Here we go again

Last Thursday we had our scheduled consult with Dr. Hudson with the Victoria Fertility Clinic. Originally, our plan was to cycle in October or November, in part so we could enjoy the summer, and I also had a few cycling goals, which I met (yay, upgrade!). During the call with Dr. H, he asked where I was in my cycle. I was expecting my period over the weekend and said as much, and also mentioned that my cycles were becoming irregular after two decades of almost textbook cycles. Based on that, as well as some of my blood work results, he thinks I might be treading in to diminished ovarian reserve and poor egg quality territory. Then he said 'You know, based on your medical history and what's going on with your cycles, you could and probably should start right away.' A little bit terrifying, but we're ready, so here we go.

Today is cycle day four, and I'm downregulating until the end of August. On September 1st, I start injections. I will be starting with a high dose of Gonal-F and Luveris, which I used for our first IVF. The difference this time is that I'm starting at a high dose, whereas during the first IVF we started low and ramped it up quickly due to poor response. I ended up stimming for longer than normal, which may have overcooked my eggs and resulted in poorer egg quality. This time we're starting with the big guns.

Interestingly, I will be taking Femera at the same time. Femera is also used for hyperovulation, but usually on it's own, and usually for timed intercourse or IUI. From the limited research I've read so far, this should do what I'm referring to as 'slow cooking' my eggs in a way that slightly counteracts the high dose of Gonal-F. This will hopefully result in many high quality, mature eggs.

Starting on September 6th I add Centrotide to stop my body from ovulating and keep things cooking. We head to Victoria to finish things off on September 7th with estimated egg retrieval somewhere between September 12th and 15th. Using a combination of natural fertilization and ICSI (where they take a single sperm and inject it in to the egg - see image below), they will culture the embryos until day five. Each embryo will be biopsied before being frozen and the biopsy cells will go to the U.S. for Pre-Genetic Screening (PGS). This will be done to determine which embryos are genetically normal and ready for transfer, which will take place, if everything works out, sometime before Christmas.

Fingers crossed it all goes smoothly - here we go again!