Tuesday, 23 November 2010

CD1 – The IVF Cycle

Yesterday, I had hope.

In the morning I spied some pinkish/brown spotting and Dr Google told me that yes, this could be implantation bleeding. As I was only at CD19 and there was no more bleeding during the day I held on to the teensy bit of hope that maybe, just possibly, my body had finally done what it’s supposed to do and just in time too. Yeah right.

This morning, I got my period.

Well, that was a short cycle. Makes me think I probably didn’t ovulate after all. Who knows? Who cares? It’s done.

So it’s CD1 of the 18th cycle since I started trying – The IVF Cycle.

I called the nurse at the clinic to ask if they’d still start my drugs on CD21 bearing in mind how short my cycle was. She suggested I start them on CD17 instead to make sure I get in a few days before my next period starts.

After checking the calendar, I realised this means I’ll be starting the drugs pretty much on the date we’re supposed to move into our new house. I was hoping to be in and settled for a week or so beforehand.

But what the hell. Bring it all on.

Until next time.


Sunday, 21 November 2010

No final shot

I thought my blog this week would be about giving it one final shot before starting IVF next cycle.

Sadly, I don’t seem to have been given that shot as I don’t think I ovulated this month. Sod’s law really as I tend to ovulate most months.

Usually, it’s somewhere between Days 12 and 15 so I started testing on Day 9 just to be sure and was convinced my body was giving me signs I was going to ovulate soon. The Husband and I had all of the sex (still enjoying that bit at least ) and I carried on testing through to Day 16. But I never got the smiley face.

What was more weird was that my boobs had started getting sore around a week after my last period. I was really confused by that one and of course one tiny part of me thought ‘maybe I’m pregnant!’. It would have to have been a miracle pregnancy to have survived a period but stranger things have happened. Plus, I have the warped mind of someone who’s been TTC for too long.

So on Day 14, with boobs still sore, I did the only thing a desperate, sad, confused girl who’s been TTC for 17 months and is staring IVF in the face would do – in the space of one pee, I tested for ovulation AND pregnancy. Yep. Oh the shame...

And the results? Both negative. Double whammy.

So either I ovulated and somehow missed it or I just didn’t ovulate. Either way, it means I’m not taking progesterone, which means a much shorter cycle, which means I start IVF sooner.

So here I am, CD18, mood dropping faster than a ton of bricks, waiting for my period to come. I can’t deny I’m scared shitless of what’s around the corner but I have to put my trust in the fact there’s a very good reason for all this and that the result will be worth it.

Until next time.


Sunday, 14 November 2010

IVF – one step closer

On Friday, we went to see our lovely charming fertility doctor for the next stage of talks about IVF (he’s definitely getting more handsome each time we see him).

This session followed some tests The Husband and I had to have over the last couple of weeks to check we’re ok to get going. Thankfully, everything is fine - our HIV, Hep B & C bloods came back negative, my ultrasound showed a tiny cyst but the doc isn’t worried about it and everything else in there looked normal. Plus, The Husband’s sperm are plentiful and mighty (there’s about a zillion of them and they’re strong enough to swim through concrete - or something).

Actually, there is one small worry The Husband and I have about his sperm and my eggs. We both have an appalling sense of direction, so even though I have a good reserve and he has lots of strong sperm, what if they have no idea where they’re going? We sometimes amuse ourselves by imagining his sperm swimming frantically round the kidneys and my eggs trying to burrow their way into my liver.

Anyways...this is what we went through with Fertility Doc. We taped the session (with his permission) so I have a fairly detailed account of the discussion. It’s long but bear with it if you’re interested in finding out more about the IVF process:

1. s 1. As I have a decent reserve of eggs (FSH of 3.3 and AMH of 15.7), he thinks the Long Day 21 protocol is best for us, which is a six-week process.

2. I’ll be injecting Buserilin for two weeks from Day 21 of my cycle. As I understand it this will switch off the part of my pituitary gland that produces the hormones which stimulate my ovaries - effectively mimicking the menopause but without affecting the eggs. At this point, I could experience the joys of hot flushes, night sweats, sleep disturbance and mood swings (yay).

3. At the end of the two weeks, I have a blood test and scan to see if the Buserilin worked. If it has (let’s hope so, sounds like I don’t want to carry on taking that shit for longer than I have to), I start with Gonal F injections to stimulate the ovaries again to produce (hopefully lots of) eggs.

4. The Gonal F injections will also last for two weeks, during which time I’ll have bloods and scans on Days 5, 9 and 12. These should show how my follicles are developing – hopefully neither under- or over-stimulating. By Day 12, I should be ready i.e. I should have lots of lovely healthy eggs waiting to be collected.

5. Assuming that’s the case, I then go into hospital where they give me a light anaesthetic and shove a thin needle up my lady bits to collect the eggs from the ovaries. The Husband also comes in to give a sperm sample. Then they introduce the eggs to the sperm and hope they really really like each other and want to get it on (as The Husband’s sperm are good, it’s unlikely we’ll need ICSI and will go with conventional IVF).

6. They then leave eggs to grow and develop and hope around 50% will fertilise. The length of time they leave them will depend on the quality and quantity of the embryos. If we’ve only got a few that are good quality, they’ll put those back around 2-3 days later. If I’ve got lots of good quality embryos (more than five) it becomes survival of the fittest and they leave them for up to five days to get to blastocyst stage. By that stage, they know which are the best ones to put back so we have the highest chance of success.

