1st IVF/ICSI in Jan 2013: What do we need to know?

[Anonymous]

Hi everyone -- my husband and I are planning to start IVF/ICSI in January 2013, likely with Dr. Sacks and Dr. Sherins at Columbia Fertility. My husband has got very bad (1 to 2%) morphology and I have checked out as normal. This will be our first ART procedure; we were told that IUI would be pointless with my husband's numbers.

To the ladies and gentlemen out there who have been through this process: What should we know? What do you wish you had known before you started the process? What questions should we be sure to ask the doctors? How might we prepare ourselves, mentally and physically?

Also, I'm wondering if anyone has an opinion about fresh vs. frozen transfers. The WSJ had a story this week about higher success rates with frozen, so I'm wondering about the anecdotal evidence here.

Thanks for any info -- I know many of you have been through this process. We're optimistic, but still feeling pretty fragile, so any encouragement/support/success stories are also very much appreciated.

[Anonymous]

Just be realistic about your chances of success. We also did IVF with Dr. Sacks at Columbia Fertility, using donor eggs. We did 3 separate FET's, transferring 2 embryos each time. It worked the third time, and I now have twins. So hang in there, and don't give up easily. Oh, and I asked Dr. Sacks about the fresh/frozen transfer success rate, and he said it's about the same.

[Anonymous]

I can't speak to Columbia Fertility specifically but the high success rates etc with FET is because only the highest quality get to the stage where they are frozen and those are also the ones that survive the thaw.

I advise is to be aware you have about 6-8 weeks where you can't going anywhere and need to be around for monitoring and appointments. Also, get your meds a week or two before you actually need them.

[Anonymous]

Went through my first IVF transfer in July (now 15 weeks pregnant), and did ICSI.

Honestly listen to the guidance of your doctor and really use the help of your nurses for quetsions throughout.

We made it to a 5 day transfer and transferred 1.
The day of retrieval I felt so wiped out and slept for about 6 hrs afterwards b/c of the drugs. And day of transfer I was totally fine with no after effects and went home and honestly did a lot of normal activity within 24hrs, and full activity within 48hrs.

I also did ICSI. We split our batch 1/2 ICSI 1/2 natural fertilization and only ICSI made it to day 3 and beyond. We started with 11 embryo's with 3 now frozen.

I'm 32 DH 34 and we had female issues (tubal scarring) but the day of sperm looked terrible and we were highly advised to use ICSI even though it wasn't on the original plan.

[Anonymous]

This is so helpful -- thanks all for the insight.

I'm wondering about what kind of relaxation techniques you used during the process: massage, acupuncture (not sure how relaxing that is), meditation, exercise? We are both totally wound up and are going to need some serious chilling-out.

[Anonymous]

my husband and I were in the same situation - I was totally normal and he had low volume and mobility. We did IVF/ICSI and although I wasn't prepared for the intense schedule (as PP poster said about being available for lots of appointments), it was manageable. I have a strong fear of needles and I handled it better than I thought. As the PP also said, definitely get your meds early, I ran into some hangups with insurance and ended up going to Grubbs pharmacy near the Capitol at the last minute so I didn't screw up the schedule. We did one embryo transfer and have a beautiful little girl (1 yo now) because of it.

The best advice I have for relaxation techniques is to simply do what you normally do, unless it's really intense. I maintained exercise and did everything normal (just lower intensity_. Trying to create a new routine will be more stressful than you think.

Good luck.

[Anonymous]

Anonymous wrote:This is so helpful -- thanks all for the insight.

I'm wondering about what kind of relaxation techniques you used during the process: massage, acupuncture (not sure how relaxing that is), meditation, exercise? We are both totally wound up and are going to need some serious chilling-out.

For my successful IVF cycle, I did a massage between ER and ET. I also didn't exercise after ET until the pregnancy test. The good advice the doctor gave was not to do anything during the cycle that would make you wonder about whether you messed anything up. Up until then, I kept myself relatively sane with regular exercise and a list of fun things to do that I checked off (I will finish this book before I obsess, I will participate in this activity before I obsess, etc.).

I also got myself a big treat just for finishing the cycle before I found out whether it was successful. I since heard of folks having a "if this doesn't work" treat and plan so that at least there is an immediate silver lining. I plan to do this next cycle.

[Anonymous]

Anonymous wrote:This is so helpful -- thanks all for the insight.

I'm wondering about what kind of relaxation techniques you used during the process: massage, acupuncture (not sure how relaxing that is), meditation, exercise? We are both totally wound up and are going to need some serious chilling-out.

I did acupuncture. I know there are mixed feelings on whether it's actually helpful or not, but I at least felt like I was actively doing something else to help my chances, since so much of this is really out of our control. Also, just from a logistics point of view, I typically schedule my acu for lunch, so considering that many days during your IVF will include very early morning monitoring appointments, it was nice to have this "down time." I often fall asleep during acu (I use Dr. Gao of Comprehensive Health Clinic and really like her).

Also, plan some nice things for you and your husband: a sushi dinner just before embryo transfer, cracking open that nice bottle of wine you've been saving, etc. Something to make it nice and memorable. And yes, plan something equally nice for a "back up" plan in case the cycle isn't successful. After my first unsuccessful cycle, I immediately took myself to a spa for an afternoon.

