Trigger Instructions were wrong.. our fault or the clinics?
So we were doing our IVF specifically the Egg Retrieval Cycle. We were schedule for a Tuesday May 12 130pm Egg Retrieval surgery. As everyone knows the plan is to take trigger medications 36 hours prior to surgery.
Our clinic uses a portal which tells you the medications, dosages and time to take for each date.
We did a dual trigger (Lupron Dual Trigger and a single Pregnyl/HCG) Per our Portal we were instructed to take the trigger shot Pregnyl and 1st dose of Lupron on May 10th at 130am. We did this as instructed. It was instructed in our Portal and on the document. I have pictures of both for you to see.
We then had the second trigger of lupron scheduled for 130 pm on may 11. But as the description instructions states..you take the second lupron shot exactly 12 hours later after the first. And honestly in our heads even though it says the 11th we did not realize that the time difference was 36 hours we actually thought it was just 12 hours since it was night. So we actually took the second lupron at 130 pm on May 10.
Right after we did the second shot we had a realization that something was wrong. It hit us all at once that we just triggered way to early and that we might have messed on the second lupron because per the instructions in table and portal it was for the 11th not the 10th.
Also, our nurse sent a message stating “ You will trigger 130am Sunday Night”. The message was sent in Friday May 9. That’s an oxymoron sentence…130am Sunday NIGHT???? Per the portal we did the trigger Saturday night into Sunday at 130AN in May 10th. I guess she actually ment Sunday night into Monday May 11th.
We called the on call number and after a few hours of waiting they ended up moving up our retrieve to the 11th on Monday to make sure we retrieved exactly 36 hours later.
We managed to obtain 6 eggs,3 matured and successfully fertilized. We are happy with that but we definitely feel like there was a major error and it should have been better.
We take blame that we should have noticed there was a major discrepancy on the instructions in multiple areas. But still..we’re not the experts between the emotions of excitement, nervousness, etc..we’re never realized it until we did that second trigger of lupron. Plus we got the instructions that we would be triggering at 446pm on Friday and our clinic closes at 5pm. So we didn’t even have the chance to talk to them anyways.
We did review everything on Friday the 9th but just total my missed that they had us triggering way to early. We just looked at the instructions and figured we had to follow as requested.
There’s also other issues where we were scheduled to take Ganirelix on the 10th which was the instructed date of initial Trigger. Ganirelix is to prevent ovulation..so if we had taken it the whole retrieval would have been failed and potentially cancelled.
On our final day of tests we had 26 follicles. 6 were above 15mm 10 were between 13-15mm and 10 were under 13mm. Because we triggered early and missed out on one more day of stims (follistim and menapur) we feel like we missed out on a lot of eggs.
The clinic is stating nothing was affected. At this time we are playing nice with them but we have asked for a full record of medical file including all test results etc. and who signed off on our medication instructions for trigger etc.
From what we know the Timing of the Trigger is one of the most important steps in the whole process because it’s a balancing game of to “immature eggs and to overture eggs”.
What do you guys think? Is this our fault because we didn’t catch the error or is this there fault for improper instructions?