7. At this point The Husband asked if they screen for imperfections, genetic problems etc. Fertility Doc said in a way they’re screening just by seeing which survive and which don’t. They’re screened on the basis of morphology i.e. what they look like under the microscope, how quickly they’re dividing etc. He then spoke about a much more in-depth, experimental screening which involves making a tiny hole in the egg and taking away a small sample of genetic material so they can analyse the genes and chromosomes. They don’t think this affects the egg but it’s such a new process, they don’t really know yet. There are only two clinics in the UK and two in the US that do it and they’ve only done about 40 of these procedures in the UK (for anyone who’s interested in finding out more, it’s called Pre-Implantation Genetic Diagnosis/Screening). They only recommend it for people who have tried IVF unsuccessfully 3 or 4 times or for women who are heading towards their mid-40s and have a higher chance of genetic abnormality in the embryos. But be aware, it doubles the cost of the treatment.

8. Back to my embryos...if they get to blastocyst stage, they’ll put back the best one or two (our decision at this point). This isn’t under anaesthetic as it should just have the discomfort level of a smear test. Once the embryos are safely back in, the progesterone support begins. We had a bit of a discussion here about whether I’d take suppositories or progesterone in oil (PIO) injections. As I have a short luteal phase and on occasion have had breakthrough bleeding on progesterone suppositories, he advised going for PIO – old-fashioned injections in the backside which, he said, ‘hurt like hell’ but which are necessary if we don’t want to take a chance of the lining breaking down (yay again). I may need to start these one or two days before they put the embryos back in depending on which day they’re put back.

9. And two weeks later you find out if you’re pregnant – simples!

After our discussion, we had a chat with the nurse about timing. We won’t be able to start this cycle as our egg collection could clash with the four days the clinic is shut over Christmas for deep cleaning. So it looks like we’ll be starting the following cycle which would mean injections starting around Christmas day. At least the clinic will be really really clean though.

Between now and then we go for a session with the nursing team to learn everything we need to know about the drugs and injections. We’ll also get a 14-page consent form where we sign our lives away.

And that’s where we are. How do I feel about it? As though I’m heading towards a dimly lit path signposted ‘The Unknown’. I hope as I travel along the path, it will progressively get brighter and that something – or someone – very special will be waiting for me at the end of it.

Until next time.


Wednesday, 10 November 2010

Releasing the crap

As each month goes by and I’m still not pregnant, I withdraw into myself a bit more. I find it hard to express emotions at the best of times but dealing with infertility is on a whole other level. Even in my blog and on Twitter, where I should feel comfortable in the knowledge I’m among people who completely understand and who will get me, I just can’t bring myself to let loose and reveal everything that’s going on in my head.

I know I’m not alone with this but I have so many thoughts, fears and emotions that are with me ALL THE TIME. There’s barely a waking moment when I’m not aware of desperately wanting to be pregnant, to know how it feels to have our baby growing inside me - but not being able to get there.

A lot of the time when I appear to be fine, I don’t feel fine. And my attempts to seem fine – either to the few people who know or to the many who don’t – are so bloody tiring.

I feel like I need to start trying to release all the crap that’s been building up inside me, especially before I start IVF. So I’ve started regular therapy sessions to try and get rid of some of the demons. I don’t find the sessions easy but my therapist has helped me through a previous low point, so I trust her and feel safe there.

This Friday I have my appointment with the fertility doctor to talk through timing and protocol for IVF treatment. I’m nervous but I know it’s a positive step.

I’ll update again over the weekend.

Until then


Wednesday, 3 November 2010

So be it

This morning I did my third pregnancy test in five days. It showed my third BFN.

I’ve been taking Cyclogest (progesterone) again this month and I don’t get my period until I stop taking it so I had to test. I decided to do it a little earlier this month at 12dpo. My thinking was that if I got a BFN, I’d take that hit with the knowledge I was testing early and things could still turn around - softening the blow a little perhaps.

When I tested yesterday at 15dpo and got my second BFN, I was pretty sure it was a conclusive result. But someone put a little doubt in my mind, saying they’d got all three of their BFPs at 16dpo or later. It left me with a teeny tiny smidgen of hope that made me test again this morning.

At least I know for sure now.

My response to not getting pregnant each month has started to shift a little lately. I think in the first year of trying I still had a lot of hope and expectation. After all, apart from low progesterone and a short luteal phase, the doctors couldn’t give me any real reason that I wouldn’t get pregnant. So each month that went by, where the hope and expectation were shattered, I had quite a strong reaction – lots of tears and moody silences, needing attention and reassurance.

But I think there comes a time with such regular and extreme emotional reactions that you just get tired, that you can’t deal with all that emotion anymore, and that you have to start protecting yourself from it.

Plus, the secrecy and taboo surrounding infertility means you have to get on with everyday life as though nothing’s wrong, as though your heart hasn’t just been ripped apart a little bit more.

So in the last few months, my reactions have been a lot less obvious and a lot shorter lived. And I’ve just been trying to get on with life without being pregnant. But I know the scars are running deeper.

I’ll keep going though, I’ll keep doing everything I can and carry on believing that I will have children one day because anything else is just unacceptable to me.

And if IVF is what I need to bring me my baby, then so be it.

Until next time.