IVF questions

[Alwaysasking]

DP and I will have to undergo IVF as he has a zero sperm count. We are waiting to be see by a specialist but in the meantime can anyone please tell me exactly what I have to 'do' in the IVF process. Not medically, but do I have to be operated on? What is the process for the woman?

At the risk of sounding very ignorant I'm not sure what's involved (I know about the sperm being injected into the egg with ICSI and the medical side). I have a ds from a previous relationship so they aren't testing me for any fertility problems. I know DP is having surgical sperm retrieval, but after that, as the woman, what happens?

Sorry I know this sounds jumbled, I'm sure you can all appreciate the confusion and jumbled state of mind I am in. Also, I am aware IVF won't be funded as I have a DC, does that mean the sperm retrieval procedure will need to be funded by us?

[Cornwall73]

Hi, sorry to hear your diagnosis but good news that you have been referred to a specialist to help. As for the ins and outs of IVF the Human Embryology and Fertilisation Authority is a good place to start and it has a page describing the progress here.

Have a good read of it all, google or ask on here if you don't understand the terms and prepare questions for your meeting with the specialist. It is a very medical process so don't be scared to ask.

You don't actually have an operation to collect your eggs or put the embryos back it is done under general anaesthetic with a very fine needle through your cervix. If the issue is just the sperm it may be that the doctor suggests sperm retrieval as you describe and then IUI (basically artificial insemination) may be an option.

As for the funding it depends on where you are and what your PCT will fund. The fact that you already have a child may affect any funding, you will to contact them to find out what their policy is.

Good luck!

[PicaK]

I wasn't quite sure what you mean when you say you know what happens medically but not as a woman.

But then i thought - you know you're right it's very different to conceiving normally.

There's all the preparation and the faff of taking the drugs (and the side effects and the risk you don't respond even tho nothing is wrong with you). The whole process is like being at the bottom of a set of lock gates and you get let into one and then wait and if you're lucky you get through to the next.

When the egg goes back in you have to cope with knowing you could be pregnant and waiting 14 days to find out. The dreaded two week wait (or 2ww). My husband and i found that we snapped at each other like we have never done in our whole relationship in the last few days. We ended up spending them apart which sounds dreadful but saved a lot of aggro.

You will also feel pregnant cos you have to stuff pessaries up your fanjo or your bum for that time and they will give you the symptoms. This is ivf at its most cruel.

Then you pee on a stick. If it's positive you are declared to be 4 weeks pregnant and they usually scan you at 7 weeks. There is no element of lovely surprise or gentle awareness. You have people to ring and inform within hours either way. Though my GP wouldn't fill in pregnancy forms until after that scan.

If everything is ok at 7 weeks they turf you over to the usual midwives - who will then ask for the date of your last period and give you a wrong due date. This is hugely irritating.

You come into pregnancy with baggage. If you have a great clinic they should have counselling available. Take it - it will keep you sane whtever outcome you have.

Good luck on your journey. It's not an easy path to tread but with humour, patience and love you get through it. Keep talking to your DH.

[PicaK]

Plus i disagree - it is an operation. You are out for the count, there is a danger of piercing your intestines and ending up in intensive care. A very very small chance obviously and a risk we all accept.

All the medical research states you don't need time off to recuperate - my petsonal experience is that i wanted to rest up from egg collection to egg put back so i did.

You cannot be too kind on yourself at this time.

[Alwaysasking]

Thank you, these are exactly the answers I was hoping for and what I meant by the woman side lol, like the 'story' of it, the stuff they don't tell you on the websites! I'm very worried about the drugs and side effects, my sister's friend is having IVF for Polycystic ovaries and got something to do with hyper stiulation? And was very poorly. Worried about long term side effects of drugs also. But mainly wanted a kind of step by step on what you do, do you inject drugs or take them orally? How long for? Then what? How long does IVF itself take?

A million questions and I'm so impatient I feel I can't wait until this sodding referral, it's been a year since diagnosis but due to dps 'highly unusual' anatomy we have been up and down the country seeing doctors to establish what is going on.

Having massive problems contacting our PCT also, I was assuming IVF would have to be funded privately but TESE would be funded but I don't know if that's considered part of the IVF? It is so unfair and I feel so guilty that dp could miss the chance of being a father as I have a dc, we are saving up as much as we can but I honestly can't see how we'd afford more than 1 cycle, and that's assuming the TESE is funded.

[highlove]

Hi there, sorry to hear its all taking do long. One of the (many) terrible things about not being able to concieve is that you are constantly bloody waiting for something - first it's ovulation and period, then it's appointments, then tests... And then IVF.

I'm sorry to say that in my experience it's unlikely you will get funding for TESE. I hope I'm wrong but generally most PCTs have a policy of 'treating you as a couple' and that means that it won't matter that your DP hasn't got children. It's really very unfair.

