Feb 25 2011

IVF Part Two: Flurry of Tests and Consents

Published by at 3:04 pm under Infertility,IVF,The Man

The Man and I had both had a bunch of tests done when we were first starting treatment for infertility, but once we came under the care of Dr. Singh at WSU, the testing had to start over, because it had been about three years since the initial tests were performed. For The Man, this meant another semen analysis and getting a vial of blood drawn. For me, it was slightly more involved. I needed:

  • Blood work requiring nine vials of blood. I’m not totally sure of everything they were looking for, but I know one of the things was making sure I was not a carrier of the gene that causes Cystic Fibrosis. If I was a carrier, The Man would also have to be tested to see if he was a carrier. (I ended up not having the gene).
  • A regular pelvic ultrasound
  • A Pap smear
  • A sonohystogram – boy, was THIS pleasant. Or not. My advice is that if you’re having this done, take three ibuprofen about 30 minutes before the test. It might help with the cramping.
  • A trial embryo transfer, which basically is them pretending to transfer embryos to make sure they’re not going to run into any issues.
Because WSU is near Detroit (actually in the city of Southfield), and we live about two hours away, a lot of those tests were consolidated to save us driving. On one day I got my blood work and pelvic ultrasound. We drove back a week later to do the Pap, sonohysogram, and trial transfer. I was quite glad that I had The Man with me after the second day of tests, because for about 30 minutes afterward, I felt like someone had punched me in the guts, repeatedly.
If I had been over 35, I would also have had a Clomiphene Challenge test. If I were over 40, I would have had to have a mammogram done within the past year.
After all of our tests were completed, we had to meet with Kris, who is one of the nurses at WSU who works with patients on what to expect and guides them through the process. At the meeting, we went over everything that would happen during the process, including all the drugs I’d have to take, and all the tests that would be done during the process to monitor me for ovarian hyperstimulation. The class was overwhelming, because you’re covering a ton of information in under an hour, but the point is not for you to come away having memorized all the steps you will be taking. The point is to give you an overview of what’s coming up, and to answer any questions you might have. WSU also gave us a big packet of information including a timeline and all of the information on the drugs I’d be taking. Kris gave me her direct number and told me to call her immediately with any questions.
One important piece of information we got from the class was that once we started on the stimulation drugs, I’d have to be at WSU every couple days in the early morning for testing. This led us to decide to book an extended-stay hotel for the duration of the stimulation/implantation period. We just couldn’t see driving back and forth to Detroit, leaving our house at 5 AM every other day or so.
The final step is signing the consent forms. I’m not sure if all places are this form-heavy, or if WSU’s lawyers are just overzealous. Dr. Singh told me that they were working on consolidating the forms, which would be nice. We had about five separate consent forms to sign, and each consent required multiple signatures. The forms we had to sign consisted of:
  • Informed Consent to IVF Procedure: Outlining the general risks and possible outcomes (or lack of outcomes) in undergoing IVF
  • Informed Consent to Gonadotrophin Therapy: Because the injectables you use during IVF may cause ovarian hyperstimulation, which is a potentially serious condition, and can be fatal if left untreated (in rare cases), we had to sign this consent saying we understood the risks.
  • Informed Consent to Micromanipulation: Not every IVF procedure requires micromanipulation, which includes Intracytoplasmic Sperm Injection (ICSI), which is using a needle to inject one sperm into one egg. Micromanipulation may also include assisted hatching, which is chemically weakening the cell walls, allowing the embryo to more easily hatch. But, Dr. Singh recommended ICSI in our case, so this consent was necessary.
  • Informed Consent for Cryopreservation: This is if you want to store your excess viable embryos for later use, in case the procedure doesn’t work or you would like to try for more children later. This form contained a lot of decisions like: what do you want done with the embryos if you both die? Or divorce? Or one of you dies?
In addition to these four, we had to sign a separate agreement with the cryopreservation facility, basically agreeing to their storage fees and saying that we know that not every embryo survives cryopreservation.
Once the consents were signed and the tests were done, we were ready to go, theoretically. In reality, we had to wait for a month or so for our financing issues to be resolved, which was fine with me. I needed to gear up for the next phase: stimulation. But before that, we had to get a whole bunch of drugs.

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

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