IVF Abroad - The Plan

            The great lengths that we subject ourselves to in order to achieve life goals result is a test of human fortitude.  Whether it’s scholastic, endurance, personal challenge, or even infertility, a similar outlook remains the same, to gaze upon the finish line.  With any challenge though, there is always the subtle undertone of failure that lurks in the idle mind, so this is why we train; to stay focused, conditioned, and goal oriented.  As with infertility, an adversity that directly affects both individuals in the relationship is met with the same spirit and fortitude that any life changing event has the tendency to create.  Of course with any obstacle in life unfortunately we often face scrutiny from our peers and loved ones, usually innocent in nature, but sometimes hurtful nonetheless.  Comments typically range from, “oh you just need to relax and it will happen.” Or my personal favorite, “just go out and get drunk.  That’s how I got pregnant.”  These types of insinuations lead me to believe that some people don’t even realize that they are indeed blessed.  All the while this disease is affecting 1 in 8 couples, but yet, infertility remains underrated and unappreciated by health care and health insurance alike.   However, like many diseases, infertility is not life threatening, but it is life altering.  The Merriam-Webster dictionary defines disease as: a condition of the living animal or plant body of one or more of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.  By this definition it would appear to me that infertility is the diminishing function of the reproductive system, and thus a disease.  And yes I can see that a 45 year old woman having trouble conceiving can be suffering from aging, not infertility.  Though in our case and many others, Jill and I are still young, healthy, and been trying for a long time.  So please, next time don’t tell me I should just adopt.  Adoption should be a choice, not caused from unfortunate circumstances.  We want to explore all options before adoption is necessary, because we also need resolution and the clarity that only comes from knowing you did all you can to conceive.   In other words, this is not the end of the road for us; it’s the beginning of a new chapter.

                

               So we bought our plane tickets with Delta Airlines and will be traveling for our European IVF journey on August 28^th through September 18^th.  Our adventure begins at Denver International Airport at 8:20AM.  We bought modestly priced tickets, so to be expected, there are some speed bumps along the way.  We fly from Denver to Cincinnati where we change planes and have a 3 hours and 45 minute connection time.  At 4:40PM we leave Cincinnati to arrive at JFK in New York where we change planes once again and have a 1 hour and 20 minute wait.  At 8:10PM we finally leave America to arrive in Prague, Czech Republic at 10:40AM the next day with a total travel time of 18 hours and 20 minutes.  Jill and I decided it would be best to rent an economy car, something comparable to a ford focus, and drive from Prague down to Brno where ReproGenesis is located.  We have already made reservations at Orea Hotel Voronez in Brno, and during that time Jill is scheduled to have an ultrasound on Aug. 29^th and Sept. 2^nd.  Tentatively on Sept. 5^th is the egg retrieval and sperm collection. 

               

               TVOR (transvaginal oocyte retrieval) is the technique used under general anesthesia to remove oocytes (immature ovum, or egg cell) from the ovaries, enabling fertilization outside the body.  With the use of ultrasound to guide a needle through the vaginal wall and into an ovarian follicle, our doctor will carefully aspirate follicular fluid containing the oocytes.  The procedure will then be repeated on the other ovary with the hopes of having several quality eggs to choose from, and if we are really lucky to freeze any extra embryos for future use.  Before all this happens though, the ovaries need to be pharmacologically suppressed and then hyper stimulated.  The treatment started with one birth control pill a day from July 30^th- Aug.14^th.  From Aug 15^th- 18^th Jill will take two birth control pills a day plus prednisone and a massive dose of folic acid every day.  On Aug. 19^th Jill ceases the birth control but continues folic acid and the uses prednisone to suppress the immune system, because in an IVF pregnancy the body may consider the embryo to be a foreign invader and declare war upon our embryo.  On Aug. 22^nd her period will come.  Then Jill starts daily injections of 225 iu gonal-f to hyper stimulate her ovaries on Aug. 24^th, which will continue through Aug. 29^th.  On Aug. 30^th in the Czech Republic Jill will have an ultrasound and adjust medications accordingly, though will receive some injections of orgalutran, to keep her from ovulating to soon.   On Sept. 4^th Jill will receive a shot of HCG to trigger ovulation, and TVOR is typically preformed 34-36 hours after HCG injection.  Assuming Jill will be wiped out after her invasive procedure, we will go back to the hotel for recuperation.  The next day Jill will be on progesterone in oil injections for 2 weeks daily, and we will be told how many eggs have been fertilized.  The fertilized eggs (zygotes) are carefully cultured as cell division immediately begins, and approximately 5 days after fertilization, the zygote has about 100 cells and is now a blastocyst.    Between day 5 and 7 a healthy blastocyst begins hatching from its outer shell, called the zona pellucid.  This is when the embryo transfer takes place (tentatively Sept. 10), and two of Jill’s best quality blastocysts (assuming we get at least two blastocysts) will be released into her uterus via catheter for the embryos to (hopefully) implant in her uterine lining with the hopes for the embryonic period to begin (the beginning stages of formation.) 

                 

                After IVF our clinic requires a 48 hour bed rest with only getting up to use the bathroom.  With this in mind I insisted on Jill to stay in the nicest hotel Brno had to offer from Sept. 9^th-12^th, and not mention September 10^th being particularly special to us because we exchanged vows on 09/10/11.  So not only for our anniversary, but also implantation we will be staying at the Barcelo Brno Palace, the swankiest place in town, and by looking at the pictures online, I’m not sure if I would want to leave.  Fortunately, Jill and I always believe in having a contingency plan, so we built in 5 extra days after bed rest for any unexpected mishaps or miscalculations with IVF, and of course relaxation and recovery.  So maybe I could talk Jill into staying another night at the Barcelo before we downgrade to a cheaper hotel for the duration of our stay, since she will be bedridden during our anniversary. 

                

              With high hopes for success we leave from Prague, Czech Republic on September 18, 2013 at 1:25PM.  We arrive back at JFK in New York at 4:38PM.  From there is a 2 hour and 22 minute connection time and then we leave for home at 7:00PM.  We finally arrive in Denver Colorado at 9:31PM with a total travel time of 16 hours and 6 minutes.  In our minds, totally worth it, especially if we come back with a souvenir or two!  Never know, so stayed tuned as the IVF abroad chronicle continues, and as always thank you to everybody that has extended their prayers, support, and sympathies towards our cause.  Your empathy and selflessness helps fill the void in our life.