Our IVF cycle officially started the day after my birthday. I was started on the long protocol, which is recommended for many younger patients or those with strong ovarian reserve (clearly I was the latter of the two…).
For this cycle, I will be taking Lupron, Follistim and Menopur. Here is a brief overview of each shot’s purpose:
Lupron- This essentially “shuts down” the body’s reproductive hormone system. Ovulation cannot occur naturally while on Lupron because LH, which triggers ovulation, is suppressed. This prevents a premature surge of the LH before the retrieval, which could cause loss of the cycle. (I ovulated prior to my trigger shot during our IUI cycle).
Follistim- It is a recombinant follicle stimulating hormone that helps healthy ovaries to develop and release mature eggs.
Menopur- Menopur injection contains human menopausal gonadotrophin as the active ingredient. Human menopausal gonadotrophin is a combination of two naturally-occurring female hormones, follicle stimulating hormone (FSH) and luteinising hormone (LH), extracted and purified from the urine of post-menopausal women. In the case of IVF, Menopur is used to stimulate multiple follicles and eggs to develop.
I started on 0.2mLs of Lupron, however after our baseline ultrasound (on cycle day 3), it was reduced to 0.1mL, and I began 150 Follistim and 2 IU of Menopur nightly. My hubby gave me my Lupron shots each morning, and my coworker (who was a labor and delivery nurse previously!) was able to give my 2 nightly shots, thankfully!! I was not ready to do those myself.
Lupron is easy, since there is no mixing – you simply draw it up and inject. The Follistim was also incredibly easy, since it is a prefilled pen with a very small needle. The Menopur has been my least favorite, both to prep and to inject. My dosage used two vials of the Menopur (which is actually a powder) mixed with saline, so mixing it was a bit more cumbersome. The needle is a bit bigger than the Follistim, but the actual needle itself wasn’t too bad – the medicine itself… ouch! Menopur stings a bit going in and for a few seconds after it is administered. We injected all of the meds into my abdomen, rotating the site daily, so I also had a ton of little bruises scattered across my stomach.
After our second ultrasound (CD7), I had five follicles on the right and 7 on the left. They were still relatively small, so we continued on the same dosage for the next few days. Our ultrasound on CD10 showed 8 follicles on the right and 9 on the left with my lining growing at a good pace. The follicles were still overall small, although two on the left were measuring at least 14mm.
Finally, after 4 ultrasounds (CD13) we were finally ready and retrieval was scheduled for CD 16 😀