Archive for January 15th, 2009

Lori asked, Why would you both need to take Doxycycline in the last year? That is just strange. No one ever cared if my husband took an antibiotic during our infertility journey.

Well, Lori, you got me. Now, I understand the reason to take Doxycycline during a cycle in general, but why on earth taking an antibiotic any old time at all in the last year matters is beyond me.

Per the Arizona Reproductive Medicine Specialists, Doxycycline, an antibiotic administered in pill form, is given to the male partner during the wife’s stimulation cycle to further reduce the low levels of bacteria that may be found in the semen and which may compromise the performance of the sperm during an IVF cycle.

Now, personally, I think it’s a bunch of crap. I think there’s a lot of voodoo in IVF cycles that’s done just for the sake of “Well it helps a teeney weeney tiny percentage of patients, and it doesn’t hurt any of the other patients, so we may as well make ALL of our patients do it.” Like Progesterone in Oil injections, for example. Crap, absolute, complete crap for most patients. My perinatologist told me the literature absolutely does not support the routine use of PIO injections for IVF patients – and yet, virtually all IVF patients in the US are routinely tortured with these thick, awful, painful injections for weeks at a time. For what? For a theory that it can’t hurt, and it might help.

Which brings me back to Doxycycline. Sure, there may be a VERY small percentage of patients whose male partners have low levels of bacteria in their semen which are causing issues with sperm performance or with implantation. And yes, it could be that taking Doxycycline during the stim cycle of a woman’s IVF cycle helps reduce those low levels of bacteria. However, for most patients, those low levels of bacteria are completely normal and are causing absolutely no issues whatsoever. In this case, of course, what’s the harm in taking five days of an antibiotic, just for kicks? Not much, unless you start getting into all the arguments of why one shouldn’t needlessly take antibiotics willy-nilly.

So no harm, no foul, but I’m not all broken up about the fact that my nurse isn’t making my husband take those darned pills.

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And So It Begins

So although I was supposed to start taking my Lupron on Monday (whoops), a couple days isn’t the end of the world (even though it DOES mean two more days of the evil BCPs!), so I was given marching orders to start taking it today. Of course, my protocol has me taking Lupron in the morning, and I didn’t find out about this until, oh, 2 o’clock-ish.

No problem, because as much as the clinics all like you to *think* that the timing on these meds is super-duper important, the fact of the matter is, there’s plenty of room to fudge it. So really, it’s all good. Just for good measure, I emailed my nurse to make sure and she said it was fine to take it when I got home today, then take tomorrow’s dose around noon, and then Friday’s dose on my morning schedule. Fine. No problemo.

Meanwhile, technically speaking, I shouldn’t have been allowed to have gotten any of this started, because technically speaking, they don’t have my current pap smear on file (I just had that done this week, results aren’t in yet), my ID bloodwork isn’t back yet (I just had that drawn yesterday, and the labwork from The Hatchery hasn’t been faxed over yet), etc. But they trust me. Heh. Oh, and then there’s the fact that both of us are supposed to have taken doxycycline within the past year. I took Doxycycline in November before my HSG, so I’m covered. But they’d asked me if my husband had taken any sort of antibiotic in the last year and I’d said, “sure, I think so.” He wasn’t so sure, so I told my nurse that today and she said, “Yeah, we need to get right on that.”

So anyway, I get home to take the Lupron. Bear in mind, I’ve never taken Lupron before. And we didn’t take an injection class, because, seriously? Why would we? So I’m looking over the stuff, and it’s a multi-dose vial, with insulin syringes, etc. Easy. Except then I start realizing I’m not sure I understand the unit of dosage. My instructions say 20 units. But what KIND of unit? I call my husband and ask if he’s close to home. Fortunately, he’s just pulled into the driveway. It is handy having a pharmacist for a husband. So he came down and explained to me like I’m a five year old that “unit” was exactly the word they’d intended to use because some medicines are measured in “units of activity” or some such thing. Whereas I’d thought they were using some nebulous, non-exact unit of measurement, it turned out, they were using the technical term, and if I’d looked at the syringe, I would have seen that the syringe also had things labeled as “units” so my minor panic attack was unwarranted.

He showed me how much to draw up and then stepped far away from the needle I was waving all around (sorry honey!) as I tried to remember how to do all this. Seriously, you’d think this was like riding a bike, right? I mean, one subcutaneous injection is just like any other, RIGHT? But it’s been like 2 YEARS, people! And man, the needles on insulin syringes? They’re way bigger than I remember. (I mean, they’re not big, but they’re way bigger than the follistim needles)

Anywhozit, aside from having to shoo my eldest away a few times, it went smoothly and in plenty of time to let my nanny go for the night. Tomorrow will be trickier because I’ll have to take it at work since I’m supposed to take it at noontime, which presents two separate problems: first, now that it’s been opened, the Lupron has to be refrigerated. We do have a refrigerator at work, but … sheesh. Secondly, doing this in a cramped bathroom stall? Not my idea of fun. Nevertheless, it’s not like I haven’t done it before!

And now, the requisite IVF Med shot:

Not pictured is my Follistim Pen, which I forgot to include.

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