Hammitt Family Adventures : Cycle date 1

***warning I am going to talk some more about my vagina***

On Tuesday Jason and I met with the doctor at Iscare for our appointment prior to the start of my period and the start the stimulation injections. After rushing to get there after my yoga class, we ended up waiting for a hour to see the doctor (not very different from the US). I wasn't expecting another vaginal ultrasound but it made sense once I thought about it. He wanted gain information for the future cycles and needed to see my endometrial lining to make sure that it was normal and that it was adequate for embryo implantation. This time there was a room for me remove my bottoms and a cloth to drape around myself. Jason and Jarslov were still still sitting at the desk when I came out (which happens to be at the foot of the examination table) and while the doctor got up to perform the vaginal ultrasound, Jason continued to sit in the chair. I told him that he might want to move to a different view point - just for now - he'll have plenty of time once I am pregnant and giving birth to see my vagina in all its glory. Jarslov was pleased with my endometrial lining and showed me the corpus luteum on the ultrasound. After he was done, I went and changed and then we discussed the stimulation plan... oh boy!

So the plan is to start the injections on Day 2 of my cycle. Jarslov said that I should start my period on the 18th or the 19th (he knew this by looking at my lining and knowing approximately when I ovulated). His stimulation plan for me is 6 ampules of Menopur once a day on days 2-4 and then 5 ampules on days 5-7. In addition, I have another injection of Orgalutran on days 6-7. He said the nurse would explain how to administer the injections and the dosing -- (that was an interesting conversation because her English was a little lacking and my Czech is nonexistent. But after 10 minutes of struggling to understand, another nurse came over and explained it and her English was great while my Czech is still nonexistent...) Then the doctor discussed what he thought the best plan was for the rest of the cycle. As a side note, Jason and I have been educating ourselves on various success rates for different protocols as well as trusting the original plan of the doctor we saw at the Colorado Center for Reproductive Management (CCRM). That plan was to "bank" the embryos for 3 cycles and then test them all after 3 cycles to find the best embryo(s) to implant. This plan was crafted by CCRM to help save their patients money (One full cycle with all medications runs around 30K but 3 cycles of banking and one implantation is discounted to 50K). The other factor is that frozen embryo transfers (FETs) show a higher success rate. Jarslov explained that this is skewed by the fact that only the best ones are frozen and then only those that survive the unfreezing process are transferred. He is suggesting a fresh transfer for this first cycle. He doesn't think I will have many follicles to collect - from there it is like a pyramid - fewer will start dividing, and fewer will divide normally. Depending on how many I have to start with that doesn't leave very many viable embryos to freeze and not all survive freezing and thawing.

So here is how it will all go down. Stimulation meds as outlined above on days 2-7. Day 7 or 8 -ultrasound to see how the follicles are developing and the doctor will determine if any additional medications are needed at that point. The egg retrieval will occur somewhere between days 10-12. At that point, I will start taking progesterone. Jason will donate his swimmers on that day and the eggs will be fertilized. From there the lab will watch them divide (24hrs/day for 3-5 days). They will decide after 3 days of embryo growth if they want to let the continue to grow to day 5. The embryo transfer will occur either after they have grown for 3 days or 5 days which will be somewhere around day 13-17 of my cycle. I will continue on progesterone and then from there I am not sure when we will test to see if I am pregnant but I am sure I will find out more after the embryo transfer.

Today is day one of my cycle so that means that tomorrow I start the injections. Oh boy! I wasn't given much guidance on the do's and don't regarding my IVF cycle. I assume part of that is because the US is so hyper-sensitive to possible complications so they give you all the warnings - don't run, don't drink coffee, don't drink any alcohol, don't stress, don't stress about stressing and so on. When I asked the doctor his answer was - there are no special restrictions (of course please avoid higher amounts of alcohol and very heavy exercise). It is advised not to change your lifestyle significantly during the stimulation period. So there you have it. That is what we know so far. Tomorrow I might be a hormonal crazy person... we were planing to go to Vienna for the weekend but we have decided to postpone the trip until we know how I react to the injections. The plan for tomorrow is to give myself the injection and then go to the Vietnamese market. If you know me you know I LOVE Asian food so this makes me very happy!

Here are a few random pictures from around Prague for your viewing pleasure!

Mmm...bread.