IVF STIMS Injections + Daily Monitoring

Four words to describe my emotions right now… I am not ready. But ready or not, STIMS injections start tonight. After two weeks of birth control pills and three miserable blood tests, plus a date with Wanda (the dreaded vaginal ultrasound wand), I was cleared to have my husband start traumatizing me with two injections in my stomach every night around dinnertime.

Injections 
Due to Covid, our clinic switched to online training for all the medications, so we basically bought a 5 grand DIY injection kit. For the first two nights, my husband mixed and prepared the meds (Gonal F and Menopur) alongside the instruction videos, but by night 3, he had gotten the hang of it and didn’t need the videos again until we introduced the third injection.

Two nights in and no, the injections did not get any easier for me. I tried icing the area, numbing cream, Buzzy (a vibrating ice pack supposed to minimize pain), but nothing fully took away the sting, or more importantly, my fear. In fact, it was especially hard on the second night because my husband had to inject me twice with the same syringe in order to get out some remaining medication. (He was a pro after that though, don’t worry.) At 25+ grand an IVF cycle, we were not about to waste any or mess up a dose. I will say the needles are small, so at least there’s that, but the Menopur is no joke. It has a notorious reputation of burning on the way in and let’s just say, the internet didn’t lie.

Monitoring
My first monitoring appointment was 3 days after my baseline (blood work + ultrasound) and then I had to go in almost every morning after that. Thankfully the appointments are quick, but unfortunately; always include blood work and an uncomfortable ultrasound to check follicle growth. Every month, women naturally mature one egg, but the injections help mature as many as possible for the doctor to retrieve in surgery at the end of the cycle. 

Following that initial monitoring appointment, my doctor actually lowered my medication dosages since he saw my follicles were maturing faster than expected. This was a huge blessing since injecting one vial of Menopur versus the original two brought the pain level down tremendously.

Saline Sonogram (SHG)
Just when I had a routine going (injections, monitoring, repeat), my coordinator emailed me about the saline sonogram I needed to schedule. This procedure includes a catheter, saline solution, and an internal ultrasound. By filling my uterus with saline, the doctor is able to check for any fibroids, polyps, or scar tissue. If there are any abnormalities that could affect implantation, the next step is often a hysteroscopy surgery to remove them. I was super nervous, but the test was pretty quick and really important as it’s done to make sure the uterus is clear and ready for an embryo transfer. 

The test wasn’t half as bad as the HSG, but it was still extremely uncomfortable. Good news though… no polyps or fibroids!

Injections Cont
After my monitoring appointment on day 5, my nurse called with the results and instructed me to add in the third injection, Cetrotide. Most people do this one in the morning, but there’s only so much this needle phobe can endure, so my doctor gave me permission to do all three at night. While the first two injections are for maturing follicles, the third is actually meant to keep you from ovulating since the last thing you’d want is for your body to release the eggs before surgery. 

Because my follicles grew quicker than expected, we were able to finish injections after 8 days instead of the anticipated 11-12. Woo! That meant we had more than $1,500 of medication left over, which was a huge blow, but I was more than happy to stop. 

Monitoring Cont
Over the course of STIMS, I had a total of 5 monitoring appointments, plus the initial baseline and pre-egg retrieval blood work. That means 7 blood draws in 10 days. I felt like an actual pincushion and my inner elbows became so bruised that I started running out of veins to use. 

The Trigger Shot
Toward the end of STIMS, you go in for monitoring every day so the doctor can determine exactly when your follicles are big enough to trigger ovulation -- enter the trigger shot. This injection forces your body to ovulate and exactly 36 hours later, your eggs are surgically removed.  

After 8 days of injections, I was finally ready to trigger! I was initially prescribed two trigger shots, but based on my body’s response, my doctor changed it to one and we were instructed to use it at 11:40pm on the dot. Not a minute sooner or later. 

It felt incredible to be done with injections, but a part of me was seriously anxious that there was absolutely nothing left for me to do to help mature my eggs. It was really all in Gd’s hands now. My husband was not as excited to be done because he was thoroughly enjoying living out his doctor dreams for a week. lol

Final Bloodwork 
The morning after the trigger shot, I went in for one last bloodwork appointment to make sure everything looked good for surgery the following day. 

The final appointment was actually the worst because the stick was so painful and blood wouldn’t come out, so the phlebotomist had to try again. My veins were just done. I had to keep a heating pad on my arm for a few hours afterwards before the pain stopped. 

As always, my nurse called sometime in the afternoon with the results and I was told my egg retrieval surgery was scheduled for 11:40am the next day. EEK!

xx Esther

*These posts do not reflect my current situation as they were written in the moment. 
Still waiting on our miracle, but sharing now to help others feel less alone. 
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