Anatomy of an IVF meds picture

I'm pretty sure there is an unwritten rule about posting a meds picture for a third IVF cycle, but I assure you there is a method to my madness. Method 1 entails satisfying my OCD nature to capture "everything". Don't worry, I don't really fully get it either. Method 2 involves me finding something else to focus on for now so I can avoid my anxiety building over this cycle for just a little bit more. Talking about the cycle, travel, protocol, etc, etc. seems to be fine, but ask me how I'm really "feeling" about it all and the tears are generally instant. I will save this stuff for another day and make you suffer through my mindless babble on IVF meds for today.

I know most of you who read this blog can look at my meds and figure out what protocol I am on without any further explanation, so I apologize to you in advance. This post is mostly for me (selfish little bitch, I know) so I can look back a year from now when I have forgotten what all this crap was for and really see how far I have come. That's the plan anyway.......growth and moving forward, no matter what.

So here it is in all it's glory. I know, another IVF meds picture.......ooohh......ahhh...... right?




Now, for the part that will occupy my head for a bit. What is all this crap? What's it for? When/how do I take it? How does it make me feel? How much did it cost me?

Of course, I'm no RE (although I like to think I could play one with all the information I have earned ever so expensively) so take this with a grain of salt and feel free to correct me where I screw things up. I'm only 2 Lupron shots into this cycle so I can still try to play nicely.
The 30,000 ft view of IVF meds is basically this. RE needs to take over full control of my cycle (which includes taking over my body, my emotions, my bank account, and my dignity in turn). He will make my body grow multiple eggs which he will then surgically remove and fertilize with M's sperm in a lab, creating embryos that he will culture in the lab until they are ready to be transferred back to my uterus.
To do this he uses mega doses of injectable hormones to stimulate my dusty old decrepit ovaries to grow the multiple eggs and uses other medications to prevent me from ovulating on my own. There are others to help the eggs inside the follicles to fully mature and yet others to prevent infection, inflammation, and rejection of the embryos. There are still others to help with my response and others to help get my uterus ready for implanting those embryos and sustaining a pregnancy. Easy so far, right?

*

1) Oral Contraceptive: Let's start with those dreaded nausea-inducing little pills. A BCP to get pregnant?

• What's it for: It can be used to regulate cycles or to help prevent OHSS in high responders. I don't qualify for either of these, but because I'm doing a MDL protocol I am taking them to help prevent having a lead follicle. (The risk is that I could be over-suppressed, meaning my ovaries will have a hard time waking up when it's time to make some eggs.)
• When/how to take it: I would like to think this one is easy, but I have alot of fertile friends who have forgotten 1 or 2 pills and ended up with babies. Novel concept, huh? I guess they really are good for getting pregnant. I took 13 of these bad boys starting on cd3 and am thrilled to tears they are done.
• How do they make me feel: nauseous and headachey with a flip-flopping tummy and near constant spotting and cramps
• My cost: $45

2) Lupron (microdose): aka the devil's drug at our house

• What's it for: Lupron (given in microdoses) is a drug that will stimulate my pituitary to release its own natural store of FSH and thus "flaring" my ovaries to start working before we add in medicated FSH. (My body needs all the FSH help it can get since I am considered a "poor responder".) After a few days the Lupron will take on a suppressive effect to prevent me from ovulating on my own and thus losing all those precious eggs we are working so hard to grow.
• When/how to take it: For my MDL protocol, I will start this 4 days after my last BCP which is around cd3 again. Contrary to popular belief it is NOT licked on by kittens, but injected subcutaneously (under the skin) in the belly or thigh with a 1/2" needle every 12 hours from cd3 until trigger (~24 injections).
• How does it make me feel: full of hormonally induced rage with hot flashes and night sweats. For a recap of my last encounter go here, here, or here.
• My cost: $105.14

3) Gonal-f

• What's it for: Gonal-f is pure FSH (follicle stimulating hormone) and it does just as it is named - stimulates the follicles to produce more than it's one monthly egg quota.
• When/how to take it: I will be taking 300IU of this drug every evening with one more sub-q 1/2" belly (or thigh) shot. (Hmmm, remember the days when belly shots meant something totally different**.) I will take it from ~cd5 until trigger (~10 injections).
• How does it make me feel: bloated and moody
• For extra credit: There are 2 ways that FSH medications are made. One is from recombinant FSH occurring in genetically modified Chinese Hamster Ovary cells cultured in bioreactors (gonal-f, follistim) and the other is made from the urine of menopausal women (bravelle). Lovely thoughts of what is being injected, huh?
• My cost: $2390.00

4) Menopur

• What's it for: Menopur is made up of 50% FSH and 50% LH. It serves the same purpose as gonal-f with the FSH. The LH is used to help mature the eggs.
• When/how to take it: I will be taking 150IU of this drug every morning with one more sub-q 1/2" injection to the belly or thigh. It is also taken from ~cd5 until trigger (~10 injections)
• How does it make me feel: pretty much the same as gonal-f except this one burns a bit when injected
• More extra credit: Menopur is made from the urine of menopausal women. Upon learning this during IVF#1, I decided that we will try to recoup our IVF costs upon my early menopause by selling my old lady piss back to the companies that charged us an arm and a leg for their product. Total full circle, huh?
• My cost: $1318.00

