IVF clinic comparisons (Australia)

Someone just posted this link on an IVF Facebook group I'm in & I thought it was really useful.
Sorry, it's only for Australia.. hopefully there's similar sites out there for other countries.

http://ivfcompare.com.au

It's worth noting, though, that with clinics that appear to have multiple locations in the one city, e.g. Genea in Sydney, some clinics are only for blood tests and ultrasounds. You usually have to have an initial appointment in the CBD (or main location) with a nurse to sign up, go through and collect your medications. You may also need to have your procedures (egg collection and transfer etc) in their city day surgery. So make sure you keep that in mind when choosing a clinic based on location, and ask these questions.

For us, IVF Australia was much more convenient as everything was done in Greenwich & they had an (albeit small and poky) car park. Bump also did everything in Mosman & had a great car park, plus they had a courier deliver all your medications to you. With Genea, I get my monitoring in St Leonards but everything else requires a trip to the city on public transport which I find a bit of a pain (no car park, even for day surgery pickups, although there's VERY limited street parking out front).

That's just my comparison on convenience. As you'll see on the website, IVFA & Genea are the most expensive with Bump bulk billing most things. Bump wasn't for us as they provide quite standard treatments & I needed a more "out of the box" approach after so many failed cycles. I think a lot depends on your specialist also. My FS at IVFA was great, got us pregnant twice, but after the birth of our son, just kept using the same protocol despite no change in results. We moved to Genea for a new approach & they have great success rates. The FS I went to is well known for second opinions & has tried me on a couple of different drugs.. I guess if that doesn't work then at least I'll know we tried everything.

Hope this helps!

Mixing injections (for dummies)

I remember the first time I had to mix my injections. I'd done about 8 cycles with premixed pen injections, so they were simple. Then I was given the powder & water vials to mix myself & I freaked out! I had no idea what to do! The nurses thought I had done it all as I was a bit of an IVF "veteran".

So here's my little IVF community service:

This is my Luveris. 

I get two vials - one is water for mixing and the other is powder (which is the actual drug):

Flip the lids off the vials & discard:

Place the largest needle onto the end of the syringe & remove

the plastic covering:

Poke the needle through the middle of the rubber covering on the vial of water:

Turn the bottle upside down, pull the needle out a bit so the tip is underwater, & pull out the syringe plunger to remove all the water (you may need to pull the needle out a bit more as the water level goes down):

Inject this water into the vial of powder & swish side to side until it's mostly dissolved (do not shake it up, you want to avoid bubbles). Then use the same process above to draw the new solution back into the syringe. Place the cover carefully back over the large needle & remove. 

Attach the small needle, remove the plastic cover, push the plunger VERY CAREFULLY & SLOWLY to remove most of the air from the syringe. Be careful not to squirt all of the solution into the air! I try to keep a thumb in the way so I can't accidentally push it all the way. Pinch your skin & inject into your tummy. This one can be a bit ouchy so I sometimes ice the spot first to numb it a bit.

Now this is my Cetrotide. It's a very similar process, however the water is already loaded into the syringe.. you pull the White plastic cap off and instead of pushing the large needle onto the syringe you actually screw it on, then pull the plastic lid off. After injecting the water into the vial of powder, mixing and drawing it back up, you place the plastic cover back on the needle & unscrew it again. Then screw the small needle onto the syringe, remove the air & inject into your belly. 

Hopefully this all makes sense!

You might also want to use the alcohol wipes on your belly before injecting. 

I understand these tips might not apply to other medications.

Anyway, feel free to ask if you have any questions & I'll endeavour to answer them.

Happy injecting!

First scan & blood test results

Cycle day 11, day 8 of injections:

This morning I had to have my blood test & first scan. I went to the local clinic just after 8am, figuring I'll get it done early & have just enough time to go home & make my lunch before walking to work (which is 5mins away)...... WRONG!! I walked in & it was standing room only! It's a tiny waiting room & it was full to the brim! There's usually only about 2-3 other women in there, if that, but this time there would have been about 15! It seems that people have been diverted to other branches for their tests until the fire and water damage is repaired in the city headquarters. What a nightmare! I was in there for about 45mins. I had to duck off to the toilets to do all 3 of my fiddly bloody injections (lucky I brought them with me!). A lady went into the cubicle next to mine & just sat there, listening to me unwrapping everything & clinking bottles. God knows what she must have thought!

Anyway, I only have 3 follicles - 10mm, 8mm & 6mm (or thereabouts). My uterine lining was around 5mm. So I was told by the nurse this afternoon to keep stimming over the weekend & come back for another BT & ultrasound on Monday. This cycle really isn't looking much better than the last few. And despite googling my head off, I know deep down there's nothing I can really do about it now. It's all up to fate.

Anyway, on the positive side, the nurse told me the day surgery in the city should be back up & running on Monday. One less thing to worry about!

Fertility under fire

Yesterday I found out (thanks to a woman on Facebook) that there was a fire at my clinic on the weekend.. apparently there was significant damage caused to the reception area, day clinic & day surgery, but stored embryos, eggs & sperm weren't affected. This woman was told her transfer couldn't go ahead as planned this week & if her one embryo wasn't deemed strong enough to freeze they would let it expire. I'm horrified & distraught for this lady. Like me, she gets very few eggs collected, then is lucky for them to fertilise, so this new development is a huge blow and may cost her the chance to conceive another child. Thinking of her this week x

I haven't yet heard if my procedures will be affected next week. I was going to call but I'm assuming they're flat out making other arrangements for this week's procedures, so I'll give them a bit of space. I go to a smaller clinic close to home for monitoring on Friday so I might wait to ask them. Hopefully the repairs are fast-tracked & all is sorted again by then.

