Steps followed @
Guna Fertility Centre: My IVF journey:
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I
got my periods on 2nd November
2016. I called up Ms. Mohanapriya,
our IVF coordinator and she asked me to come the next day. She told me I will
have a trial transfer, a scan and an injection following the scan.
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It
is better if we take our husbands for this first day of IVF. The remaining days
we can go on our own. If you are working, you can take a short break for the injection
and get back to work.
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With
a lot of prayers and anxiety we reached the hospital in the morning.
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As
soon as Dr. Manu saw me she asked me if I was ready. I said I was nervous. She
told me it is a simple task and we just have to take each step with less
rigidity. If the trial transfer is done on the second day, it will be less
painful.
●
After
signing the consent papers, I laid down. She explained to me to be calm and
relaxed as the more rigid I get the more painful it is going to be.
●
In
trial transfer basically a thin catheter is passed through your vaginal canal
to assess the cervical length. This information is mandatory for the transfer
of the embryo. It is a few seconds of discomfort and nothing compared to the HSG
tube test.
●
Once
the length is noted, the doctor does your internal trans vaginal scan. We have
to get used to this scanning as it will be done very often right through the
treatment.
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I
was fortunate to have Dr. Manu who does this scan very well. Initially I was
quite nervous but soon got over it.
●
Dr.
Manu showed me the scan on the monitor where she showed the picture of the
uterus and ovaries. She showed me a black dot and asked me to observe the same-
This is what will change in the upcoming days as the follicles are
stimulated.
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Dr.
Manu advised the dosage of injections to the nurse and wished me good luck.
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First
day blood samples are also withdrawn to check FSH, LH and estrogen levels. In
the beginning they will show normal values and as our injections proceed the
values will increase.
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For
the next fourteen days, injections are to be taken at the hospital only and it
is best to stick to a specific convenient time.
●
For
me either Ms. Chandralekha or Ms. Keerthana would administer the injections; these
injections are given around your navel area and they are not at all painful.
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The
important instructions to be followed during the injection period are that we
must drink at least 3 litres of water, no out-side food and no sexual intercourse.
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Apart
from this we can carry out our normal routine.
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For
the next couple of days only the injections are administered.
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The
fourth or the fifth day the next scan is taken. In this scan Dr. Manu showed me
the black dots that had multiplied – this means good stimulations were happening.
The black dots are the follicles; they are black because of their water
content. It was an experience to see the follicles on the screen.
●
The
seventh day is like the mid period where a blood test and a scan are taken. Now
the doctor starts counting the follicles on either side of the ovary.
●
Dr.
Manu told me stimulations were happening according to their expectations and the
blood values were also raising steadily. At this stage if stimulations are less
they are likely to alter the dosage.
●
This
is a combination of three injections; the cost of these injections is very high
as they are human hormones, and not many companies produce these drugs.
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There
are no pronounced side effects to these injections. But, due to the stimulation,
you will feel a bloating sensation in the lower abdomen. Yoga or other
strenuous exercises are not recommended during this time.
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I
did not gain weight during the injection period. This could be because of very
cautious eating and drinking a lot of water.
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On
day 12 a final scan is done to ascertain the number of follicles and their
measurements. I think the follicles need to reach 18 mm in size to be considered
to be fully developed.
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The
doctor uses the monitor to decide your egg retrieval time. This is done in
consultation with the embryologist. Based on his availability a time is fixed.
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At
this stage I was informed by Dr. Manu that they will be retrieving about 10 follicles. This is one of the hospital’s highlights - they are
very transparent at every
stage. All our reports are given to us as print outs at every stage.
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The
reason I am specifically mentioning this here is because many centres I've
heard aren't transparent, neither reports are given nor the follicles are shown.
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If
you are not shown or informed it is better you speak to your doctor.
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All
our payments were with credit card and we were given bills immediately. This
further establishes the transparency of this hospital. Some IVF centres insist
on cash especially for egg pick up or embryo transfer. Please get acquainted
before you start the process.
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Based
on the egg retrieval time, a trigger injection needs to be given; this
injection will ensure the eggs mature completely and do not rupture.... this is
usually given 33 hours before the pick-up time.
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My
egg pick up was scheduled at 11.00 am on 16th November 2016, so I had my
trigger at 11.45 PM on 14 th November.
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Please
stick to your time as it is important. In my case, the nurses Keerthana and Chandraleka were
ready and exactly at 11.45 pm injection was given. This injection is also
intramuscular but not very painful. They also explained the instructions I needed
to follow till I report for egg pick up.
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The
day after the trigger injection is a break day and we need not go to the hospital.
One has to just relax at home eating normal food with lots of water. Based on
the timing, eating after a specific time is not allowed. A little bloating may
be experienced.
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November 16 th was our egg retrieval day. We left home in a cab and
reached the hospital. In normal ICSI the male partner gives his sample ahead of
time so he will be free to take care when the female partner will be undergoing
the process under anaesthetic conditions. Then both can actually manage just in
case parents aren't available to help.
