How else is babby formed (SCIENCE)?

April 22, 2012 8:03 AM

Have you had IVF? What do you wish you'd known before you started, and what do you regret doing or not doing?

I'm 42, one child (via IUI), 2 miscarriages. We're about to start our first round of IVF and I'm terrified - mostly of the shots, but also of all the unknowns. We are planning on doing PGD because of miscarriages. I am also terrified of multiples, but am unclear how much control I will have when it comes to how many embryos get implanted. Would love any and all stories. Throwaway email: [e-mail]

posted by anonymous to Health & Fitness (8 answers total)

My son is an IVF baby, and we had a great experience. Fortunately, it worked on the first try for us. I think a lot of that had to do with my age at the time (28) and the progesterone shots I took until I was about 11 weeks along.

1. Shots - they really aren't that bad. You get used to them quickly, and most of the time you'll probably barely feel them since the needles are small. You can always get a script for EMLA cream, which is a topical numbing agent. Now, the small needles don't apply to the progesterone shots that you may have. The liquid is thick, so you'll have to use a larger gauge needle. For the most part, though, I found that those shots didn't hurt that much unless my husband accidentally hit one of the bruises/knots from a previous injection. As long as you switch sides and vary the injection site a bit, you'll be fine.

2. Multiples - They are always a possibility, no matter how you get pregnant. How many embryos they transfer depends on their quality and your age. Because you are older, chances are they will transfer no fewer than 2, most likely more. I had 2 transferred, both excellent quality, because of my age. Only one stuck. My friend, who did IVF at age 31, had 2 transferred, and she's now got twins. The best thing to do is wait to see how well the embryos form and discuss the chances of multiples (should you transfer several embryos) with your doctor. Even if they transfer 4 or 5, remember that we are not all Nadya Suleman, and it is highly unlikely that all of them will stick.
posted by jenny76 at 8:32 AM on April 22, 2012

You should be able to ask your ART doctor about his/her stats. They should be able to tell you average implantations per procedure, live births per procedure, embryos per procedure, etc (these stats are reported to the government and are available online but may not be as recent).

The day of our implantation we knew we had more than one embryo so we had decided we would take our doctors advice regarding number of embryos to implant. Ultimately it was our choice. Lucky for us, she was satisfied with the quality of a single embryo to implant only one. We also were successful on our first try. Six years ago when we were going through all that our doctor told us that implanting more than three embryos was highly discouraged by the ART certification boards and was rare. I doubt that's changed in the last few years.
posted by tayknight at 8:58 AM on April 22, 2012 [2 favorites]

Good luck!

unclear how much control I will have when it comes to how many embryos get implanted

They won't transfer embryos against your will. However, it's unlikely they'll be willing to transfer fewer than three given your age. Please talk about your concerns about this well in advance with your doctor and (if your doctor's practice has this) with your case manager.

I didn't find that the shots hurt, though I agree with jenny76 that you need to be vigilant about not injecting into a recently-used spot. I did have some minor complications after the egg retrieval--some pain and swelling--but they cleared up with a three-day course of prednisone.
posted by Sidhedevil at 8:59 AM on April 22, 2012

From a friend I know doing IVF:

1. Join resolve.org for support if you haven't already - a lot of helpful advice and understanding!
2. The shots don't hurt much - but can make you feel a bit sick. Plan to take it easy.
3. Clear your schedule - this is not the time to get a new job, take on a big project, move house or even make lots of social plans. Between carefully timed shots, feeling sick, blood tests, ultrasounds, etc, you will be really busy.
4. Do acupuncture. Who knows if it makes a difference, but it's relaxing and that's a good thing.
5. Plan to take some time off work - once the monitoring starts around day 5 you will need time off in the mornings to get to appointments. Plus, you need the day of egg retrieval off plus ideally the day after. You also need the transfer day off plus 2-3 days afterwards to rest.
6. You get to choose how many embryos get transferred but the older you are and number of embryos all play a part in what your doctors recommend. If you do a day 5 transfer, 2 embryos are usual, with 3 if you have a day 3 transfer. Most clinics will transfer on day 3 unless you have lots of good embryos on day 3 and it's hard to pick the best - then they wait til day 5.
7. The emotional side is harder than the physical but everyone responds differently and it can be quite uncomfortable. But: you can do it!
8. It doesn't always work the first time. Prepare mentally for that. And the majority of people don't have embryos to freeze.

Good luck!!
posted by inflatablekiwi at 9:51 AM on April 22, 2012 [1 favorite]

You have a lot more control than you think. You can say no. The nurses may push back. Ask to speak to the doctor about it and be firm about what you want. I literally had to say 'will you refuse to move forward if I don't do this procedure?'.

Also, look into international travel, especially if you are near a border. It can save a lot of money.
posted by bq at 10:08 AM on April 22, 2012

We went through 3 IVFs. I found the most helpful thing was to have a great clinic that did this a lot. They gave you a schedule, you followed it and before you know it, you've had your transfer.

With the number of embryos, you have a lot of say. With our first we transferred 2, one took and then miscarried. With #2, we transferred 3 and none took. With #3 we transferred 4 (!) and one took all the way for 9 months.

What I wished I had known before hand is the great difference between a 3 day transfer and a 5 day transfer. Blasts that make it to 5 days tend to be more robust and strong. Our son resulted from a 5dt. Our miscarriage was from a 3dt.

Also, discuss the stimming protocol that your doctor is planning on using for you. We ended up using a slightly different protocol for the third one and it turned out to be the charm - it was focused more on egg quality since my prior miscarriages had been chromosomal.

Be prepared also for the possibility that you won't have as many eggs retrieved as you like and that not all of them will fertilize or keep growing. The Fert Report was almost as hard as the beta day results because you invested so much getting to that point and it could be for nothing.

Feel free to memail me if you have questions - and best of luck.
posted by Leezie at 11:15 AM on April 22, 2012 [1 favorite]

My son and daughter-in-law have endured IVF. I sent them this link to assure them that it wasn't "just them." I hope you find comfort in it, too. Paul Ford's essay, "The Age of Mechanical Reproduction."
posted by Lynsey at 1:55 PM on April 22, 2012 [1 favorite]

Multiples are unlikely at 42. Generally at your age they'll put in say 6 embryos at once and get either zero or 1 implanting. You need to remember going into each round that zero is a likely outcome so you don't get too discouraged.

A daily dose of baby aspirin seems to help implantation. It was recommended by a fertility doctor we saw very late in the process and apparently worked for us so well that Mrs W0mbat got pregnant the normal way before we could schedule round 3 of IVF.
Worth a try, right?
posted by w0mbat at 6:02 PM on April 22, 2012