Hi Pickletilly,
I wanted to respond to you as I've undergone treatment at BH in Cambridge on 2 occasions in the past year. I'll try to answer your questions and give you a run down of my experiences but if there's anything else you want to know, just ask. I apologise in advance if this is long but I'm going to try to cover everything.
The seminar normally lasts for around an hour. You're taken into a room with a group of other couples and you're given a talk by the Medical Director of BH. He walks you though a presentation, giving you an overview of how IVF works and allows you to ask any questions you might have. From what I remember (ours was in Nov 2013), he also talks about what drugs you'll be taking at each stage, side effects etc. I can't remember whether I had the consultation before or after the seminar, but during the consultation, the doctor looked at my AMH levels and told me what dosages I would need to start on.
I started my first treatment in Jan 2014 and whilst I'd got my head around what the treatment was going to entail, emotionally, it's harder to prepare for. I didn't notice any massive side effects mood-wise but all in all, it's a bit of an emotional rollercoaster. During my first treatment cycle, I was given the contraceptive pill to bring on a period, as I have irregular cycles due to PCOS. Once my period started, I had to call the clinic in order to arrange delivery of my medication. Whilst I was waiting to start the meds, I had to go down to BH for a drug teach to make sure I was comfortable with injecting myself.
I started down regging (with Buserelin on day 21) and had to do that for 2 weeks. Once the 2 weeks is up, you then move on to the stimulation phase (Gonal F). This lasts around 2 weeks, although it really depends on how you respond to the drugs. On day 6 of stimming, you go for a scan and the nurse looks at your follicles to see how they're responding. After that, you go back every 2-3 days for repeat scans. If you're not responding as well as they'd hoped, they'll increase your dosage of the Gonal F. I started on 112.5 IU, which was increased after each scan, and by the final 2 days, I was taking 300 IU, which I believe was the maximum dose. Once you have several follicles hit the 18mm mark, they'll give you instructions on how and when to take your trigger shot. Once you've triggered with the Ovitrelle, you then go in for egg collection 35-36 hours later. I didn't respond particularly well the first time and ended up triggering with 4 follicles at size.
I couldn't tell you whether the EC was painful as I was put under general anaesthetic on both occasions. I think it's generally done under local but I have a tilted cervix and one of my ovaries was difficult to get to, so they recommended a GA. Whilst you're getting ready to go to theatre, you're OH will be asked to go off and provide his 'sample'. I don't remember having any pain after EC but you may have a little bit of spotting. After EC, you'll have to stay at the clinic for 2-3 hours and during that time, they'll tell you how many eggs they managed to collect. The following day, you'll get a phone call from the embryologists to tell you how many eggs fertilised. The number/quality of the embryo's will determine how many days you have until transfer. Since I only had 3 fertilise first time around, I had to go for a 2dt. We lost one of the remaining 2 embryo's over the course of the 2 days and the third wasn't suitable for freezing- they have to be above a certain grade, so they have a good enough chance at surviving the thawing process.
In terms of testing, they ask you to wait until 15 days after EC to take the first HPT. Regardless of the result, you need to phone the clinic to tell them. If it's negative and you've started to bleed, then unfortunately, it hasn't been successful. If it's positive or if it's negative and you haven't had any bleeding, they tell you to repeat the test 7 days later. Again, regardless of outcome, you need to let them know. If it's positive, they'll arrange a viability scan, which is done around day 35 (or week 7 of pregnancy). On my first attempt, I was over the moon to get a BFP, especially since I had such a small number of eggs collected. However, when I went for my viability scan, the baby was measuring a week behind and they couldn't locate a heartbeat- I was told that I'd had a MMC. Due to risks of scarring through a D&C, the clinic advised me to await a natural miscarriage and call them back when I was ready to consider trying again. I eventually MC at 10+5 and my only way of dealing with the heartbreak was to focus on trying again.
I had my follow up consultation in the June, where I was told that I would have to wait until September to start my second round of treatment, as they like to leave a 6 month gap between fresh cycles.
Similarly to my first round of treatment, I started down regging on CD21, which was at the end of September. I was on Gonal F slightly longer second time around as they were more consistent with my dosage, upping it very slightly over the course of the stim cycle. At the time, I was getting super frustrated as it seemed to be taking so long but when I did eventually have my EC, they managed to retrieve 12 eggs. Of those 12, 10 fertilised and due to the quantity and quality, they told us they were going to go for a 5dt. We also managed to have 4 embryo's frozen. I did experience a fair bit of pain after EC second time around but I think that was due to number off eggs and follicles that I had.
Due to the experience we had first time around, the 2ww was killer but we did get another BFP, 4 days before the date that our angel would have been due. Again, waiting for the scan was torture and my DH and I were terrified of something going wrong again, but after what seemed like an eternity, they showed us a beautiful little heartbeat flickering away on the screen. After the scan, I was referred back to my local NHS trust but the nurses made me promise that I'd go back to visit once the baby is born. I've had my ups and downs with the pregnancy (all unrelated to IVF) but I'm now 17 weeks along with a baby boy
I won't say that it's an easy ride but it's so, so worth it.
Wishing you lots and lots of luck xxx