This is a guest post by Hellobee community member Mrs. Green Grass.

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When Bee asked for guest posts about IVF, I figured it was time for me to step up. My husband and I started TTC during our honeymoon in August of 2010 when he was 41 and I was 30. We felt a bit of a rush because of his age.  We finally got some testing about a year later after absolutely no luck, but didn’t quite feel ready to pull the medical intervention trigger. In September of 2011 we had a chemical pregnancy.  That really pushed us towards the medical end because we came so close. Finally, in January of 2012, we started working with a Reproductive Endocrinologist (RE).  We did 3 Clomid plus Intrauterine Insemination (IUI) cycles (the “Turkey Baster” according to DH).  But none worked.  In March we made the decision to move to In Vitro Fertilization (IVF).  I’m currently 11 weeks pregnant… so it’s been well worth it so far!

I’m an English teacher, not a scientist, so hopefully I can break down IVF into the most understandable basics for you today and throughout this short series.


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Before you can start IVF, you have to have an STD panel as well as a blood test of all of your hormone levels and a semen analysis for your husband.  The STD panel is law, but the other tests give the doctors valuable information about what may be causing the infertility – although rarely is the answer clear-cut – and what type of medical protocol to use during the IVF.  My husband’s morphology (the shape of his sperm) was below average.

On my side, I always spotted for a couple of days before I got my period.  The doctor said this is like “pulling the carpet out from underneath the embryo before it can get comfortable.”  I was also right on the edge of normal for the tests that looked at ovarian reserve (how many eggs you have left).  As your egg supply diminishes, fewer eggs are of a high quality, which definitely impacts how quickly/successfully you can get pregnant.

At an initial IVF consult, you discuss payment, get all of your prescription information, and get a calendar of when everything will happen.  From this point forward, you go on some type of birth control until your baseline ultrasound.  At this ultrasound you want everything in your ovaries to be “quiet.” No follicles.

My baseline ultrasound was good, so I started the big meds that night.  I had never done injections before, so this was very different!  For the first 8 nights or so I took 2 vials of Bravelle and 1 vial of Menopur.  These are in powder form, so first you put sodium chloride in your syringe.  Then you squirt the liquid into 1 of the vials, swirl it around, pull it back into the syringe and then repeat with the other vials.  You can inject meds into your belly or thigh.  I did belly exclusively.  The needle was only 1/2 an inch long, so the injections were not that bad.  They stung a little, but I got used to them pretty quickly.  I did bruise, but I bruise pretty easily.

You go in for your first monitoring appointment after 6 days of meds (in my case).  They do a vaginal ultrasound to see how things are growing.  You can see all of the follicles on the ultrasound, which is pretty cool.  Then the nurse measures each one.  The goal is to have a decent sized amount of follicles that are somewhat similar in size.  If one is much bigger than the others, it can hurt the rest of the cycle.  If the follicles are growing too slowly, your medication may be increased.

Towards the end of monitoring, you have to add a new drug to make sure you don’t ovulate on your own.  The one I took was called Cetrotide.  I took this for the final 4 nights of stimulation meds (stims).  During the last few days, I had ultrasounds almost every day, which was difficult with work.  Finally, after 12 days of stims, they said I was ready to trigger!

I triggered exactly 36 hours before the retrieval, at 10:00pm at night.

The retrieval is under full anesthesia so you can’t have anything to eat or drink after bed the night before. At this point you will be extremely bloated and uncomfortable because your ovaries are much bigger than usual.  This is also why you have to cut down exercising during IVF.  If you bounce or twist, you can have ovarian torsion (twisting), which is apparently extremely painful.  I didn’t feel like working out at all at this point. Prior to this I was playing soccer, running occasionally, and doing yoga.

I took a Zofran for anti-nausea before the procedure, got all prepped, walked to the operating room with my IV in, looking hot in my little hair cap, sticky socks and gown, sat down on the table and the next thing I knew, I was OUT! That stuff works quickly!

For the procedure, they insert a needle through the wall of your vagina, into the ovary and aspirate (take all of the liquid out) each follicle.  The embryologist checks to see whether there is an egg in each follicle.  I believe I was 12 for 12, which is rare.  You often have a few follicles without eggs.

Your husband will have already given a semen sample before the procedure, so while you recover, the embryology team takes over.  There are 2 options now.  1) Put the sperm into a petri-dish with all of the eggs and let nature take over.  2) Do a procedure called Intercytoplasmic Sperm Injection (ICSI), which is what we did because of my husband’s low morphology.  They embryologist chooses the best-looking sperm and injects one into each egg with a syringe.

Some bloggers said that they went back to work the day after retrieval, but I was extremely sick the day of and after.  I wasn’t too sore, but the anesthesia made me so nauseous I could barely move.  I think it’s safest to plan on 2 days off for this one.

The next morning you’ll get a call saying how many of the eggs fertilized normally.  At this point they told me that of my 12 eggs, 9 were mature, and 8 fertilized normally.  The 9th did fertilize, but did not continue to divide normally.

Each day after, they call and give you an update on how your embryos are doing.  It’s common for a few to stop dividing each day.  Based on the progress of the embryos, the doctor will decide to transfer the embryos on the third or fifth day after retrieval.  I was lucky and all of my 8 embryos made it to a 5-day transfer. Both types can be successful, but 5-day has slightly higher success rates.

