if need be! i found i was sleepy during part of the pick up . my husband tells me i was awake for most and chatting however i dont have a memory of the event ( thanks to midazolam a drug they use). i was a little sore after the fact but it has definatly taken the fear factor out of it for me an im much more relaxed going into this next cycle.
i hope this helps u
Like many of you, my biggest concern was EPU. My clinic routinely uses GA during EPU, and I've always been nervous of GA's (irrational fear of never waking up...). I asked about having EPU without a GA, but was told that they do all their EPU with it, so I went along with it. This cycle (I'm on day 4) I'm going to ask again if there is any chance at all of not having a GA for EPU. I wasn't happy with the outcome last time. It was a bit of an unusual situation though. I was in quite a bit of pain a couple of days after the procedure (more than I thought I should be) so called my nurse who assured me that it was normal, so I just dealt with the pain for the next week or so until it went away. Two and a half weeks after the procedure I discovered that I had stitches inside my vagina that I had not been made aware of. I freaked out! It was after hours on a friday night and I couldn't contact anyone until the next day. Even when I finally spoke to a nurse the next day, she had no idea why I might have stitches and had to ask a more senior nurse. It turns out that occasionally if there is some excess bleeding they will put in a stitch. They were disgusted that I was not told after the EPU, and even more amazed that I wasn't even given any after-care instructions. Turns out it was just a really bad situation that almost never happens. BUT, it makes me even more scared about going under a GA this time around. I'm also still skeptical about what happened because there was not just one, but three stitches! It's now been about 6-7 weeks and there is still one that hasn't dislodged and come out...
Hmm, gosh, I'm really not making you feel better about things am I? In regards to the pain of the EPU, I think I had a bit extra from the stitches, but even with all that considered, it wasn't excruciating pain. I'm not able to take pain killers and I was still able to move around ok, and even carry my baby who was 9-10 months old at the time. Just take it easy for a couple of days afterwards and you'll be fine The needles aren't exactly fun, but it's the mental part of things that's the worst. The actual needle really doesn't hurt (a mosquito bite ) but it's the mental aspect that makes it hard to stick that silly little needle into your own skin. When I did my first needle I sat there going "ok, one... two... three..." and then not moving the needle any closer to my skin, LOL! Took me about 5 countdowns to finally do it. I've heard some people say it's easier to push it in really fast, but I still do it moderately slowly because it seems less 'stabby', hehe.
Good luck with everything! I hope you can tell us some wonderful news soon!
Firstly I just want to wish you all the best luck on your cycles!!
It can be a very scary time BUT I promise the outcome is very well worth it
The EPU was my bigest fear as well so you are not alone My first cycle I had light sedation and really can't remember much of it. My second cycle had nothing and was wide awake for the procedure.
There is some discomfort after the EPU, but nothing like what I expected and really just took it easy for the following couple of days. Nothing like a cozzy bed, panadol and a few trashy mags...LOL!!
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
Sorry, I have not been on here for couple of weeks.
Quick update for you.
Had 10 days of Puregon (125) and 7 days of Orgalutran. Took the trigger the next day and went in for EPU yesterday. Was told there was only about 4 eggs they were aiming for based on ultrasounds however ended up getting 8 eggs which was great I thought (was under a general so didn't feel a thing and had no pain at all after). Received phonecall this morning to say out of the 8 eggs, only 6 were suitable and overnight only 2fertilised. I am trying to be positive yet at the same time don't want to get my hopes up.
It's a waiting game now until saturday morning, feeling very anxious.
How are you girls doing, would love to hear what's been happening in last two weeks. Hopefully we will have some good news to share over coming weeks
Hey there Babydownunder -
Just to let you know that after my EPU, of my 6 eggs, only 2 fertilized -- despite using ICSI -- so I was feeling pretty down, too. But the 2 that fertilized both became perfect embryos with no fragmentation. They transferred one 13 days ago and grew the second out to blast then froze it. I'll see in 3 days if the one they transferred has become a BFP. But my point is that great things can happen even with only 2 fertilized eggies. The way I see it, the other ones probably would not have turned into good embies even if they had fertilized, whereas the ones that did fertilize were clearly the best. I hope your 2 embies have been going well. Please jump back on and let us know how they did when you have a chance.
KitKat72 - It's great to see you have 2 Grade 1 embryos. I hope your blood test gives the BFP. good luck for Saturday.
babydownunder - I hope it's worked out for you, thinking of you
Lise - thanks for sending your positive words our way.
AFM - I will have last Gonal-F (follicle stimulating) injection maybe tomorrow or Wednesday and EPU on Thursday or Friday.
Have 3 really good follicles on the right and 2 more that may be big enough by EPU as well.
Timeforafamily - best of luck for your EPU this week!!
Puffsgirl - welcome and good luck. We have male factor issues, too, and luckily ICSI has held out promise for us (see above re: our 2 great embies thanks to ICSI). And yes, my DH doesn't like discussing this stuff too much, so this forum is a godsend.
Reply With Quote
Registered User
Just starting ICSI
Just starting too!
) but it's the mental aspect that makes it hard to stick that silly little needle into your own skin. When I did my first needle I sat there going "ok, one... two... three..." and then not moving the needle any closer to my skin, LOL! Took me about 5 countdowns to finally do it. I've heard some people say it's easier to push it in really fast, but I still do it moderately slowly because it seems less 'stabby', hehe.
My first cycle I had light sedation and really can't remember much of it. My second cycle had nothing and was wide awake for the procedure.
) 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.
good luck for Saturday.
Bookmarks