Injections, injections, injections. There are a lot of them when you’re having IVF, and you have to do almost all of them yourself. Depending on the protocol your clinic decides is best for you (it can be a long or short protocol), and how your body responds to the drugs you may have several weeks worth of daily injections.
We had what is know as a long protocol, which meant that you first have about two weeks of daily injections to ‘down regulate’ your reproductive system. These injections bring your own natural hormones down to a base line and the effect they have is often compared to going through the menopause (with the possibility of very similar symptoms.) If all goes well with the down regulating then a second daily injection will be introduced to begin stimulating your ovaries.
Our first injection was at the hospital at what they call the ‘injection teach’. One of the nurses walked us through our kit and showed us how to prepare the syringe and safely carry out the injection. It felt so surreal that the next day (and the next and the next) we would be doing this ourselves. Surely we couldn’t be trusted with something with such huge consequences?! We left the hospital with our little bag, full of needles, syringes and drugs, and our very own sharps bin. It suddenly felt very real, and quite special. At home we set up something of an injection station on the dressing table and tried to take it all in!
It was nerve wracking to begin with but we soon found our rhythm, with alex preparing the needle and me actually doing the injection into my stomach. Most days I could barely feel the needle as it pierced my skin, it was so fine, once or twice there would be a tiny spot of blood. We always had a little bit of cotton wool ready to press on the injection site just after.
I did feel some of the side effects of this first drug, but I realise that I perhaps had it easier than some women. I had a couple of absolutely crazy hot flushes which seemed to come from nowhere, and a few days of hormonal headaches. I also had mood swings of course, but I found it so hard to know whether these were down to the drugs affecting my system, or just due to the huge pressure of the situation! This was something I felt throughout our treatment…when I felt sad or fed up or angry, was that the hormones doing it, or was it the fact that we were so emotionally invested in this highly tense situation?
After a fortnight, and successfully down regulated, the second injection was introduced. This one was a little more fiddly to prepare as you had to mix the powdered drug with liquid before sucking it up into the syringe and injecting.
Over the days that followed I could physically feel my ovaries swelling as the drugs began to take effect. After 9 days I went in for a scan and the doctor carefully counted and measured the number of follicles which had grown on each ovary. For many women having IVF there may be several scans over several days, as you are watched to see how your body responds to the drugs and to wait for the optimal moment – that of enough growing follicles to increase your probability of a successful egg collection, but not so many so as to be ‘over stimulated’. Incredibly for us the doctor decided my ovaries looked ripe on my first scan and prepped us to come in for egg collection the following Monday (2 days later.)
And so to the final injection, this is the big one: The Trigger. So much rests on this and the clinic are very clear to impress the importance of doing it just right at just the exact moment it needs to be done. This drug had been sitting in our fridge from day one, waiting for its moment, and would signal my ovaries to get those little follicles and eggs ready to leave the mother ship. It is precisely timed to fit in with your scheduled egg collection operation and the pressure on doing it correctly felt enormous!
Luckily they made it as easy as it could be for us, the injection was in a pre-prepared pen, all we had to do was correctly use it at the right time. After double, triple and quadrupley checking it we took the final plunge, as it were. Now all we had to do was wait and hope we’d done it correctly.
I remember when I’d first read the ‘what’s involved’ sheet our clinic gave us about the treatment protocol we’d be following. I got so upset. I felt like something had been stolen from us that we would have to go through all this just to give us a shot at what seemed to come so easily for so many others. But now I know how much we gained. The period of time when we were having our daily injections each morning was so precious. It brought us closer in a way I think few other things could have, and even now Alex often randomly looks at me and says ‘remember when I used to inject you?’. It’s a uniquely intimate thing to go through together and I’m grateful to have shared in the experience with him.