Starting Medications

When day one of my cycle arrived, I phoned Fertility Associates to let them know as instructed. The nurse I spoke to went through a list of questions, took some notes and then let me know that someone from my team would call me back. That afternoon they called back, and said they’d like to start me on Levlen ED, starting that night. They sent the prescription through to a pharmacy near me so I could collect it that same day.

Interestingly, Levlen is actually a commonly prescribed oral contraceptive pill, the same one in fact that I took for over ten years before deciding to try a copper IUCD instead. While seemingly counterintuitive to IVF, this is commonly used at the start of a treatment cycle. The low dose estrogen in the pill stops the release of Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH). This causes down-regulation or ‘switches off’ my ovaries, a step which actually increases the reliability of the treatment cycle in most women. They decided to start me on Levlen before I start injections because it starts the same process (down-regulation), but the first injection (Buserelin) can apparently make you feel pretty crappy (basically PMS), and starting the Levlen first will apparently help temper this effect.

Two and a half weeks later, Fertility Associates called to let me know that they were couriering my medications to me, and they arrived the next day. In the courier package were:

·        Medication vials of Buserelin and Puregon (with chilly pack as are refrigerated)

·        Syringes, needles and a Puregon injection pen

·        A sharps disposal container

·        A specimen container

·        A letter detailing my treatment plan with important dates as they currently stand

·        Information sheets on the various medications, protocols and contact information

·        Lab forms for the blood tests I will have in February

·        Prescriptions for Azithromycin for both Dave and I. This is an antibiotic that is used as a prophylactic against Ureaplasma, a bacteria commonly found in the reproductive tract that is hard to test for, but is known to increase the chance of miscarriage during IVF and ICSI.

The medication kit that arrived from Fertility Associates.

The current timeline:

20^th December: Start Levlen ED pills.
22^nd January: Start daily Buserelin injections.
29^th January: Stop Levlen ED pills.
4^th February: Blood test to check down-regulation.
5^th February: Start Puregon injections, continue Buserelin injections at lower dose. Start
      Azithromycin.
11^th February: Blood test to check response to Puregon.
17^th Feburary: Trigger injection (Ovidrel) and egg collection is expected this week, dependent on further scans and blood tests.