I have just started my first round of IVF after three failed IUIs. I am on Synarel nasal spray, and will move on to Gonal F injections next week, then egg pick up & transfer in a few weeks time.
I'm feeling a bit nervous about putting the needle together for the Gonal-F injections. Is it difficult to do? And what sort of side-effects should I expect? Has anyone not had any side effects at all?
How many days would you recommend taking off work for the egg pick up? And did you take any time off after the transfer?
Also, how many embryos did you have transferred?
Sorry about the 20 questions - and thanks in advance!
Any advice about what I'm in for would be appreciated!
Weclome, Miss Scarlet - I hope you find this site as informative and supportive as I have.
Now... the injections, while the pen type thingy looks difficult to use it is actually fairly easy. I don't recall getting many side effects, but I was on puregon instead of gonal F. The listed side effects for both are headache, indigestion, weight gain, dizziness, stomach cramps, diarrhoea, breast tenderness and bloating. You may not actually get any of those, though.
When it comes to taking time off for EPU - you'd probably be best to follow the advice of your clinic. Normally it is suggested that you should be able to return to work the following day. I'm a bit of a worst-case scenario and was off work for three weeks with pretty bad OHSS - something you want to avoid at all costs!For transfer - generally just that day, I probably would have been able to return to work the same day as transfer (mine was a FET cycle, there was no transfer with my full cycle because I was too sick), but I wanted the time to rest and relax rather than racing around stressing about everything else. I also took the day of my final blood test off work so that I could be alone to deal with the result, whatever it was.
I only had one embryo transferred, because we had blastocyst embryos, are relatively young and it was our first cycle, we weren't given the option to have any more than one. Some clinics work differently, though.
Good luck with everything, and feel free to join us in the LT-TTC and AC buddy thread.
Hi Miss Scarlett
BW's covered it all...but for me I've always taken a week off to recover from EPU and I know some girls who take the whole 3 weeks for EPU, TWW and Preg test...I think you go with what you need...my clinic has always written Doc certificates for me for whatever I've needed...they want you to be in the best place possible so they'll look after you!
Your first cycle is so consuming because it's all new and you don't know what to expect but you do get through it and you learn and your FS learns what your body responds too etc...I really hope this is your one and only cycle...best of luck xxx
The needle was certainly the scariest part of the process for me. I use puregon, but I would say the pen would be pretty much the same. At my clinic, the first needle is done at the clinic where they walk you through the process. They also had a DVD you could take home to watch before you commence the injections. I do recall that first time taking several deep breaths and fighting the urge to close my eyes as I put the needle in.
As far as side effects go, I was told to drink lots of water or rehydrating sports drinks as dehydration can cause the headaches etc. As the follicles develop you may feel quite full. As my clinic says – you may feel like you are carrying around a bunch of grapes.
My first cycle I only had the pickup day off work (as I was on a course the next day). The second I had two days off. This cycle I’m increasing the dose of puregon, and as I felt tender after last pickup I have told work that I may take three days. It really depends on what you feel like and I guess what your work involves.
The first cycle I was only allowed to transfer one. This cycle was considered a trial cycle to see how I responded to it all. From there I could increase to two if we elected to. In our second cycle we were going to go with one again, but the remaining embryos were fragmented so would not have survived the freezing/thawing, so we elected for two to be transferred. This was decided at the transfer appointment, so was a bit ‘spur of the moment’ but DH and I had already discussed the one versus two option.
I have been physically able to return to work after transfer but tend to take the day off and take time for myself to do as I please and relax. As BW says, I also take the day, or part of, off for the final blood test. There’s just too much racing in my head to even consider being at work and you can deal with whatever the outcome when and how you want.
the gals have covered most things, and as they say it is up to how you feel as to how much time you may need off for EPU and ET. i think being relaxed and as comfortable as possible is important. my DH and I have always gone out for a cosy lunch and maybe movie or DVD at home after ET as we think it is a pretty special moment.
i have used Gonal F in the past and it was actually easier to use than Puregon as it comes preloaded and setting the dose level was pretty easy too. i recommend getting an empty pen to practice setting the level and getting a feel for how it operates as you are injecting yourself. i think Sarah H has a good description in her TTC journal about how the action of the pen is strange at first.
i described the injections to a friend, who was about to embark on IVF , as being less painful than plucking my eye brows, and she said knowing that took a lot of fear out of it for her.
re the number of embryos to transfer, i started a discussion on this a couple of weeks ago and there may be some useful info in there for you To transfer 1 or 2 embies tomorrow??? Sarah H also had a similar thread which she linked from this one. Hope that helps!
best of luck with your cycle and lots of vibes....
dusty
Last edited by dusty; August 18th, 2007 at 09:49 PM.
: added info
Thanks everyone - that's all really helpful!! Since I made my post, I actually discovered a 'how to' video on You Tube for the Gonal-F injections (the wonders of modern technology!) I am also yet to have my first appointment with the clinic (it's tomorrow), so they may well give me more info then.
At this stage, we are going with transferring two embryos. I am quite young (27), but the doctor actually suggested it and we were both happy to go along with that.
As for work, I have told them I will need three days for "surgery".... so I might just play it by ear.
I just had my first egg collection last Wednesday. I needed Aaron home on the Thursday to help me look after Zander because I was very sore, but I went to work on Friday & Saturday as per normal. I'm still a bit sore now, but nothing to stop me from doing normal things.
Thought I'd say hello I don't post often but your story sounded v similar to mine! I have just started IVF after 3 failed IUI's, I think we are pretty much at the same stage with the IVF & I to am v nervous! I was supposed to start the Synarel nasal spray on Tues but my clinic had run out & the expected delivery had been delayed so I had no choice but to take the alternative - Lupron, which is an injectable!