Each day they’ll also tell you the grade of each embryo and the number of cells the embryos have.  The embryologist can count the number of cells up through 8 or 10.  After that, the cells start to condense at the center of the embryo and it’s called a Morula.  Then it expands back out with two separate layers (which will become the fetus and the placenta), which is the blastocyst stage.  Embryos are graded differently at different labs, but they told me the number of cells and whether it was good, fair, or poor.  Good and fair are both acceptable for transfer. I had 3 Blasts on Day 5, and all were “good,” but 2 were looking the best.  Those are the two we transferred.

Transfer Day is easy!  It’s very similar to an IUI.  The most delicate part is working with the embryos — they have to be taken out of their incubator to be transferred.  The doctor inserts a vaginal ultrasound wand, a speculum, and then a catheter into your cervix.  He pushes the liquid and embryos through the syringe and catheter and you actually get to see 2 bursts of white as the embryos enter the uterus.  Weird and cool!  Then you just lay there for about 20 minutes and you’re off!  My doctor emphasized that it is not necessary to have bed rest after this procedure.  The embryos will not “fall out.”  Your body is designed to hold on to everything, like how normal people get pregnant.

I did acupuncture for an hour after the transfer, which was a nice way to allow extra time for the embryos to get comfy and for me to relax.  My clinic is just across the hall from the RE.

Then comes the really hard part… you just wait.

The day after transfer I had a lot of cramping which Google told me is very normal.  That’s implantation.  I also started taking progesterone both orally and vaginally after the transfer, so it was hard to tell if symptoms were due to that or actual pregnancy.

I had a beta blood test scheduled at 15 days post retrieval (that’s O day).  I took my first home test at 9dpo and had a faint line, which was still from the HcG trigger shot that makes you ovulate.  On 10dpo the test was stark white and I started to freak out.  But on 11, I got another beautiful second pink line.  The lines kept getting darker until beta day so I knew that the result would be positive.  You get a second beta either 2 or 4 days later to check the doubling time to make sure everything is progressing normally, and then you’re officially an OB patient!  I had 3 ultrasounds at the RE and graduated when I hit 9 weeks.

The biggest shock came at the first ultrasound when there were FOUR babies.  We almost had a heart attack.  One of the TWO embryos split into triplets.  (This is very, very rare.)  One of the triplets did not make it to the second ultrasound so currently we have 3 babies and some very big decisions to make!

Here in California, we do not have any mandatory infertility or IVF coverage.  My original insurance covered absolutely nothing, not even diagnostics. So at the original OB we paid about $250 for blood tests and semen analysis.  I switched insurance to an option that covered everything through IUI, but it didn’t kick in until January.  We had already been seeing the RE (out of pocket) and liked him and didn’t want to switch to Kaiser, so that insurance was a big waste of time.

Our initial consult was approximately $400 with the RE.

– Each Clomid IUI cycle was $505 (monitored – meaning with ultrasounds).  If you need to do a trigger shot, that’s an additional $75.
– My HSG was $200 at a radiology company. (Hysterosalpingogram – to see if your tubes are open)
– My SHG was $370 at the RE. (Sonohysterogram – to see the shape of your uterus)

Meds are the most expensive part of IVF.  I ordered mine online and got the most expensive of the medicines at a discount from a fellow blogger.  The meds were $2,600 total, which is much less than average.  We were quoted between $4,000 and $8,000. This included: 5 boxes of Bravelle (from a blogger for $200 – a $700 discount), 3 boxes of Menopur, 3 boxes of Endometrin, 200 Progesterone pills, 30 Estrace pills, 10 Provera pills, 1 Zofran, 2 Z-pacs (antibiotics for both DH and I before transfer), 4 Cetrotide syringes, 1 HcG trigger syringe, a million (ok like 30) ½ inch syringes, 2 hazardous waste containers, and lots of alcohol swabs and gauze.

I also had to refill my Endometrin and Progesterone pills (both meds are progesterone – the pills are oral, the Endometrin is vaginal) and that was $600!!  It’s just a month’s supply.

Throughout the entire fertility process I also took 4mg of Folic Acid a day, which is $24 for 400 pills (I’ve filled it 4 times).  Prenatal vitamins – cheap.  Baby Aspirin – cheap.  These meds were all from Target and all based on doctor’s orders, so do not take these without your doctor’s advice.

Last – the IVF cost.

My RE provided 4 different cost options.  You could pay for 1, 2 or 3 fresh IVF cycles single or in a package, or you could do the “Success Guarantee Program” if you qualify.

The 1 cycle IVF package was approximately $10,000 without meds or anesthesia.  If the fresh cycle is unsuccessful, you can transfer frozen embryos if they were able to freeze any.  Each Frozen Embryo Transfer (FET) would be an additional $3,500.

The “Success Guarantee” was $18,000 (again without meds or anesthesia). This plan guarantees a take home baby through 1 fresh cycle (where they transfer the eggs immediately after retrieval) and as many FETs as you have embryos.  If you do not have a “take home baby” after all embryos are used, you get your money back.  The proportion varies by age, but under 35 is a 100% money back guarantee.

We went with this plan because it allowed us to not have to make any additional decisions if the initial fresh cycle was unsuccessful.  I knew I would be absolutely devastated, and thinking about money at a time like that would have been too difficult for me.  So we went “all in” with a guarantee that if it did not work, we would get our money back.

Granted to say, this has been a very expensive process.  If my husband did not have the job he has, we very likely could not have afforded IVF. I think it’s extremely unfair that up to 2 IVFs are covered in some states when there is no coverage elsewhere.  In some countries IVF is much cheaper. But we are very lucky that the process worked for us and very hopeful that we will truly have our “take home baby.”  I don’t think I’ll truly believe it until I see it!

If you have any questions about IVF, I’m basically an open book, so contact me and ask me whatever you would like to know.