I started to take birth control pill 12 days before my expected menstrual period. I do it to make sure that I get my periods on time. There were times when I wait and wait for my periods to start and it never happened. The reason was, either I failed to ovulate that cycle or I ended up with a cyst which prevented my periods. So, to be on the safer side, I took birth control pills. After 7 days on birth control pills, I started taking lupron too (overlapping BCP and lupron). I stopped BCP after 10 days and continued only lupron. When my period arrived, I started FSH injections on day 3 of my menstrual cycle (lupron continued until egg retrieval). Don’t ask me the name of this protocol. This is what has helped me previous time to get more eggs and so we followed the same.
I ordered medicines in Madurai. In the beginning, I was scared. Medicines necessary for IVF will not be available in nearby medical shop (definitely not in our village). In a small city like Madurai, I was wondering, where will I go in search for it? But to my surprise, I found that, I could order all the medicines from home. I just have to call the pharmacy and order the medicines and they delivered the medicines to my home safely in a cool pack. I never expected this in Madurai and I was relieved. If any of you staying in Madurai was wondering how to order the necessary medicines, please contact Vasan medicals. They are very sincere, and prompt. They do their best to get the medicines you ask for in time.
I called Vasan medicals and the first question I asked them was which FSH preparation is the cheapest in the market. FSH is available in 3 different forms – Gonal F, Menopur and Menogon. Gonal F is the purest form of FSH. It is a recombinant preparation (genetically engineered) and hence very costly too. Menopur and menogon are prepared from the urine of post-menopausal nuns and hence called as hMG (human menopausal gonodotrophins). They are of course purified (not as pure as Gonal F) and contain equal amounts of LH and FSH. Menopur is a much purer version than Menogon. Menogon is the cheapest. I ordered Menogon. I used Gonal F for my first five IVFs in Germany. My ovarian response to Gonal F is very, very poor. But when I came to Dr. Malpani for my 6th IVF, I was given menogon and I responded so well to stimulation and produced many, many eggs. Might be I needed LH too for getting my follicles to grow. So, when you are given an option to select between gonal F and menogon, chose the cheaper one. Scientific studies have failed to show that one form of FSH preparation is superior to the other.
When I got all the medicines and when my mom saw it, her eyes became so wide for a moment and then watery too. She asked with fear, do you have to inject them. I said, amma I am so used to it. I don’t even feel any pain. If at all I feel something, it is just like an ant bite. From that day onwards I made sure my mom doesn’t see me injecting the medicines. Many women who are about to start IVF ask me with fear, "I am so sacred of injections, will they hurt?” Believe me, they don’t. I think, when compared to all the emotional turmoil we undergo during IVF, pain caused by these injections are nothing, absolutely nothing. If you are afraid of these injections, how will you face the pain of child birth? They say childbirth is the worst pain you could ever feel. I actually like those injections (FSH) for another reason. They are like costly anti-aging drugs (who wouldn’t love to look younger!). This is what my RE in Germany says. I truly, truly believe so. When you take those injections and when your estrogen level starts rising, it is a wonderful feeling, at least for me (I know women who suffer from nausea and other side-effects because of it). I feel like a teen ager. My thoughts change. I become so optimistic, I sleep too well and my skin becomes beautiful. Do you remember the first time you fell in love as a teenager (your first crush), it feels exactly like that! As a scientist, I am amazed to see and feel by myself how hormones could control our brain, our thoughts, perhaps our actions too. Is there anyone out there who could relate to what I say (very curious to know)? So, please do not panic about your injections. They are not as evil as you might think. One another fear most women have about IVF drugs is, “will I put on much weight when I take them?" I have heard women complain – “only after I started using them I became fat”. Please be assured that it is not true! What makes you gain weight is the depression that you go through during your infertility treatment. Because of the stress and depression, you unknowingly increase your food intake. Eating food, especially which are rich in carbohydrates, creates a feel good sensation due to the release of a hormone called serotonin. In order to beat depression, many women get addicted to the effect of serotonin and overeat unknowingly. The best way to prevent weight gain during fertility treatment is to develop creative strategies for beating depression. In my case, infertility actually helped me to maintain a healthy BMI. I understand the impact of body weight on fertility and I don’t want to put myself through another problem, I think I already have enough problems to tackle!
Rajender came to Madurai. I was eagerly waiting for him. How happy I was to see him! The first question I asked him was, “did you miss me?” He replied with a naughty smile, “no, never!” But his happy face said otherwise. I took my medicines for the first four days in Madurai, and on the fifth day we were in Mumbai for my first ultrasound. I asked Dr whether I could come to Mumbai much later, after 8 days of taking stimulation drugs (I thought I will reduce the hotel expenditure there, Mumbai is of course costly!). He was not happy. He said, “If you want to do so, I need a very good digital picture of your ovaries after 4 days of starting stimulation”. I was so sure I wouldn’t be able to get a digital picture (I remembered the not so cooperative doctor in that scan center). He said, “Manju, don’t be penny wise and pound foolish. It is better we monitor you closely so that we can adjust your stimulation drugs as and when needed, this will provide you with a high chance for having an optimal outcome”. So, we were in Mumbai a lot earlier this time and I love Mumbai.
Mumbai is very beautiful and lively. People are friendly. Shopping areas are amazing. But the most important attraction for me in Mumbai is the Marine Drive area. I just love to sit and watch the sea. I feel so happy and relaxed when I do so. One thing that makes me sad about Mumabi is the wide-gap I see between the rich and poor people. There are overwhelmingly rich people who drive BMW and dine in Taj, and on the other hand I could see poor people, especially poor children who are just left on streets. I really, really feel guilty at such times for pursuing a costly way to have a baby, after all a baby, which are present in abundance in India, even on roadsides (babies babies everywhere but not even one for me !) Once I was walking near the Taj hotel. The beauty and richness of it always amazes me! There were so many Benz, BMW and Jaguars parked there. Rajender was telling how much those cars would cost. I was hearing it open-mouthed. I thought what a life it is! I wanted to be that rich too. I want to drive a costly car, enjoy my evenings in a five star hotel like Taj and wanted to live like a queen (who wouldn’t want to!) Caught up so much in those thoughts I forgot to see the foot path. I was about to stamp on something and Rajender pulled me aside and looked at me angrily (It happens many a time when we go out, most of the time I will be too attracted by what I see or will go into dream mode). I looked down and realized that I was about to place my leg on the hands of a 12 year old girl. All my excitement drained in a second. There lay a poor girl, near that richest hotel, clothed in rags and with a small torn bag under her head (I hope it is her only possession). She was fast asleep in that busy roadside (serenity amidst chaos!). I was ashamed of my inability to do anything for such unfortunate children, yet, desiring after things which could make my life even more comfortable. I felt guilty. I was angry and bitter, I cried. People like me, easily blame Karma for such inequality and unfairness, and move on with their life. I realized that there are so many things in my life I must be grateful for. I had a safe childhood, I couldn’t imagine the life that little girl was leading. How unsafe it is for a girl to live on streets! I have a shelter above my head, I have good clothes to wear, I have food not only to satisfy my hunger but I could have food for my enjoyment too. If I start writing the things I must be grateful for I need several, several pages. If that is so, do I have any right to complain about infertility, not being able to have a child?
I went to the clinic for my first scan after four days of taking 300 IU Menogon. I was very happy when I went in. I was eager to meet everyone, especially my Dr. I was very eager to know how I am responding to stimulation. But when I came out of the clinic I was too tired, tired of crying my eyes out!