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Monday, August 15, 2011

In Vitro Process

I have been getting lots of questions on how this whole in vitro process works- so I thought I would educate you guys on how this works and where it all began. :) Plus it was good for me to read about this in depth- it's amazing what science has done for us- it's even MORE amazing what Heavenly Father has allowed our bodies to do. Louise Brown was the first successful "test tube" baby from 1978. It really wasn't THAT long ago that this whole process started. You can read about it here. It's crazy to me that my future baby will be considered a "test tube" baby- After LOTS of testing and trials they have found that it's a pretty high success rate for most couples that could have never had a baby otherwise. What a miracle!!!

I have dealt with the issue of this being in god's plan or not. Am I not having a baby because I was supposed to adopt another child?? There are people who feel in vitro is unethical because you freeze all your eggs and some may get thrown out. All I know is that I have prayed long and hard what direction we are supposed to go with our family- and I feel good about this being our next step. It may not be the right thing for everyone- but it IS the right step for us right now. I have met children born from in vitro who are AMAZING perfect children. They were spirits who were supposed to be a part of that family. I would actually love to still adopt down the road either way. Now here is how things work:

PHASE 1:
Pituitary and Ovarian Supression


1. Start Birth Control (I started this a few weeks ago-I have been bleeding for like 2 weeks straight!!! grrrr)

WHY birth control: The Doctors use oral contraceptive pills and/or leuprolide acetate (Lupron) shots to suppress your natural hormonal surges and “take control” of your stimulation with gonadotropins (injectable fertility medication). By suppressing or “down-regulating” your pituitary (which releases hormones) and ovaries, the formation of naturally occurring ovarian cysts may be minimized and the FSH and LH receptors on the ovaries may become more sensitive and require less medication to stimulate them.

***August 24th @10:00 am- Training on Injections and Drugs at fertility center - This is the day I start injections (ONE week from today!!) I am totally freaked about this- I HATE needles!!

PHASE 2:
Ovarian Stimulation

During the stimulation phase, I will give myself daily injections of fertility medications (gonadotropins) for 9 to11 days. These injections stimulate the development of multiple ovarian follicles which contain the eggs. Careful monitoring with ultrasounds and blood hormone levels allows my Dr. to make necessary adjustments to my treatment regimen and minimize any complications from the powerful fertility drugs. Once the follicles have reached their ideal size, a subcutaneous (under the skin) or intramuscular injection of HCG mimics your own body's hormonal LH surge which causes final maturation of the eggs prior to harvesting (retrieval).

***September 3rd I start MORE injections- taking up to 3 shots a day for almost 2 weeks!!! (YIKES)

PHASE 3: Egg Retrieval:



***Sept 14th Estimated Day of Egg Retrieval (HCG trigger shot is given)






Occurring 35-36 hours after receiving the HCG shot, the egg retrieval is performed in our on-site dedicated procedure room. A board certified anesthesiologist will provide intravenous sedation to prevent any pain or discomfort during the procedure. Under ultrasound guidance, a very thin needle is passed through the upper portion of the vagina into the ovary and into the individual ovarian follicles. The fluid containing the egg is aspirated and subsequently identified by our embryologist in the adjoining laboratory. In general, the recovery from an egg retrieval procedure is rapid and you will be monitored by one of our registered nurses for 30 to 60 minutes after the procedure prior to being sent home. Since anesthesia is used on the day of retrieval, someone must be available to drive you to and from our facility. Some women may experience mild cramping on the day of retrieval which usually subsides by the evening of retrieval. In some cases, a sensation of fullness or pressure may last for up to one week following the procedure.




** A side note: I have a friend who said you look like 5 months pregnant during this part- partially because you have like 40 EGGS during the day of retrieval!!!! SHEESH!




*** Sept 6th- Get my blood drawn to check hormones



***Sept 7th- Ultra sound and more Blood work


***Sept 10th: ( partner ejaculates for optomized sample) As if he hasn't had to do that enough through this process- haha! Poor guy!








PHASE 4: Fertilization











Once the follicular fluid is removed from the follicle, the eggs are identified and isolated by the embryologist and placed into an incubator. The eggs are fertilized with sperm later that day by conventional insemination or by Intracytoplasmic Sperm Injection (ICSI). For conventional insemination, the sperm obtained from the male partner is placed into a specialized culture solution with the egg and then placed in a specially regulated incubator. If intracytoplasmic sperm injection (ICSI) is to be performed, this is when it will occur. Under the microscope, the embryologist picks up a single sperm and injects it directly into the cytoplasm of the egg using a small glass needle.



The eggs will then be checked within 18-20 hours later to document fertilization. The embryologist will check the eggs again the next day to evaluate for early cell division. Once a sperm fertilizes an egg, it is considered a zygote which then develops into an embryo. The embryos are then transferred to a different culture media and grown over the next 2-6 days. On day two or three after fertilization, the embryos will be evaluated for blastocyst culture. If there is a sufficient number of dividing embryos they will be placed in special blastocyst media and grown for two or three additional days. Ideally, the embryos will have grown for five or six days until they reach the blastocyst stage. For many couples these blastocysts have the greatest chance of implantation. This allows us to transfer fewer embryos, in some cases only one, and lower the risk of multiple births while increasing the chance of pregnancy. Some embryos may also be cryopreserved (frozen) at the end of the culture period.




** I am opting for 2 eggs to be transfered! :) The rest will be frozen for next time.

PHASE 5: Embryo Transfer



This brief, painless procedure involves the use of ultrasound guidance while the embryo(s) are placed into the endometrial cavity of the uterus either 3 or 5 days (blastocyst transfer) after fertilization, using a small highly specialized plastic catheter. No sedation is necessary for this procedure, although we do recommend and prescribe diazepam (Valium®) to ensure overall relaxation. After transfer, progesterone supplementation via injection and/or vaginal suppository will be taken for the next 10-12 days and a blood pregnancy test will be performed approximately 2 weeks from the retrieval date.



**Sat Sept 17- Sep 19th (Embryo Transfer depending on how the babies are growing)
Continue Medications

Blood draw for estrogen and progesterone levels



**Dr. wants me on bed rest for at least 2 days after transfer- then I go to Hawaii to relax :)



PHASE 6: Pregnancy Test and OB Care





The initial pregnancy test will be performed in our office 2 weeks after your retrieval date. Blood hCG levels will then be checked every 2-3 days for those who do have an initial positive pregnancy test. An ultrasound will be performed at approximately 5-6 weeks of pregnancy (2-3 weeks after embryo transfer) and repeated one to two more times during first trimester until a normal healthy heartbeat is confirmed. Once viability is confirmed, you will be referred back to your Ob/Gyn for appropriate obstetrical care.




****and there you have it (SUCCESS!!!!)****


2 comments:

  1. This is fascinating stuff. Thanks for sharing - I know this is going to be a hard process, but it is amazing that the technology exists. I hated going through a c-section until I realized that a) there are dear people struggling with this very thing and b) at least the technology exists to make it happen. I am glad you get to do this and praying that it works!

    keep the updates coming- i love it!

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  2. I can't imagine the journey your about to take Brittany! I am so excited for you and Johnny... The Lord will give you the strength to get through this first phase.. HANG IT THERE! I love ya and good luck tomorrow :-)

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