My fallopian tubes don’t know what my uterus is doing (or Everything You Never Knew You Wanted to Know About the IVF Drug Cycle)

My fallopian tubes and my uterus aren’t speaking to each other at the moment. But don’t worry; they’ll get over it eventually.

The familiar bull’s head diagram of the female reproductive system. Remember in 5th grade when we had to color one of these? Vagina..hee hee hee.

One of the best unforeseen consequences of this process is how much I am learning about the female reproductive system. I thought I was pretty well-informed, having sat through elementary, middle, and high school versions of sex ed as well as a college biology class, not to mention the 32 years I’ve spent owning all the lady parts, the healthy number of those years I’ve spent exploring said parts, and the 4 1/2 years I’ve spent in the throes of pregnancy and breastfeeding. But there’s always more to learn! Ready for your science lesson? Today’s topic: hormones! (Because they have become such a driving force in my life and who am I to keep all my newfound knowledge to myself?!)

It all began with Lupron. Lupron is a gonadotropin-releasing hormone agonist. Gonadotropin-releasing hormone (‘GnHR’ to some, ‘the gonad hormone’ to the less mature, namely…me) is the hormone responsible for the release of the follicle stimulation hormone which regulates and stimulates ovulation. After a brief period of increased hormone secretion, the Lupron eventually inhibits GnHR from reaching the brain, thereby halting ovulation. Straight talk for the ladies (men, pretend you’re not listening): you know those several days per month when all those “headaches” you’ve had the past couple of nights mysteriously disappear and your husband’s not-so-subtle advances are suddenly less annoying and more arousing? Your juices are flowing and you suddenly feel a little randy?  Yep, that’s your pre-ovulation surge of good old GnHR, the sly manipulator responsible for millennia of procreation. Then enter Lupron, o ye of the subcutaneous injections, and goodbye, fun gonad hormone. I’ll miss you, sex drive! See you in about a year.

After about three weeks on Lupron, I was in the midst of a menopause preview. With no GnHR, there was no follicle stimulation hormone, and thus no estrogen. We all know estrogen–primary female sex hormone, essential for (among many other things) the development and maintenance of the uterine lining. Once the Lupron did its job and completely shut down my cycle, the doctor began to add back exactly what I need for optimum embryo transfer conditions. I began taking (well, receiving) estrogen injections (you remember my friend the 22 gauge needle). The estrogen, or  specifically estradiol, builds up my endometrium, providing a nice, fluffy landing pad for the embryos. Next comes the progesterone, the essential element in helping the little guys stick, also delivered via enormous needle into my butt muscle. The progesterone, along with the estradiol, prepares the uterus for implantation and supports the ensuing pregnancy. If this transfer sticks, I will remain on estrogen and progesterone until the placenta takes over producing the hormones around the 12th week of pregnancy. My tushy is already planning a party.

Currently, as I am typing this, my lining is 8mm thick, up from 3mm when I began this drug cycle. A good thickness for an IVF embryo transfer is between 8 and 13mm, so…yay! The estrogen is doing its job. My uterus is smoothing its comforter and fluffing its pillows in anticipation of receiving two little embryos.

My poor fallopian tubes and ovaries, however, are still out to lunch, completely unaware of what’s going on mere centimeters below. I find this utterly fascinating and little baffling, that my lady-parts can be so easily manipulated and duped. Poor, clueless fallopian tubes, sent out to buy more beer only to return to an empty house, the rest of the gang moved on to the next party, a cooler one with hotter chicks and better booze. So sorry, tubes. Catch you on the flip side.