5) Saizen

• What's it for: Hell if I really know. Saizen is a human growth hormone and there have been some "studies" that have shown it may or may not help with increased response during IVF cycles for low or poor responders. It's one of those WTF kinds of things that we might as well try.
• When/how to take it: I will take 0.33ccs by way of 1 1/4" intramuscular injection in my upper ass cheek from cd3-cd7 (5 injections)
• How does it make me feel: I have never taken this one before, but I like to think I will feel like lifting a bus (or at least my ovaries will feel like picking up some slack and making a couple of really good eggs for once).
• Just wondering: I had to buy 6 dosages of this, but will only use 5. My 1 extra dose lost cost is $101.16. Think it has the same street value?
• My cost: $606.93

6) Dexamethasone

• What's it for: Dexamethasone is a steroid used to help prevent my immune system from attacking any embryos that might want to implant.
• When/how to take it: This is an oral medication taken once a day beginning with my first Lupron injection and lasting through the first weeks of pregnancy (at least 25 pills)
• How does it make me feel: I have never taken this one before, but the side effects listed are difficulty sleeping, feeling of a whirling motion, increased appetite, increased sweating, indigestion, mood changes, nervousness
• My cost: $1.68
7) Pergnyl
• What's it for: This is the HCG trigger which is used for the final maturation of the eggs and to help loosen them from the follicle just before ER.
• When/how to take it: This injection is very time critical and is done ~35 hours prior to egg retrieval. At ~ 40 hours past an HCG trigger shot, ovulation could occur "naturally", the eggs would be released, and the cycle would be over. Very, very bad to screw the timing up on this one. This injection is an intramuscular one given in the rump with a 1 1/4" needle on about cd13-15ish (1 bad ass injection).
• How it makes me feel: It makes me feel relief because I know the end of my egg growing and belly injections are near. My ass usually hurts for a few days.
• My cost: $50.90
8) Medrol
• What's it for: Medrol is another steroid used to prevent any inflammation between the embryo and endometrial lining.
• When/how to take it: I will begin taking this orally the night of ER for 4 days (4 pills)
• How it makes me feel: I haven't taken this one either, but side effects listed are fluid retention
• My cost: $13.16
9) Tetracycline
• What it's for: Tetracycline is an antibiotic used to help prevent infection that could be caused when the vaginal wall is punctured during the egg retrieval process.
• When/how to take it: I will begin taking this orally 4x a day the afternoon of the ER (14 pills)
• How it makes me feel: Usually just a bit of an upset stomach
• My cost: $4.20
10) Endometrin
• What it's for: Endometrin is progesterone. During the ER process, the progesterone producing cells are removed along with the eggs and follicular fluid causing the ovaries unable to produce progesterone. Progesterone is necessary for endometrial development and embryo support and thus, must be supplemented.
• When/how to take it: This is a vaginal suppository shoved up the lady bits 3 times a day beginning a couple days after ER into the first weeks of pregnancy. (at least 39 coochie pills) (Another option for progesterone is the PIO (progesterone in oil) injection given intramuscularly in the rear). I was given the option and chose the mess over the sore ass.
• How it makes me feel: This is the bless-ed thing that makes me feel crazy during the 2ww as all of the side effects mimic pregnancy - sore boobs, abdominal pain, nausea, and fatigue. It also makes me feel totally messy "down there" and wishing I had bought stock in panty liners.
• My cost: $261.20 for 40 inserts
11) Vivelle dot patches
• What it's for: Vivelle patches provide estrogen needed to help maintain an early pregnancy.
• When/how to take it: The patches are little stickers placed directly on the skin. The estrogen is absorbed into the skin. I will put 2 of these patches somewhere on my abdomen or back starting on the day of ET and change them every couple days into the first weeks of pregnancy (at least 12 patches)
• How they make me feel: headache, nausea, upset stomach. They also really suck to pull off leaving huge red marks for awhile after removing one. I would do another injection over removing these little fuckers any day of the week.
• My cost: $108.80 for 16 patches
12) Stuart Duet DHA
• What it's for: That good old pre-natal vitamin with folic acid, DHA, and all that other good stuff a baby needs. This one has 2 pills, hence the duet.
• When/how to take it: Duh....I like to take 'em at bedtime because the aftertaste of the fish oil is disgusting. I have been taking these kind of things for over 4 years now. (at least 40 x2 taken during this cycle).
• How they make me feel: Occasional upset stomach if I haven't eaten for awhile, disgusting tasting burps
• My cost: $30/month
So to anyone who has ever said, you can "just" do that IVF thing, I say at the minimum "just":
• swallow 56 pills and 80 vitamins
• inject 44 needles into your belly/thigh
• inject another 6 big honkers into your ass
• shove 39 horse pills up your lady bits
• and wear 12 of the stickiest - rip your hair off - patches on your belly
• pay just shy of $5000 for "just" the meds and
• act like a raging hormonal, bloated lunatic for over a month
And this is "just" the meds. We haven't even gotten into the daily vaginal ultrasounds, blooddraws, ER, mature eggs, fertilization rates, embryo quality, ET, or that dreaded 2ww followed by the infamous beta that will tell us if our hopes of having a biological child will ever come true. I wish any of the above stuff was part of the "hard stuff". This is all a walk in the park compared to the emotions that go along with one of these cycles.....the emotions I need to avoid for just a bit longer. *Doesn't this picture remind you 70's kids of that Sesame Street song. Sorry, I couldn't embed this one and double sorry that this song will now stick in your head like it did mine. **For the record, I have never done a "belly shot". First, I'm a bit of a prude and second, the thought of having alcohol stuck in my belly button is beyond my comfort level in more ways than one.