Everybody who goes through IVF, IUI or an embryo transfer cycle will have a protocol designed specifically for them. While there are a lot of similarities with these well-established medical interventions to create the miracle we dream of, there are a lot of differences too. This is what my frozen embryo transfer cycle looks like for me…
For most of my cycles we have done a “controlled” cycle. This means that my cycle leading up to the embryo transfer is controlled by hormone injections (estrogen and progesterone). In the past I was able to try a natural cycle, which relied on my body’s own ability to manage my menstrual cycle and thickening of the uterine lining where there was minimal medication use. That worked one time, then the next try, my ovaries weren’t cooperating and we had to start over. In my controlled cycle, I start with a baseline ultrasound on day 2 or 3 of menstruation to check that the uterine lining is thinning and that there are no cysts developing on my ovaries. From there I start on Delestrogen intramuscular injections twice a week for a little less than two weeks. This also involves blood draws to check my estrogen levels and any necessary dosage adjustments. Another ultrasound is performed to check that the lining is thickening appropriately and to check that my ovaries are “quiet” and no cysts are developing. Then the progesterone injections start. My husband has become a pro at giving me injections. We went through IVF twice and have now made it through eight embryo transfers, plus a couple cancelled cycles. So, he’s really got this down.
Here’s the cool thing about the controlled cycle. The progesterone injections (which are daily) are required for 5 days and on the 6th day, the embryo transfer occurs. This gives me and the doctor flexibility in scheduling the transfer because we can start the progesterone on the right day based on our schedules (well, mostly his schedule). Since we want to make sure we get to have “our” doctor for the transfer, we can make sure to set up the injection schedule accordingly as well as avoid weekends or holidays.
Here’s the tough part about the controlled cycle. Once the progesterone injections start, there are daily intramuscular injections into my hip/glute area. After doing SO MANY of these cycles, it’s getting pretty painful and there’s a build up of scar tissue and/or “oil” (ethyl oleate) from the medication settling into my muscles. Delestrogen and progesterone are oil based medications. After two very painful injections leading up to our transfer on Friday, we did learn some new tips from the nurse for intramuscular injections:
- Use a cold pack on the area of injection for 10 minutes prior to injection
- Immediately following injection, massage the injection site
- Use warm compress on area of injection for 10 minutes after injection
- Do glute and hamstring stretches to help the ethyl oleate part of the medication move through the muscles. This is what tends to build up. Even though the progesterone will get absorbed, the oil base of the medication can build up (yuck).
- Make sure you understand the full surface area available for the injections. My husband had been using a smaller surface area which left us little real estate for repeated injections. After another session with a nurse, we discovered there was a bigger area we could use that was still safe.
The embryo transfer occurs on Day 6 after starting progesterone injections. The procedure itself is a simple one and just a bit uncomfortable. This has to be done on a full bladder to help visually guide the small catheter on the ultrasound through the cervix and into the uterus. The ultrasound wand is pressed on the lower abdomen…yep, right over bladder territory so that’s the biggest challenge. After a couple of rounds of verifying our information and number of embryos to be transferred, we are then ready to go. It’s very exciting to watch the catheter on the ultrasound make it’s way into the uterus where you can see it as a very faint white line with slight movement. Then the embryo is released and it is slightly visibly as a white flash or very small blob on the ultrasound screen. After the embryologist checks the catheter to confirm it’s empty, we are then free from medical intervention and now it’s up to luck, a healthy embryo and lots of baby dust and embryo sticky vibes to implant and make this miracle happen.
The embryologist brings us a photo of our little embryo and we get to feel hopeful and terrified for 10 days.
We get some time alone with our little embaby photo and think positive thoughts. Since my husband is a huge Star Wars fan, there were a lot of good vibes with references to Jedi’s and the force awakening in my uterus. Maybe it will work.
Our HCG blood test will be on November 15. We’ve been let down so many times. Please, please, please, let this be the one.