Just starting ICSI

Hi girls

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?

Thanks

Hi and welcome to BellyBelly!
You can join the girls currently cycling in LT TTC & Assisted Conception chatter thread for advice and support.
All the best~~

Hi Babydownunder,

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!

KitKat72

Hi Babydownunder,

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.

Good luck

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 :hug: 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!!

Best of luck ladies :goodluck:

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. :)

Hi all,


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 :dance:

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!

KitKat72

Hi all,
NIcole - thanks for your wishes, yes all legs, fingers and toes crossed.

KitKat72 -
I hope your 6 eggies are getting on well. :fertilise: :fertilise: :fertilise: :fertilise: :fertilise: :fertilise:
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 :cry:) 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. :leap:
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 :)

Hi girls

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

xxx

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.

Good luck!
Kitkat72

KitKat72 - It's great to see you have 2 Grade 1 embryos. I hope your blood test gives the BFP. :crossfingers: 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.

Hi,

I am a newbie here, but have been following the threads for a couple of weeks.

My DH and I don't start ICSI until late July and I have to say i am very nervous.

DH and I found out we had severe MFI nearly a year ago and our hold world has been IVF! :redface:

DH doesn't like to talk about it too much so it is great to have others to talk to.

Goodluck to everyone on their journey.

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.

AFM, 2 days till my BT!!

Best of luck for your BT tomorrow KitKat...have everthing crossed for you :crossfingers: :goodluck:

Thanks, Nicole!! I'm dying here!

Hi girls,

Just checking in with everyone. I had my EPU last wednesday. 8 eggs retrieved, only 6 were suitable for ICSI.
Only 2 ended up fertilising normally. On saturday I received call to say that both embies were doing well, one with 8 cells and the other with 11 cells. They were graded good and fair. Was booked in for transfer on Monday.
When we got to clinic on monday, we were told that both embies were downgraded to poor as they had only reached early blast stage. They advised us to transfer both embies as neither would survive being frozen. Blood test is tomorrow week. My doc was very honest and said that she wasn't that confident & that she had to manage our
expectations. To be honest I am more prepared for a BFN, I think it's because we have been trying for nearly
18 months and you get used to being disappointed. At the same time, I am trying to be positive. DH is cute, he
keeps talking to the little embies and telling them to hang in there!

How is everyone else going?

Kitkat, hope today went well for you

xxx

Hi Ladies,

I've been following this thread as my husband and I also had our eggs fertilised with ICSI.

KitKat72- you probably have your results now and I really hope they're positive.
Babydownunder- Are you in the TWW now? How's it going?
Puffsgirl11- Welcome. I was rapt when i found these forums. They've been a helpful and reassuring in so many ways. Good luck!

Maggie

Hi Maggie,

Thanks for the encouraging words. You've probably seen it by now in one of the other threads, but yes, I got my BFP! I can't believe it! I realize we were very very lucky to get this result on our first go, and now I'm just praying nothing goes wrong. I really hope that your FET gives you your BFP this cycle.

Hugs,
Kitkat72

PS. I know this is totally anecdotal and therefore probably not of much real value to anyone, but in case anybody is wondering what exactly I did to try to support implantation/pregnancy, these are the things I did (in addition to taking Crinone after EPU up till today (still waiting to hear if I can stop it)):

1. Acupuncture once a week, starting the first week of this cycle, plus the "usual" sessions before and after ET.
2. Pre-natal vitamins (switching back and forth between Elevit and Blackmores Pre-Conception Gold), and a supplemental tablet of 75 mgs of Co-enzyme Q10 twice a day
3. I had 1-2 tablespoons of ground flaxseed in my yogurt every morning for the first 2 weeks after EPU since I read that there's some evidence that the phytoestrogens supplied by ground flaxseeds support the hormone levels conducive to implantation. I've stopped now since I've heard that, conversely, the phytoestrogens are NOT necessarily good in pregnancy -- they apparently can promote miscarriages. But I'm going to ask my FS when I see him in 2 weeks what he thinks. (NB: I had read the studies re: ground flaxseeds promoting higher pregnancy rates (in farm animals, at least - lol) online and did not ask my FS what he thought before taking them -- naughty, I know.)
4. Drinking tons of water.
5. Just generally taking it easy. I've really ramped down my usual exercise routine to just the occasional walk. Lots of sitting around reading books and BB! It helps that I work in academia and wasn't teaching this semester, so I was able to do most of my work from home = very relaxing.

Honestly, I don't know if any of the above made any difference or if it was all up to getting a strong embie. But who knows? Maybe some of this stuff helped tip the balance. Anyway, if any of you were looking to see what other people have done, then I hope this helps!!!