Assuming you are youngish and have decent ovarian reserve you will probably be put on 'long protocol' IVF. Around day 21 of your cycle you will start down-regulation drugs to basically shut your own system down. That may be in the form of a nasal spray or may be an injection. You will read lots of horror stories about down-regging and some people really have a rough time with it - it's like a sudden and dramatic menopause! Personally I didn't find it too bad - was very tired and a few hot flushes but not too horrid. About two weeks later (by which time you'll have had a period) you'll go for a scan and bloods to check you're down regulated. Assuming you are (if not you'll carry on down-regging for a bit longer) you'll start the next phase - stimulation, to get your eggs developing. This will almost definitely be an injection. After about a week you'll go for a scan and maybe bloods to see how your follicles are doing and see whether your drugs need altering. You'll probably then go back every other day for more scans until you're ready for egg retrieval. It's usually about 10-14 days after you start stimulating. Once you get the go ahead for egg collection, you'll take a final carefully timed injection called the trigger shot to get your eggs to mature. 36 hours later it's collection. I had a sedative and local anaesthetic, plus gas and air. It is pretty uncomfortable at times, but it's short sharp pain rather than anything else. I was sore for a few days after, especially going for a wee - don't know why.

You'll know straight away how many eggs you got. Then you get to go home and a bit later they do the ICSI bit. You'll get a call the next day to tell you how many have fertilised. If you've got a good number - usually four or more - they might encourage you to allow them to develop for five days to become blastocysts before putting them back. If you've not got so many they'll put them back 2-3 days after collection. Egg transfer is not too bad, I didn't think. A bit like a smear with bells and whistles. You relax for a bit afterwards then go home. As others have said, you then get to shove horrible progesterone pessaries up one of your orifices for a fortnight and this mimics all kinds of pregnancy symptoms so totally plays with your head. Without a doubtc the two week wait was the hardest part for me - I was ok-ish the first week but lost the plot completely in the second. It's tough and you will be obsessed. Then about 16-ish days after egg collection you pee on a stick.

I hope that helps a bit. As others have said, definitely explore counselling at your clinic - this is such a hard process. I didn't until after my (failed) cycle and wish I had. I'm seeing her now and it's really helping. I think I might have avoided my total meltdown had I seen her sooner.

Good luck.

[Alwaysasking]

highlove thank you. It sounds horrendous, much worse than I'd imagined. I'm a bit speechless to be honest, I thought it would take a week or so, day or 2 f drugs, transfer, done. Lol god I'm so bloody ignorant!

I have just started to think about IVF abroad, does anyone know how this would work? Do you stay in the country for the whole of this process or take drugs at home? Also if sperm was frozen in UK would it be transferred abroad?

Hope you are doing ok highlove, sounds like you've had a horrible time and I'm glad you are now having counselling.

[highlove]

Oh sorry didn't want to scare you. It's not THAT bad and it after all the waiting it's good to be getting somewhere. But as poster above says, it's like a whole series of locked gates and each time you get through one you feel great for a few minutes and then you're faced with the next one.

Sorry don't know about doing it abroad. But one option you could explore if you're under 35 is egg sharing - basically someone else pays the lion's share of your IVF fee and in exchange you give them the half the eggs at collection. Not for everyone but worth considering.

[PicaK]

I justread your other post and you do get a good discount if you share your eggs. Because you are young you'll probably produce a lot which is a small silver lining in a big cloud.

You've also said you've gone up and down the country so i'll also say that Birmingham Women's Hospital are fab. You get private treatnent but at nhs rates - so a lot less than proper private clinics. Plus the nursing team there are fab and sensitive, the drs are skilled, the embryologist team first rate and the counselling outstanding. And i've had 5 ivfs there (not worked, worked - my DS, not worked, worked - early miscarriage, worked - early miscarriage.Closure) You want a clinic that'll really support you if things fail.

I hate to tell you this but you are young and time is on your side and the drive to have a second child may become overwhelming. You might find it helpful to look at the websites on secondary infertility.

Also look at how much your infertility drops as you get older. Sooner the better.

[JRsandCoffee]

Hi, I can't add much to the other posters who give a very good picture of the process. Didn't see it but sorry if there already, drink lots of water/ squash throughout the whole process as that really helps with symptoms particularly during down regging. I spent the whole time swigging from my sports bottle and then continued throughout pregnancy.
It really wasn't as bad as I expected, I took it a day at a time, did the drugs in the morning and tried not to think about it too much, any rubbish feelings I put down as means to an end. I also did acupuncture, no idea if the pins helped but the acupuncturist did sterling work as an unofficial councillor! "I'll just leave you to relax" he'd say "you will bloody not, I have cementing to do and questions to ask! " I'd reply..... Poor man!

Good luck! Wishing you a happy Christmas and every success. Xx

[EuroShagmore]

You've had some really good advice on this thread. I will just add that if you are concerned about the drugs, a few clinics do something called natural IVF, which is IVF with no or very few drugs (perhaps just the trigger shot to time egg collection and the progesterone pessaries after embryo transfer). I'm about to try this in January after having a severe reaction to the downregging drugs when I tried conventional IVF this year. I'm not sure if it is suitable in your circs though, as there will only be one egg (the one you produce naturally) so they would probably need to freeze the sperm as I doubt it is feasible for your partner to have the retrieval done several times. The success rates are lower than for conventional IVF as you only get one go per cycle, so it can be a longer and more expensive process, but it's something to think about if the drugs concern you.

[KnittingChristmas]

Alwaysasking, you've been given lots of advice and info on here so nothing much I can add, except to say that, while I thought it was going to be truly horrendous the actual procedures weren't as bad as I thought. I found the worst part was the so-called 2ww between embryo transfer and pg test when you weren't actually doing anything.

It is very stressful though - and the reason why I get so angry when people on here who have no experience of infertility pontificate about it as if it's just "nip down the docs and get knocked up" .

Good luck - keep talking to your dh and also look at some of the IF websites around. I found the support of others going through IVF at the same time absolutely invaluable.