Ok, so we are up to the point of cycle day 9 (CD9). This is the appointment when they go in and check your follicles to see how they are progressing. Based on that appointment (blood work and ultrasound) they have a pretty good idea of when your Egg Retrieval (ER) will be. When you find out your time for ER, they also tell you the time of your HCG shot. Sometimes it can be in the middle of the night, so that can be a little nerve wrecking! Once you take your HCG shot, you do not have to take any other injections....well until after ER:)
During Egg Retrieval, you are placed under anesthesia--it is really like conscious sedation, although I have never remembered anything! While you are in the back, your husband in giving his "sample." At SIRM they use Intra-Cytoplasmic Sperm Injection (ICSI). This is where the embryologist takes a single sperm and injects it directly into the egg. This helps to promote fertilization. Some clinics still just put the eggs and sperm into a petri-dish and if it happens, good. The rest of the day after ER, you are just supposed to take it easy. Depending on how you feel, you can go to work the next day, but they recommend that you take it easy. They day after ER, they call with a fertilization report. They tell you how many were retrieved, how many were mature (they have to be mature in order to have a potential to fertilize), and how many fertilized. They then give you a tentative time for an Embryo Transfer (ET). You also begin progesterone shots--which is what the body produces in pregnancy. These shots are not fun because they are intra-muscular (IM) and have to be done in the butt every night!
At SIRM, they do 3-day transfers or 5-day transfers. There is a lot of controversy in the field over which is best. Some say that 3-days are best because the uterus is the best environment for them to grow. Others say 5-days are the best because if embryos can make it in the lab for 5 days then they are very strong and have a good potential of creating a pregnancy. I just do what the doctor tells me to do! Usually if you have a lot of good looking embryos on day 3, then you are pushed to day 5--at least that is my experience so far. For ET, you have to go in with a full-bladder (not fun!) which makes it easier for the uterus to be seen on the ultrasound. They also give you a Valium to help you relax for the process. The doctor discusses how many embryos they feel should be put back, then as a couple you decide if you agree. They they use an abdominal ultrasound to see the uterus (usually one of the nurses does this part) and the doctor uses a catheter, which is guided by what she sees on the ultrasound, and places the embryos back in the uterus.
After the embryos are transferred, you lay on the bed for 30 minutes and then are released home for at least 24 more hours of bed rest. You also have a 10lb weight restriction and no extra-curricular activity (wink-wink!) for several weeks. About 8-9 days later you go in for a blood HCG test and then again two days later for another one. If you are pregnant, you will have some sort of number on your first test and then that number should double by the second test. You get a call the day of the second test and are told if you are positive or negative. If you are positive you set up a time for an ultrasound to see if the pregnancy is progressing. If you are negative, you find out when to discontinue all meds and then are told to call later and set up a follow-up with the doctor.
Wow--it is a lot to type out! Sorry if it was at all confusing.