Thanks for the advice KitKat72.
I too am taking it easier than usual (walks around the river instead of the gym) and have been taking the pregnancy suplements.
Haven't done any acupuncture but have been hearing lots about it so I think it's worth considering next time round.
Huge 'Congratulations' to you!:hooray:

Hi Ladies,
I just saw this thread and it reminded me of a similar thread that I was in a year ago.
We went through 2 ICSI cycles - the first one we ended up with 3 embyos and one made it to blastocyst but resulted in a BFN. Second cycle we had 2 embryos and had ET on day 2 as they didn't think they would make it to day 5. Result =BFN.

However, my remaining embryo made it to Day 6, so the next month we did an FET and it resulted in a BFP!

The funny thing is, I did everything right for the first 2 cycles after googling tips etc.. But after my FET I just carried on as normal. I had actually given up hope and wasn't even going to bother doing it, but luckily I listened to my FS.

The TWW is really hard, but the 40 WW is the hardest!

Good luck everyone. You never know what will happen when you least expect it.

Ps. Sorry for crashing the thread!

Hi Nat82,

I think you've just confirmed what I believe deep down- that if it's going to happen it will. I can't help taking little precautions (they tend to give me some small feeling of control in a situation I have very little to no control over) but ultimately I think it's up to the embryo.
Congratulations on your little girl!

Maggie

Nat82, that's a really good point. I certainly agree that at the end of the day the most important factors (ie, is it a strong, sticky embie?) are really out of your control. My view was simply that, like Maggie, I wanted to feel like I was doing something in a process where so much is, indeed, out of your hands. I can totally see why you would get jaded, however, after doing several cycles. I have no doubt that if I had a couple of BFNs from my first few cycles, I probably would have responded exactly like you -- saying I'm not going to make that much effort anymore. In fact, that's how I felt when I was TTC naturally. In the beginning I would try to be good during the TWW (although not at all to the same extent as when doing IVF), but after the first few times that didn't work, I pretty much said, "Screw this. I'm not going to keep living like a monk when it's clearly useless." For years, I drank what I want, didn't bother with preg supplements, etc., because I had decided that there was no point since I had no hope of getting pregnant anyway. Of course, when I finally started IVF I learned that there really HAD been no point to being the good girl acting like I was pregnant all the time (like they say you should do when TTC) since w/DH's 1% morphology there really was no hope of conceiving without ICSI. So I can't say I regret being blase. I personally finally felt motivated to be "good" and make an effort to change my behavior again only when we started IVF since I finally felt like we actually had a chance. God only knows whether that improved mental state made some difference. Obviously your history shows that it's meaningless in some cases. I think the bottom line is that all you can do is what you feel mentally strong and motivated enough to do. For what it's worth, my FS and clinic, while supportive of complementary therapies, etc., gave me the impression that they didn't really care if you did anything special during the TWW other than avoiding getting overheated and making sure that you drank extra water. That tells me that they don't think the sorts of things that I listed above make much difference. Otherwise, they would be more insistent that you do them.

Congrats on finally getting a baby in your arms, Nat82. And Maggie, I really hope that, whatever factors end up being the cause, this FET sticks for you. (((Hugs)))

PS. Maggie, I totally was an acupuncture skeptic before I went, but I could *feel* stuff happening when I went for my first treatment, and you feel so totally relaxed by the time each session is over, so I definitely recommend it. For what it's worth, when my SIL tried it when she was TTC, she got totally antsy lying there for 1/2 an hour and decided not to go back, so it's certainly not for everyone. But I'd definitely give it a try if you have the time!

Hi all,
KitKat72 - congrats
Puffgirl11 - welcome, July seems a long time, but it will come around soon enough, just concentrate on looking after you
babydownunder - fingers crossed for you, I don't know what helps during the TWW. maybe distractions, but in the end they seem all so superficial... remember we are allowed to have our negative moments too
Nat82 - I so relate to you just having a break from it all, being so thoughtful about food choices, exerecise and everything

Hi all, just jumping in as newbie here... My partner had zero sperm I mean not one little swimmer, but after we asked for a biopsy we now have 9 straws frozen of nice swimmers.. Anyone who has male factor please look deeper into it as we suprised the doctors as well as ourselves... Hormone levels in the blood is an early indicator to proceed onto a little op to get those good spermies out... I am waiting to start injections on the 26th May and am on DHEA as well as accupuncture and elevit multi vitamins. I donated eggs many years ago and they all died before they attempted an icsi rescue... So am very worried this time around may not work for me due to frozen sperm,, plus my age and egg quality....
thanks for reading,,, only have 39 more posts before i can chat live with someone in a similiar boat as myself... :dance:

Hi Tracey,
You can also chat with others in similar situations in our LT TTC & Assisted Conception thread.
All the best~~

Tracey2010,

Welcome! Your story gives me a litlle bit of hope. They only found 4 sperm in DH sa so when they do a biopsy i am hoping they find alot more!

Good luck with your journey!