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In
our case my husband Hari went in for surgical sperm retrieval. This was
suggested by Dr. Karthik, and as the locations and quality of sperms were
already ascertained, it was a simple micro non-invasive technique with local
anaesthesia and this ensured better quality of sperms.
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His
procedure started sharp at 10.30 am and was over at 10.50 am. He was shifted to
the room. My parents were there with us to take care since we both had to
undergo the procedure simultaneously.
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Following
this I was taken in, and our anesthetist, Dr.
Senthil assured me that Hari 's part went on well and he was doing
fine. I sincerely appreciate this kind of a personal touch and care that each
doctor took in this hospital. Dr. Senthil then administered general anesthesia
for me.
●
It
is definitely an experience to see the greatness of technology. I was initially
conscious and was informed by Dr. Manu that all will be well .I realized how
many people were involved in this process-- so many dedicated and skillful hands
handling us .
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I
soon slept off and when I regained consciousness I was already shifted to the
room. I felt sleepy for few hours. After a couple of hours I was started on a
liquid diet, and since there was no nausea went on to soft solids and then after
the drips I was discharged.
●
Hari's
recovery was much faster as it was only a local anesthesia. He took care of
settling the bills and discharge formalities.
●
Ms.
Chandralekha, our nurse came to meet me and said my procedure went on for about
40 minutes and as decided before, 10
follicles were extracted. From the follicles, eggs will be removed and
fused with the sperms.
●
She
told us by the next day we will know how many have fertilized. She said she
would call and inform. She gave me the prescription for a few pain killers and
asked me to continue the perinatal multivitamin tablets. For Hari no medicines were
required.
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I
was asked to come on the 5th day of the next cycle to check if my ovaries have
shrunk and if everything was normal with the uterus after this egg pick up.
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In
this hospital the IVF ICSI protocol takes a break here. A complete break of one
cycle is given for hormones to get back to normal and the frozen embryo
transfer is done only in the second cycle after egg pick up.
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This
is done to avoid estrogen interference which might interfere with implantation.
This was explained in the beginning itself by Dr. Manu.
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This
is also very beneficial for us as we get to unwind, workout and get ourselves
ready for the embryo transfer.
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After
the instructions we were discharged by about 7 PM. It was a very pleasant
experience. We left the hospital with satisfaction and of course with some anxiety
about the results of the nature of embryos.
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That
night I could take normal dinner and I didn't have any pain.
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The
next day Hari took off from work just to relax. I was back to my normal
routine. My mother was there for a day to help me after which I could manage on
my own.
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In
the evening I spoke to Ms. Chandralekha. The embryologist's assistant had told
her six eggs had cleaved indicating six eggs had fertilised. But it was still
too early; only by Monday will they be able to update the correct status.
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Monday
was a busy hospital day and it was very difficult to get through to anyone. My
tension was building up and finally by about 2 PM, I could speak to Ms.
Mohanapriya. She immediately apologised for the delay and told me they had frozen 8 blastocyst grade embryos and
that it was a good number.
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I was
extremely relieved and happy, even a little emotional. I immediately updated
Hari who was at the office and he too was very relieved and happy.
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Just
to understand in lay man terms (there are several good web references on this)
once the sperm and egg fuse it is placed in an incubator which maintains body
temperature. Then it starts cleaving and cell division takes place. A good
quality egg and sperm will facilitate this process.
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Day
5 after retrieval is called a blastocyst stage and at this stage the embryo is
frozen, from then on no change takes place. They are frozen in a liquid
nitrogen environment and can be stored for ages.
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Some
centres freeze on day 3. Their school of thought is that the human body
environment is better for day 4 and day 5.
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The
only risk of waiting till day 5 is that some embryos that are not of good quality
may be lost and might become useless for transfer.
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But
across the world Day 5 blastocyst is recommended as it is a clear indication of
a better quality embryo since it has withstood 5 days.
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Before
the transfer, the embryos will be thawed (brought to normal temperature) and studied
under a powerful embryoscope. It is at this point that the embryologist will
take pictures of the embryos and tell us their specific quality and grade.
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So
after hearing that 8 blastocyst embryos were frozen we thanked God for helping
us cross one part of IVF with this team of very efficient medical
personnel.
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The
next one and half months were to unwind and I followed a very strict routine of
diet and exercise which included gymming and yoga. I did loose about 3.5 kgs
and I felt really good -- this can be attributed to an inner feeling of relief
that one part was over.
●
When
we first consulted Dr. Karthik,
he told us the problem was solvable once good sperms are identified through the
ICSI technique since they will fertilise the egg well. But for the success of
an IVF treatment, just egg and sperm quality are not the only contributing
factors; the overall health of the woman and how she
takes care of her protein and vitamin requirements matters. He told us this very
beautifully ‘Our aim is not to create successful embryos but to make you hold the
baby in your hands’ This was my
motivation mantra to be very strict about my eating habits and physical work
out .
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So
it is important that we take care of our health right through the treatment
period. In-fact, we always have to be careful. But we have learnt from
experience that when nothing positive happens we generally distract ourselves by
over-eating. That is why many who experience depression put on weight.
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