It’s a bit hard to believe it’s been just under three years since our last transfer prep, and yet here we are.
Earlier this week I spoke with the doctor and the nurses to go over all of the details for the upcoming transfer — medications, timing, appointments, etc. The protocol at this clinic is pretty similar to the protocol at my previous clinic, but the way the medications are administered is slightly different.
Getting the Needed Medications
The medications + apparatus (needles, sharps container, etc.) for all of this come from special mail-order pharmacies. There are only a few in the States that provide fertility medications — I can’t just go to my local pharmacy to get what I need. It took a few phone calls with the prescription organizer and the pharmacy itself to get everything sorted out. They were waiting for pre-authorization from my insurance before filling anything, despite me telling them that my insurance doesn’t cover IVF (because most do not), so it’s all out-of-pocket.
After that got sorted out, the medications were finally shipped via FedEx overnight on Wednesday. I told the pharmacy I needed to receive them by Thursday (even though I’m not starting until Sunday) so there’d be time to sort out any shipping issues. And it’s good I did that. All of my overnight FedEx packages lately have gotten stuck in Memphis and delivered a day late, and this one was no exception. There’s nothing quite like waiting for time-sensitive medications to arrive and seeing the tracker stop in a city with a vague “delayed” notification. Thankfully, it started moving again on Friday and was finally delivered yesterday afternoon.
The Transfer Protocol
That means that I now have what I need to prep my body for the transfer. The clinic had me stop birth control after Wednesday’s nurse consult and start taking a baby/low-dose aspirin daily. This Sunday I’ll start taking estrogen to build up my uterine lining to provide a happy landing place for the embryo.
With previous transfer prep, I took an estrogen pill 2x daily, and sometimes had to switch to taking it via suppository to help with responsiveness. This time, it will be an evening estrogen shot every 3 days. I could have gone with the pill again, but (1) it would have been 3x daily and (2) I always had trouble building up my lining in the typical time period, and this doctor said it could have been because of how the pill is processed in the body. The shot can be more effective. So, even though it means an additional (painful) intramuscular shot, I’d rather have an effective medication that is more likely to work within the desired timeframe than not.
I’ll do the estrogen shot every 3 days for about 10 days, and then will go into the office for a monitoring appointment on Nov. 30. That appointment will be a blood test and an ultrasound to see how my lining is faring. If it’s at the desired thickness, I’ll add in progesterone shots four beginning that Sunday. Those are 1x daily evening shots (the same protocol as my previous transfers), and are also (painful) intramuscular ones. Unfortunately, both shots have to go in the same upper butt/hip area, but at least I can rotate sides and use ice cubes to numb the injection site.
Six days after starting the progesterone, I’ll go back to the clinic for the transfer itself. That’s when I need to start considering myself pregnant (no booze, etc.) until blood tests say otherwise.
Then, 10 days after that, I’ll have blood drawn to determine if the transfer “took” (meaning: am I pregnant or not). Assuming it’s a yes, I’ll have another blood test two days later, and then again a week later. Assuming the numbers keep rising, I’ll then go into the clinic for the first ultrasound about 10 days after that third blood test. That would be at about 7 weeks pregnant — the fetus would be about the size of a coffee bean, and most women wouldn’t even know they’re pregnant yet unless they’re being closely monitored because of something like IVF.
Politics May Get in the Way
A not-so-fun fact: If, at the ultrasound, there is a heartbeat but the fetus is otherwise not viable, it’s likely I’d have to go out-of-state to take care of things. Georgia had a heartbeat law — banning abortion at 6 weeks — that was struck down in court last week, but the state is fighting to get it reinstated and I suspect it will be now that Roe is overturned and the State government is solidly anti-choice. Because going through IVF isn’t stressful enough without wondering if the state government will hinder my ability to take care of myself and my body as my doctor deems necessary.
What Next?
The next blog update, barring anything weird with transfer prep (always a possibility), will likely be after we know whether the transfer took or not.