[Anonymous]

I was a patient at Dr Rifka at Columbia Fertility, pregnant on first IVF and 27 weeks now.
1) At your "orientation" with the nurse, be sure to take a LOT of notes. I was surprised they don't write it all down for you and she seemed surprised that I asked for pen and paper. this is critical info on when/how to give shots. Ask every question you can its disturbing how much info is NOT volunteered to you.
2) Keep your schedule as flexible as possible, especially at the end of stims. The # of days you stim can change no matter than they predict. It really goes day to day. This may also inlcude ordering last minute from the pharmacy (I was told at 3pm on day 11 to keep going and thank god Grubbs can get meds delivered by 7pm dame day). Use Grubbs pharmacy for same day delivery for this purpose.
3) try acupuncture. I was going weekly for months. But I do think it helped mature some of my follicles around day 6 that didn't seem to be going anywhere.
4) I also did one hypnosis session for relaxtion ( I think I had a groupon) about 2 weeks before starting. Not sure if it made the difference but I did feel super relaxed.
5) I made a huge mistake of attending a fertility support group about a month before IVF. this was DEVESTATING and depressing. I needed to hear only success stories. I felt terrible for the women but two hours of crying, failed IVFs, multiple miscarriages,.still birth at 38 weeks, sent me into a depression spiral...thus the hypnosis.
6) You tube is great for learning how to give a shot, especially the ones in the butt. My husband drew and X on me and hit the target every time.
7) Ice the hell out that butt shot before you take, its a big needle but I swear I never felt it 70% of the time.
8) take time off for retrieval AND transfer. Again, keep your schedule as open as possible. You have no idea if it will be a three or five day transfer.
9) Keep every bill from CFA, they are notorious for fucking up billing. I just got a $500 bill last week for stuff I swear we already paid 6 months ago.
10) When I got the giant box of meds, we spent one evening putting each days needles, quanity, Q caps, swabs in individual zip lock bags. Yeah it wastes bags but its easier than doing that evey single day. having everything all separated meant we could just grab that days bag and know everything we needed for AM and PM was ready to go.
11) have your vitamin D checked. Studies show low D can affect implantation. Mine was shockingly low and I went on supplement. No idea if that made a difference but it can't hurt.
Good luck to you!!!

[Anonymous]

13:38 here again.
One more thing, Lupron can make your period very delayed. Again, something no one mentioned at orientation. I am 28 days 99% of the time so I assumed I woudl start lupron on day 21 and then stims on day 28. Period never came until day 35 and I was getting concerned until nurse mentioned that Lupron often causes a delay. So that kind of mentally through me off when thinking about the entire schedule of IVF.
And lastly, I did develop mild OHSS but not until AFTER I was done with stims. I actually felt pretty good on meds and then I got pregnant and the flood of pregnancy hormones kept my ovaries very swollen with pain. But its all worth it for a baby!

[Anonymous]

Be as loose as a goose in terms of flexibility and scheduling. And then be even more flexible. You may think you'll have transfer on week x, and then that'll get put off for one reason or another, and then it'll get delayed again for another reason, etc. Just let it all roll off your back and be totally zen. One thing that helps me (I'm religious) is that God is working thru me and whatever happens, He's orchestrating it; all I have to do is sit back and relax. It sounds corny, but it really does help. If you are not religious, do whatever it takes to accept that you are not in control of the situation, but, really, just pretty much along for the ride! Follow all the directions and do what you're supposed to do, but then just let go....

[Anonymous]

Anonymous wrote:This is so helpful -- thanks all for the insight.

I'm wondering about what kind of relaxation techniques you used during the process: massage, acupuncture (not sure how relaxing that is), meditation, exercise? We are both totally wound up and are going to need some serious chilling-out.

FWIW, I was stressed out and anxious during my IVF cycle and still got pregnant. There is a study that showed that stress/anxiety level had no impact on success (very comforting to me as I had trouble getting my stress under control). I did do a little bit of mindfulness meditation, but I couldn't shell out money for massage or acupuncture. If you want to do those things, do them to make yourself feel better, not because you think you need to do them to increase chances of success. Good luck!

[Anonymous]

I used to work at one of the big clinics in our area and then was a patient there, so I was about as well informed as one could be, but it did not reduce my anxiety. We are still ttc, but I don't have a success story or magic formula yet.

[Anonymous]

O.p. here. You guys are just fantastic. Thanks for all the tips.

Out of curiosity, what did you guys tell your bosses? I'm thinking of giving mine a heads up that I'm going to be busy with medical issues for a month or two, but not really sure when or how to get through that conversation.

[Anonymous]

Anonymous wrote:O.p. here. You guys are just fantastic. Thanks for all the tips.

Out of curiosity, what did you guys tell your bosses? I'm thinking of giving mine a heads up that I'm going to be busy with medical issues for a month or two, but not really sure when or how to get through that conversation.

I tried to go with the non-descript medical issue approach and ended up with a lot more questions than I wanted, which forced me to lie and feel a lot of unnecessary guilt. Scheduling was a nightmare, and my ER got moved 3 times, so I couldn't ever have a range of which days I would be out of the office. If I had it to do over again, I would either take the whole target week around ER off or just call in sick the day of ER or ET.