Informed Consent

Today we went to see our RE, reproductive endocrinologist, to get informed about IVF and to give our consent to all procedures with their accompanying risks. He went through each of the consents we had read earlier and answered our questions.

The "short" version is:

• He's looking for quality embryos and will most likely recommend implanting no more than two. The only exception would be if we had several low grade embryos, then he'd advise implanting more. He commented that one (and sometimes two) embryo transfers are more standard, responsible procedure in IVF, than the sextuplet fiascoes we read about in the paper.
  
• Charlie's sperm look great, and he got a gold star for that, so ICSI is not necessary. I need to find a t-shirt for the man professing his high quality sperm.
• I will end birth control pills on the 25th.
• I will begin steroids on the 26th.
• I will most likely begin stimulants on the 29th. I have baseline ultrasound and bloodwork scheduled for that day. After that I can expect ultrasounds and blood work about every other or every third day.
  
• The projected date to trigger ovulation is on or around November 7th.
• Egg retrieval 36 hours after trigger, so we're looking at the 9th or 10th of November.
• Transfer somewhere around November 13th, 14th or 15th. Transfer of embryos is 3-5 days after retrieval. We would do a three day transfer if there were few fertilized or low quality embryos. However, if many seemed to be developing, he may advise to wait until day five to see which continue to develop and look best. There is a risk of waiting until day five that no embryos survive, but the risk allows for selection of the best quality embryos.
• 48 hours bed rest following transfer, with light activity following until pregnancy test.
• Pregnancy test 10-12 days following transfer, so that puts us testing around November 26th.
• Initial pregnancy test may be positive, but subsequent blood work will check to ensure hcg is increasing at an appropriate rate to indicate pregnancy.

There's more to the story past the positive pregnancy test, but we'll wait to we get to that point to go any further.

I will go back tomorrow morning to get lessons on administering all of my drugs via injection. I am thinking that will ease my mind a bit.

He did say that his last cycle of IVF patients in September had an 80% success rate with 4 of the 5 achieving pregnancy, so that made me hopeful.

Cross all fingers and all toes. I want this cycle to be the last chapter in my ever expanding file folder of medical records in the infertility department.