The third check-up

Another three days later it was time for my third and what turned out to be my final check-up. At this stage I was feeling more bloated and a little uncomfortable, which was backed up by the scan. My larger follicles had zoomed to over 20mm, while I had a few around the 16mm mark and some at 11mm. The image on the screen looked bizarrely like Swiss cheese and the two sides were almost touching. At this point the nurse said that, pending the blood test results, it looked like I was was on course for egg collection to take place 2 days later. I then went in for the blood tests and it was confirmed that I would be booked in for collection 2 days later. That meant that I would take the trigger injection (Ovitrelle) at 9pm that night along with my last nasal spray at 7pm.

Later that afternoon I received another phone call from the clinic and had to make a quick dash down to the pharmacy. My blood test results had shown that my oestradiol levels had shot up to 19000 (from 5000 3 days earlier) and I was put on some tablets to bring this down. These have to be taken at night with or just after food for 8 days. As they can make you drowsy or nauseous I was advised to take them before I went to sleep. Fortunately there was no change in the schedule for the procedure.

The second check-up

My next check-up was three days later. Again, this consisted of an ultrasound exam and a blood test. By this time I was feeling a little bloated and noticed that I was needing to go to the loo more often – I assume this is because I am drinking more and my bladder is pressing on the larger follicles. The scan showed that my follicles had indeed grown, to an average of 13mm and I had 7 present on each side, making a total of 14 possible follicles. The larger ones will be above 20mm by the time egg collection takes place, although I was told that anything above 14mm is feasible. The scan was followed by another blood test for the oestradiol levels.

I received a phone call in the afternoon to tell me to reduce the amount of Menopur for one of the next 3 days to 75IU so that I am not risking overstimulation.

The first check-up

Six days after I had started the injections I went into the clinic for my first check-up. This was scheduled for the morning so that the blood tests could be performed during the day and then looked at by the doctor in the afternoon/evening. I firstly had an ultrasound examination at which I could see the follicles starting to grow and become more distinct. Average size was approx. 10mm at this stage and the nurse counted 21 present, although this number may grow or shrink. I then went in for a blood test which was to look at my oestradiol level. Both nurses asked how I was feeling. At this stage the answer was not too different from normal, both in terms of mood level and general comfort, though I am sure this will change!

Starting the process

My whole egg freezing process was estimated to take 3 weeks so I wanted to block out a month of time when I would not be under any stressful or difficult work commitments (easier said than done). Once I had decided on the best dates, I booked an appointment with the nurse to plan the way forward. At this stage I needed to complete all the remaining forms which gave consent to the procedure and my decisions regarding various other considerations.

Firstly I had another internal ultrasound to check my condition at the start of the process and I was pleased to learn that the same nurse would perform all my ultrasound examinations during 3 weeks. I then went for a consultation with the nurse which was quite an in depth talk and at which it was decided that I would stop the pill the next day and start taking a nasal spray. The nasal spray is to be taken morning and night (12 hours apart) and will continue until a couple of days before the egg collection. I will then start injections one week after starting the nasal spray and will have my next scan and blood test 6 days after starting injections. Egg collection is estimated to take place 2 weeks after starting injections.

At this appointment I also received my sharps box and was taken through the procedure for taking the nasal spray and performing the injections. While I had walked into the clinic with a few nerves, I left feeling reassured and in good hands.

The follow-up

After the first consultation I took some time to consider what I wanted to do and whether to go ahead with the process. I personally felt that it was beneficial to take some time to get used to the idea and all the intricacies involved. Finally I went back for a follow-up consultation at the end of 2014. At this consultation I confirmed that I wanted to go ahead and my consultant took me through the procedure again. As I have some prior commitments in early 2015 I have decided to go on the pill to manage my cycle until I am happy to start the process. I also had blood tests for HIV and Hepatitis.

The first appointment

Having got down to a shortlist of 5 clinics, I sent each of them an email asking for more information. My choice in the end came down to a personal preference. As this was my first time I wanted a clinic that would walk me through the process. I was also fortunate that, to my knowledge, I did not have a condition that might require more specialist treatment.

The first consultation was in autumn 2014. At this point I had to fill out several forms for identification purposes. I was also booked in for blood tests the day before the consultation to gain some idea of my fertility. Blood was taken for tests.

– AMH (Anti Mullerian Hormone), FSH (Follicle Stimulating Hormone) and E2 (Estradiol) give an estimate of how many eggs are remaining.

– AFC (Antral Follicle Count)

– LH (Luteinising Hormone)

Most of the tests can be performed at any time in your cycle and only take a day for results to come back. I was told that the AMH needs to be performed on the 2nd to 5th day of your period and the results are back in a week. Counts depend on age.

The next day I went back for a half-hour talk with a consultant and an internal ultrasound scan to check for any cysts etc. I did not find the scan painful, and it was quite interesting to see all the internal workings! My consultant was extremely nice and took his time to go through the biological mechanisms, what exactly each stage of the treatment would entail, the statistics and the treatment risks. He also went through my blood results from the day before (excluding the AMH) and was able to give me some idea of my fertility levels.