Protocol: this is what they call the regime of drugs that they plan for you. They base this – apparently – on a number of things – your height and weight, the amount of bloodflow they can see going to your ovaries, your AMH results, all that sort of shiz. At least that’s what they told me, it could be that they just pluck an idea out of nowhere and go with it.
And, despite my sub-par AMH results, my scans were all good. In fact they told me that if I hadn’t told them I’d had endometriosis they’d never have known, everything looked normal. Hurrah, well done ovaries, uterus etc etc. I am, by the way, skipping over various bits of the story, like the fact that I cried in my first consultation with my doctor. (She was very nice about it, I think they’re probably quite used to it.) I’m not skipping over it because I don’t want to tell you about it, but, I’ll be honest, it was about stuff that’s probably going to come up again, so why wang on about the same thing twice. But you should probably know that it happened. Just in case you’re in the same position. I think crying is totally normal. In fact I think I cried in pretty much all my first three consultations.
So, all the results were in and it was decided that the best approach for me was to use what they call an antagonist protocol. Disappointingly for someone who studied French and languages – this has nothing to do with either Antigone, or antagonising, as far as I can make out. In order to understand this, you probably need to know a bit about a normal menstrual cycle – apologies if I’m teaching grandmothers to suck eggs here (sorry, I couldn’t resist, I did warn you about pun potential) but I didn’t have a scoobie about any of this. So, normal cycle: the follicles within your ovaries produce eggs, they all grow a bit but one of them is like the Queen Egg and she’s the biggest and the healthiest and so it’s decided it is she who will have the brilliant job of being released and hopefully fertilised (think of all those periods, all those poor disappointed Queen Eggs). Anyway, once the Queen Egg has won this particular competition, all the other lesser eggs shrivel up and die. Unless, you perform magic.
OK, it’s not magic, it’s a follicle-stimulating hormone called follitropin or Gonal-f. You inject that every day for approximately ten days from day 2 of your cycle – day 1 is the day you get your period – and this hormone is all about giving the others, the would-be Queens, a bit of a chance. So not just one of them gets big and strong, but three, or four, or eight, or ten, or whatever. But you don’t want these eggs to spontaneously release themselves, god no, they have to be harvested by clever doctors, so you take another drug. In my case it was a drug called Cetrotide, which I took from around day 7, and it stops you releasing any eggs. Then, when they’ve decided that the eggs have got big enough, they give you another drug 36 hours before they harvest them which – I think – makes them ready to pluck. I used one called Ovitrelle.
Different clinics use different protocols. Mine’s all about minimal stimulation and so I was injecting 125 IU of Gonal-F every day which I think is quite low. My clinic also don’t give you a scan until day 6 of your cycle, but I know others that will scan you on your first day.
Oh yes, the scans. I hadn’t mentioned these, because it’s now so normal to me but it might not be to you. They’re an internal – or trans-vaginal ultrasound. They basically stick a condom on what looks like a dildo, cover it with gel and stick it up you. Sorry if that’s a bit graphic, but thats what they do. Honestly, it’s less painful than a smear test.