Wednesday, February 15, 2012
GENERAL IVF HINTS
The main IVF hint is to pamper yourself! An IVF cycle is a very stressful thing and anything that helps you through it without harming a potential baby is okay!
Decide ahead of time where and how you want to get news each day for how much medication to take, etc. This is especially important on the big days of finding out about fertilization and pregnancy test. Those days can be tough if things don't go well! You might want your partner or a good friend around!
Rest is very important, even before transfer. All those developing eggs are taking up a lot of space and energy.
Try to get to know the people who are treating you so you aren't just another patient.
It may help to make a friend or two who is at the clinic for IVF, too.
Bring a book, magazine, or hand-held game with you to appointments. You might be there for awhile.
Make sure they do a mock transfer prior to the actual embryo transfer. This is not fun, but it is necessary that they know the depth of your uterus so they know where to put the embryos.
Do whatever it is you need to do to make this manageable for you. (Naps, backrubs, favorite foods, etc. Be very good to yourself during this time.)
Small amounts of alcohol will probably not adversely affect you or your eggs, but caffeine has been shown to affect fertility, even in small amounts, so try to avoid it.
Buy a good, up-to-date fertility book and try to find out as much as you can about the IVF process beforehand. There are always new advances, so try to keep up with the changes in techniques.
Always ask your RE a lot of questions about your progress, what the numbers mean, etc. That is what they are there for! Also, you should be able to get copies of anything in your file (like your follicle growth and E2 test results and fertilization report). The more knowledgeable you are, the more likely they are to openly share information and take time to explain.
It can be very comforting to find someone, either in cyberspace or in person, that is in a similar situation (factor, cycle) that you can share stories and progress with.
Try to keep a very flexible schedule the week before the pregnancy test. Some people start their periods early and are stuck somewhere where they cannot just be alone and grieve.
Start taking a prenatal vitamin prior to your cycle. At the minimum, you should take 400mcg of folic acid daily for three months before conception to reduce neural tube defects such as spina bifida. The FDA suggests 800 mcg during pregnancy, so it is best to look for a prenatal with that amount.
Some clinics believe that a diet that is high in protein and low in salt and potassium can help you avoid hyperstimulation. Gatorade is a poor choice of fluid to drink to prevent/control hyperstimulation because it contains large quantities of salt. Water or Pedialyte is best, in quantities recommended by your RE. At a certain stage of OHSS, too much fluid can be detrimental.
Remember that some people get very uncomfortable and even have a lot of pain as the ovaries are stimulated. This may get worse as the follicles ripen. Loose clothing may help.
Don’t worry about your weight unless you are tracking it for hyperstimulation purposes. Unless you hyperstimulate, most of the weight gained during an IVF cycle usually disappears once your period starts and if you are lucky enough to get pregnant your weight won’t matter anyway!
If you are not taking birth control pills the cycle previous to your IVF, be sure to use birth control (no matter how ridiculous it may seem). Usually, you will start Lupron before you would know if you conceived or not and Lupron is very dangerous to a developing baby.
The extra fluid your developing follicles are taking up and being NPO before retrieval can sometimes cause constipation. Increasing your consumption of fiber and fluids as you approach egg retrieval may help alleviate this.
Don't talk to your partner too much about his role. This may cause him extra anxiety during an already stressful time and the extra stress can aggravate the performance anxiety that men suffer on the day of retrieval.
If this is your first IVF, be conservative about the number of blastocysts or embryos you transfer, especially if they are of very good quality. You may find that fertilization was your big hurdle and now that is complete you are on your way!
If you have had more than one failed IVF, consider changing clinics, especially if your doctor doesn’t have a change in protocol planned.
Remember that all cycles are not alike. Using the exact same protocol on another attempt even at the same clinic can lead to different results.
Some clinics use medications to prevent embryo rejection (low dose corticosteroids, etc.) which may help your chances of success. Check with your clinic to see if they think it would make a difference for you.
