The baby recipe, or given it's proper name, the IVF protocol, sets out exactly what drugs you are going to be on, for how long, and what else needs to be done in that time, ie scans / blood tests. We called it the baby recipe when it arrived in the post because to read through it it reads exactly like a recipe! Listed at the top are the ingredients (drugs), followed by the step by step recipe (protocol). IVF protocols come in all shapes and sizes, based on that individual's previous results of blood tests and scans, but are largley split into two main groups - the long protocol, and the short protocol.
The long protocol works by firstly using drugs (eg burserelin) to switch off your reproductive hormones and puts your body in to a state of temporary menopause. The drugs are usually started on day 21 of your cycle. This can give you the symptoms of menopause, eg hot flashes, nausea, night sweats, mood swings. During this period you will have a period. Following this you are started on the stimulating drugs (menopur or gonal F) which switch your hormones back on, and stimulate them aggressively to thicken the womb's lining and tell the ovaries to start producing eggs at a rate they never have before!
The short protocol is the one I have been put on. The short protocol is often favoured when there is a risk of ovarian hyperstimulation, because you have lots of follicles on your pre-treatment scan (I had the top end of normal), there has been poor ovarian response in previous cycles, or the woman is a bit older. It is known to be less aggressive than the long protocol, and current thinking is that it is better to put your hormones to sleep for a bit and wake them up slowly, than to switch them off altogether and then jolt them awake…and that the short protocol gets better results in terms of healthier eggs. More and more people seem to be offerred the short protocol now.
The short protocol involves starting on day one of your cycle (hence our last post of waiting for mine!). The first step is to put your ovaries to sleep, and there are various drugs which do this, one of which is often considered the most simple, which is to take the oral contraceptive pill. I will commence the oral contraceptive pill, microgynon on day one of my next cycle, and will continue this for between 3 and 6 weeks. Three weeks is the minimum time it takes for your ovaries to be sufficiently asleep, but it is very safe to take pill packets 'back to back' ie up to six weeks. Exactly how long I take it for will depend on our egg recipient; where she is in her cycle, when she is ready to receive my eggs etc. We both need to be at the same point in our cycles on exactly the same days. Once the clinic give me the go ahead (they have said we will work towards it being 3 weeks, but it may be 4), I will stop the pill and wait for my withdrawal bleed.
On day two of the withdrawal bleed I will commence gonal F injections, drugs which awaken your ovaries and tell them to start to grow us some lovely eggies! A second injection, cetrotide, will be added in from Day 6 onwards, to stop me from ovulating! Both injections continue for approximately 6 days, although I will be scanned from this point onwards to see how the eggs are doing, to see if I need to change the dosage of the drugs I am on, and to predict when egg collection might be.
Therefore egg collection will be approximately 4.5 weeks from starting the pill, but it may be a bit longer if I need to carry on on the pill for a while longer (we are happy either way!). The final drug involved is a 'trigger shot'. This has to be perfectly timed for egg collection, as it needs to be taken exactly 36 hours before the eggs are collected. It tells the follicles to mature the eggs so that they are ready to be collected. Eggs are collected, split 50/50 with our recipient, and our half is mixed with our donor's sperm.
Approximately 3- 5 days later, providing all above goes to plan, we will have a single embryo replaced inside my womb, where it will (fingers crossed) stay, grow and turn in to a beautiful baby! We can take a pregnancy test from about 12 days following embryo transfer.
I just wanted to write all this down, as I am someone who needs to know everything. I want to know what drugs are what, why I've been given what I have, and how it all works. Once I am in possession of all necessary information I can relax and let it all happen, but not knowing stresses me out! But having spent hours and hours googling, I couldn't find any straight forward information on the two types of cycles, and the drugs used, so I hope this information is useful to some people!
(Today is Cycle Day 1. Today we 'officially' begin our first ever IVF cycle!)