And the answer is....

Mini IVF!

The coordinator, Matt, pulled me into his office yesterday and made the opening of the envelope very dramatic. Unfortunately, he didn't plan it exactly right so when he pulled the paper out of the envelope it was upside down and facing him...a little disappointing that he had to rearrange the paper for me to be able to read the answer. :)

As he was pulling it out I just knew it was going to be Mini. And it was! What did I feel? I think the first two emotions were relief (that I don't have to take the hardcore drugs) and a little disappointment.

There are pros and cons to both mini and conventional. In the perfect world what I would like is to have a mini IVF with a fresh transfer. For those of you new to IVF, let me explain the lingo.

In 4 weeks I will be doing the egg retrieval. That is the most critical part of IVF and involves putting me under anaesthesia and using a very long needle (I won't mention where they go in from...use your imagination) to extract the eggs. The day of retrieval is the only other day Greg will need to come to NY, because they will need his part of the deal to fertilize the eggs.

Once the eggs are retrieved, they fertilize them using a new procedure called ICSI. They take one sperm (hopefully the best of the best) and insert it into the egg. They will do this for however many eggs I produce. In Conventional IVF the goal is to maximize the ovarian stimulation, so you get anywhere from 4-25 eggs. Not all will fertilize and mature, and many die in the process. But usually you end up with a good number of embryos.

In Mini IVF the ovarian stimulation is a lot less, and so I will probably get 1-4 eggs. The idea behind Mini is that instead of going for quantity, they are looking for quality. So even though I am producing less eggs, they are supposedly better quality and will fertilize better.

After the embryos are created, they let them grow until Day 5. In Conventional they would then transfer 1-2 embryos into the uterus 5 days after the retrieval. The idea is that waiting for 5 days allows the embryo to mature more, and it bypasses the part of where the egg would travel down the fallopian tube. They go straight to when the egg would implant into the uterus, and use a new and expensive technique called Assisted Hatching which lasers a portion of the wall of the embryos and essentially begins the hatching process, ideally allowing the embryos to implant on the uterus wall better.

In Mini IVF, after 5 days of letting the embryos grow they will FREEZE them. I will then waiting another month, and then come back 5 days after I ovulate during the next cycle, and have ONE embryo transferred. Yes folks, that means there is no option for twins. Again, a little relieved. If the first embryo doesn't work and I have more in the freezer, we can repeat the process until the eggs run out.

The only reason I was a little disappointed about getting chosen for Mini vs. Conventional is that I wanted to do a fresh transfer. I don't wait to wait until the 1st week of October to have my first transfer!!! But I have no choice in the matter.

Matt, the coordinator, told me that the reason they freeze for a month for Mini is because they want the body to return back to normal after all the drugs and be the most hospitable environment to the embryo. In conventional where you get a lot more embryos and therefore a lot more tries, it doesn't matter if you do a fresh transfer when the body isn't quite ready. But in mini where you have a lot less eggs, you need the best of circumstances.

I don't know if I quite believe all this. I've always heard that you have the most success with fresh transfers vs. frozen. Usually when the embryos thaw there is a risk that they won't survive the thawing process. The clinic uses a new freezing technique, and they have 98% thawing success. So hopefully I won't be in the 2%. I have to comfort myself by thinking that they would not be doing something that would decrease the success rate of Mini IVFs, since the entire study is meant to prove that Mini IVFs can be successful for women. So I must trust the doctor. I just really, really, really wish I didn't have to wait until OCTOBER!!!!

Yesterday I had to go to NY in order to get my meds. The meds he gave me consisted of a box of birth control pills (Yaz). It was a little disappointing to not get the $7,000 drugs (I feel like I'm getting less stuff for free because Mini costs a lot less than conventional), but I am so glad I don't have to start Lupron which is the drug that makes you the craziest. Yaz I can handle. In fact, Yaz I even like.

I will be on Yaz for 14 days. This is extending my cycle an extra week. They put you on a 14 day regiment of birth control in order to suppress your body and to put everything in synch. In short, they are putting my body to sleep in order to take control over it, and when they "wake" it up they will be able to stimulate it more. At least that's the way I understood it. You IVF veterans can correct me.

I go back to NY the day after I finish Yaz. They will make sure my body suppressed enough, and if everything is good I will start Clomid for 10 days and take injectable hormones on Days 8, 10 and 12. No problem - I did all of those things (actually even more shots) when I was doing IUI's. I am very happy that the medications are much less, and I won't have to become Mr. Hyde in the process. My students will be happy too, since school starts in 2 1/2 weeks!

Probably between Aug. 28-Sept. 2nd I will go to NY for 5 days, with the 5th day being the egg retrieval. If I have no eggs, I am out of the study. Hopefully I will have at least one or two! Then I will come back the first few days in October for the transfer.

Overall, I'm happy with being chosen for Mini. We are the exact candidates they would want to do a Mini, and I do not think our chances of success are diminished in anyway by doing the Mini IVF.

And that, my friends, is pretty much the longest summary ever!