Always repeat the directions for medication to the nurse and get your E2 level. If something seems wrong or unclear, ask for clarification.Prior to the stimulation part of your cycle, make sure you and your partner discuss how many embryos or blastocysts you plan to transfer. (While remembering that your plan may have to change because of circumstances of the IVF!) If you think you will have extra embryos beyond what you want to transfer to avoid high order multiple risk, decide whether you will freeze them or discard them. Decide whether you would consider selective reduction. These are not things to discuss under pressure right before transfer!
POSITIVE THINKING AND DE-STRESSING HINTS
Try self-hypnosis tapes to keep your mind on warm and fuzzy thoughts.
Keep social contacts to a minimum.
Use the cycle as an opportunity to focus on yourself and on each other.
Try to relax and think positive.
For sanity sake, review the odds of success ahead of time. Some people try to stay as neutral as possible to avoid major ups and downs, others try to stay hopeful to help make all the procedures easier.
Try doing things to take your mind off the process. Visualization may just make the obsessing worse.Try to manage stress in whatever way works best for you. Some suggestions are relaxation or deep breathing exercises, yoga, or meditation.
EGG RETRIEVAL AND EMBRYO TRANSFER HINTS
You will probably need at least the day after your retrieval off of work. You may be in pain or you may just be tired and need the rest. Levels of pain post-retrieval vary from person to person. Some people may have little or no pain and others may have a lot of pain. Be prepared for both extremes.
Prior to retrieval, remind your partner (or the nurse if your partner isn’t there) to keep pressure on your IV site for you once it is removed (especially if you are taking baby aspirin or heparin). You will still be a bit woozy and may not remember.
Often the medication used for sedation for retrieval is one that causes amnesia, so don’t be worried if you cannot remember everything that happened. It is disconcerting, but not a problem. Remind your partner about this so that he doesn’t expect you to remember everything!
Some people have reported that the sedation used for retrieval can cause nightmares.
A heating pad on your belly may help with pain after egg retrieval.
If you are concerned about nausea during the retrieval, ask for something to stem nausea. A drug called Phenergan is a mild sedative and also will help keep you from vomiting or having nausea from other medications.
Have someone there to drive you back from retrieval and transfer.
Make sure that you tell them about any allergies. You may be given a narcotic pain killer afterwards. If you have problems with narcotic pain relievers, you can ask for a non-narcotic pain killer which may work just as well for you.
Eat a low fat diet for a few days before retrieval. Sometimes the embryos are stored in a vial of the mother’s blood, and they don't react well to fat (or is it lipids, or whatever), which can temporarily rise as a result of high dietary fat intake. (You can check with your clinic ahead of time to find out whether they use your blood or not.)
Some clinics suggest you avoid soaps, shampoos, and perfume on retrieval and transfer day as embryos can react poorly to odors.
Don’t wear fingernail polish to retrieval. Some clinics use a clip on your finger to read oxygen saturation levels during retrieval and fingernail polish will interfere with that.
Remember that not every follicle contains an egg, so don't be surprised if the number of eggs harvested is less or more than the number of follicles you've been watching develop.
If you have any significant pain within the first couple of days after retrieval, something may be wrong. LET YOUR CLINIC KNOW IMMEDIATELY! Some people have had a blood vessel nicked which led to internal bleeding so they had to go to the hospital for monitoring.
You may find it very hard to lay still for the required time after transfer (this varies some from clinic to clinic). You may want to bring extra pillows to make you comfortable, or some music to distract you.Many clinics aren't requiring *any* post-transfer rest, as recent studies indicate it has no impact in success rate. If it helps you feel like you are doing everything you can, rest as much as you feel necessary.Most clinics recommend you avoid the following after transfer: swimming, saunas, baths, intercourse, orgasms, lifting over 10 pounds, exercise that breaks out into a sweat. So, look forward to taking it easy!
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