Here is my treatment Protocol as I currently understand it:
1. Firstly, I’ll need to call the FA nurses on day 1 of my next period (which I have been doing anyway to track my cycles). The week following they will courier me the medications and paperwork that goes with them, including more specific instructions as to the timeline and what is to happen when.
2. Approximately 2-3 weeks later, I will start injecting myself with a drug called Buserelin, which is a Gonadotrophin Releasing Hormone (GnRH). This is a modified version of the hormone my body produces to stimulate the release of Follicle Stimulating Hormone (FSH) which stimulates the follicles in the ovary to grow. These follicles are what develop into eggs during ovulation. Injecting the Buserelin will cause my body to adapt and stop secreting it’s own GnRH, effectively ‘switching off’ my ovaries. This is called ‘down-regulation’, and stops my normal hormones from interfering with the IVF process.
3. Approximately two weeks after starting the Buserelin, I will be told to take a blood test to ensure it’s done the job, and that my ovaries are ‘switched off’. Assuming this is the case, I will be advised to now start another injection, Puregon, which is a Follicle Stimulating Hormone. This Follicle Stimulation Phase is to stimulate my ovaries to start producing follicles and keeps them growing in preparation for egg collection. During this time, I continue injecting the Buserelin as well, but at a lower dose than before.
4. Approximately a week after starting the Puregon, I will be advised to have a blood test and potentially a scan (vaginal ultrasound) to track how many follicles there are, and how they’re growing. This can be done in Nelson, and depending on what this shows, I may need a follow up scan and test 2-3 days later.
5. The last scan I will need to travel to Christchurch for, and they will give me a final injection to administer that night. This will be Ovidrel, which is a copy of human Chorionic Gonadtrophin (hCG) hormone which will trigger ovulation. At this point I will be advised to stop the other two injections, and will again insert a vial into an injection pen to administer it into my stomach.
6. 36 hours after administering the Ovidrel (trigger injection) I need to be back at the Christchurch clinic for egg collection. For this procedure I will receive a narcotic sedation, and cannot drive for 24 hours following. At this point Dave will also need to provide a semen sample, which they will use to fertilise any suitable mature eggs that are collected from me.
7. The day following, they will call us to tell us how many eggs have successfully fertilised, and so how many zygotes (early embryos) we have. These are then incubated until they are 5 days old.
8. At day 5, they will let us know how many high-quality (viable) embryos there are (it is expected that some will not make it to this stage). These will each have a tiny sample (10-20 cells) lasered off and sent to the lab for genetic testing. The embryos will then be frozen to await results.
9. FA will contact us after 2-3 when the results come back, and if there is a suitable, high-quality embryo that tested negative for SCA 3, they can replace (implant) the embryo.
10. Again, on day 1 of my cycle, I contact FA, and they will advise me to start taking Progynova tablets 3 times a day. This contains Estradiol (E2/estrogen) which will help growing and preparing the lining of my uterus (endometrium) for implantation.
11. After approximately 10-12 days, I will have a vaginal ultrasound.
12. At day 12-14, I will have a blood test to check my progesterone level. When this is at the right level, they will advise me to start using Utrogestan vaginal pessaries 3 times a day. These are Progesterone (P4), which maintains the lining of the uterus so that an embryo can implant and cause a pregnancy.
13. Five days after starting Utrogestan, they will thaw and replace (implant) the embryo.
14. Ten days after transferring the embryo, I will have a blood test to find out if I am pregnant.
There’s obviously a whole lot more from here, but that gets us to a potential pregnancy anyway.
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