Today I started taking Cetrotide. So that's 3 injections every morning! My belly is already tender! And what a production it is every morning, mixing the powders and water! Why can't the Luveris & Cetrotide come in convenient pre-mixed pens like the Gonal-f?? And why do the needles have to be so fat and so bloody ouchy going in??!! I'm ok with needles, the Gonal-f is a breeze, but these other two....

God I hope they're all doing their thing in there.. I'm nearing the end of the road. I really don't think I can do this anymore. I feel optimistic, kinda, but if we only get one egg, or even one embryo at the end again, I think it's time I accept defeat. Perhaps someone's trying to tell me something. Perhaps I AM being too greedy wanting another child. Perhaps I'm not even being the best Mum to him & I need to work on that. He really does deserve my undivided attention and a healthy & strong mum. Pumping all these hormones for this long can't be doing me good. I've got some hard thinking ahead of me.

Injection day

After my blood test this morning I got the call from the clinic to confirm all my levels were good and it was time to start the injections. The nurse rattled off some vague instructions at warp speed and seemed in a hurry to finish the call. I had to stop her and double check a few things.. I think they all just assume if you've done more than a few cycles before that you don't need anything explained. To be honest , in the few months between cycles I pretty much wipe my memory of all things IVF... or at least I try to.

So anyway, I believe my instructions are:

* Begin 300iu Gonal-f and Luveris injections tonight (CD4)

* Continue having Gonal-f and Luveris injections once daily from tomorrow morning

* Add once daily Cetrotide injections on Tuesday (CD8)

* Have blood test and ultrasound next Friday (CD11)

Originally they said my EPU would happen the week beginning Feb 22 so fingers crossed things go according to plan (read: fingers crossed I have more than ONE friggin egg to actually retrieve!).

(This is just the Gonal-f & Luveris)

Light period = poor lining??

So I found out yesterday that I'm also meant to be on Luveris again during this cycle. The pharmacist had me pay for it over the phone and then delivered it to me at work today. Tomorrow I will go in to the local branch to have my first blood test for this cycle and find out later if I am to start taking the Gonal-f after that. Tonight I took my last Progynova tablet, so was only on it for a week.

On another topic, today is CD3 and my period is so light. TMI but I barely need a tampon. It does worry me a little that this is reflective of a poor uterine lining. I've mentioned this to a nurse in the past but my concerns were brushed off. My linings have coincidentally been borderline leading up to transfers a few times so I still worry a little. I guess we'll see.

CD1

It's funny how your period starting can go from being such a massive negative (pardon the pun) one month to being such a great thing the next. This time I'm stoked - it started right on time and signals the start of possibilities.

Last month, for some monumentally STOOOOOPID reason, I had dared let myself believe I *could* be pregnant.. which is 99.99999999999999999999999999% impossible considering DH's 20 year old vasectomy and my.. well.. 40 year lack of fertility.. Why does a supposedly educated, intelligent and mature (ahem) woman talk herself into believing something so ridiculous? Because she WANTS to believe it. I have always had this fantasy that I would eventually fall pregnant naturally despite all our difficulties, just like that Facebook forum poster's cousin's friend's sister's hairdresser's sister-in-law did. If you Google "pregnant despite vasectomy" etc you WILL find a slew of people claiming it happened to them, or someone else they know. What you didn't Google was "delusional woman not pregnant despite thinking she could beat the odds and medical science". Because if you did - you'd see a giant picture of my pitiful self... NOT pregnant. So here I am trying to do many of you a favour.. here I will list all of my "pregnancy symptoms" that were actually just signs of impending AF (or imaginary altogether) and, embarrassingly, a UTI:
* Sore nipples
* Sore breasts
* Bloating
* Frequent urination
* Heavy feeling in the belly
* Strong sense of smell
* Empty feeling in the tummy - frequent hunger

I'm only listing this as I think it would have helped me when I Googled my symptoms, instead of it telling me I was up the duff and getting my hopes up. You might be.. but you also might not. I really hope you actually are.

Anyway, I digress. Today I went into the city to pick up my medications. DP and DS came in with me  for a day out but I went into the clinic alone. The pharmacist asked if I knew what drugs I was picking up which freaked me out a bit.. aren't they supposed to know? Turns out I'm also meant to be taking Luveris on top of the Gonal-f and Cetrotide, which the nurses I spoke to didn't mention. Anyway, a call later confirmed they would send it to the clinic closer to home so I can pick it up when I go for my blood test on Friday. I might be starting them medications on Friday but I think I'll call them tomorrow to confirm AF started today, just in case. My plan is different this time so I just want to make sure I don't stuff anything up.

So we went out after the clinic & had a lovely day, however I had to carry the medications around everywhere in a cooler bag with an ice pack. It was a pretty warm day and I was a bit stressed worrying about whether they were cold enough!! :-/ DH & I had a few drinks with lunch (I always have a few leading up to a cycle just in case I have to abstain for at least 9 months after ;-) but I didn't have enough water to drink so subsequently I have been nursing THE.WORST.HEADACHE I think I've ever had (apart from migraines). Rookie mistake. Thanks Progynova.