I take it you didn't do the Pregnyl trigger shots with your IUI then? We had to do 4 a month so have got used to injecting at home, DH does mine, I have to put something over my head so I can't see him doing it otherwise I keep trying to grab his hand!!!! The Lupron is a syringe type, same as the triggers so we haven't had to many problems with it. I think the stims will be fairly easy for us given we are having to do daily injections at the moment, an extra 1 a day won't hurt! (Well it will hurt but you know what I mean).
I am on day 4 of the Lupron & so far just some mild headaches & bloating, hope it stays that way.
My clinic want us to take a week off around the eggie time, they also told DH that I have to be treated like a princess, no cooking, cleaning or work for 5 days. Sounds good to me, I think by the time I get to that stage I will deserve some "me" time!!!
The girls have covered just about everything to a T. When i have had egg pick up and have always had 5days off work, everyone is different on how they feel after egg pick up , i was sore for days, and the bloated heavy feeling has always lasted weeks. Some girls just breeze thru it but not me, the day of EPU or should i say a few hours after i am very very sore, hot water bottle or hot pack is recommended after egg pick up with panadol only. You might be on of the lucky ones who don't suffer to bad, i never had alot of eggs so that does not seem to make a difference, my clinic does not use general anes but some clinics do, they just use a local on me which helps but still feel it, i wish you luck with the first cycle, at first it is a little confusing etc but lets just you only have to do it once.
I am also on my 1st cycle. Am on the synarel at the moment. Havent noticed any side effects yet. Have a few twinges, but think that is cause my AF is due soon. Should start on the Gonal F next week. So looks like we'll be going through the same thing! And my EPU In sept.
Havent decided how much time to take off. But have found all the comments above useful!
Be good to hear how your jouney progresses in the LT TTC thread.
Mon
CAH - I did have the pregnyl trigger injection with 2 of my IUIs, but they were done for me at the clinic, so it'll be the first time I have to try the injection thing at home myself.
And a quick update from me...
I'm still on the synarel, but due to start injections on Monday. I've been to see the clinic nurse since my first post, so am feeling a lot more confident that I'll know what I'm doing with the needle!
I've had no ill effects from the synarel that I'm aware of so far. In fact, sometimes when I can't taste it going down the back of my throat, I worry I've not taken it correctly!! I'm such a worry wart.
Anyhow, fingers crossed that egg pick up will be in about a week and a half. I'm taking Wed, Thurs, Fri off work at this stage (if eggies grow according to plan), so that will give me five days in total before I need to head back to work.
I'm not sure yet whether I'll need to use progesterone afterwards, but from what the nurse told me it's sure not the most glamorous thing in the world!! I read in the materials I got that some women have to use either the crinone cream or the pessaries until the end of week 11 of pregnancy!! The things we have to do to have a baby, huh??
I'm the same re. the synarel. I even did a squirt the other day, before I put it up my nose just to make sure.. Probably wasted a precious squirt. Sometimes it take a few mins before I even feel it down the back of my throat.
I wonder if it matters if you dont take the spray exactly on the time you should take it. I am so hopeless I never seem to be able to take it on the dot. ie I do at 8am and 8pm. and usually end up being up to mins late at times. Does anyone know? Will have to ask nurse.
Yesterday was feeling abit depressed, and reading my sheet depression is a side effect, but also think its cause AF is due.
I start my injections on Wed, so we are pretty close together.
Don't stress about the timing of the synarel spray - I was told that it doesn't need to be precise. I have one spray when I get up in the morning and one spray when I get home from work. It just needs to be at opposite ends of the day.
Sounds like your clinic is being v supportive I am sure you will do just fine with the needles, its not so bad once you've done a couple.
My clinic said to let them know if Iam more then 2 hours late taking the meds so I think a bit of time either side is ok. Hope so cause I have been 30 mins late & 30 mins early once this week!
I use another forum & the girls on there have described the progesterone pessaries as the "bubble bum" phase - really looking forward to that
Good to hear you will be starting the needles soon Miss S, sounds like everything going ok so far.
Hmmm, maybe I should be a bit more strict with the 12 hour intervals for Synarel. They didn't make that much of a big deal about it though, and just said that if you miss a spray, do it whenever you remember.
I had my first gonal-f injection today, and it was much easier than expected - not painful at all. I haven't felt any ill effects so far, so I'm wondering if it's even working!!
Has anyone else been on 112.5 and ended up with penty of eggs? It seems kind of low, but I think it's because of my PCOS. I didn't ovulate on clomid until 100mg, so I'm worried that this dose of gonal-f won't work for my first time round and they'll have to increase the dose. Hopefully I'm worrying about nothing.
Scarlett, I started on 150IU of puregon, and didn't respond. I was then increased to 300IU and ended up over responding with pretty bad OHSS and no transfer on our pick up cycle.
Having been there - starting low and increasing gradually is certainly safer when PCOS is involved. Trust that your FS knows what they are doing... but certainly scream like mad if they suggest such an enormous leap as was used with me.
I'm convinced that stimming longer and slower is much better than running the risk of hyperstimulating... been there, done that... pray that I never have to get anywhere near it again!
DW had 100IU of Puregon (same as Gonal-F) throughout the stim cycle and produced 26 eggs. It depends a lot on your size and of course your own individual characteristics, but as BW said, it's much better to do it slow and steady than end up with 5 million eggs and a hospital stay due to OHSS.
Good on re your first needle. DW was dreading them but if she can now be totally relaxed about needles then anyone can in my opinion. Out of all the needles she had only a couple "hurt", and by hurt I don't mean agony, just discomfort.
Starting first round of IVF
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vibes....
you only have to do it once. 
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