Monday, January 31, 2011

There's nothing like bad news to send people running for the hills

I checked my blog stats today. This blog was initially just for people I knew but spread a little more over time. It's interesting to see the countries around the world light up, some that I've never even been to. Everything has dwindled since I started bleeding on Thursday, not just my mood and happiness but blog hits too. I would have thought there might have been a few hangers on just to see how it turned out, a bit of a cliff hanger maybe but perhaps not.

I have been glad of this blog really as it seemed a way of letting people I know (in addition to anonymous readers) that the treatment failed rather than having to contact everyone separately and directly. I have actually found it hard to write the words. The problem is as I have not been direct about it I have not had many direct responses and am finding it very lonely at the moment. It's a relief so few people know yet it's difficult at the same time. I've managed to avoid people all weekend but if I was still in England I know I would not have been able to avoid seeing friends and would have felt better for it.

I suppose this blog is a rather cowardly way of breaking bad news, even the writing is ambiguous and I'm my own worst enemy. Despite all the hormones pumping around since 01.01.11 it's only this week I've felt terrible and I grew nervous about any well meant anonymous comments. I considered deleting the blog or coming off it for a while but in the end I removed the comments box for a few days, just to avoid upset. People I have given my email to were then of course still be able to contact me and those that did to say they were thinking of me made all the difference.

Some people know but don't have access to the blog so I don't expect to hear from them. I suppose people don't know what to say or feel they have to say something informed or useful which isn't true. So anyway my blog has failed one it's purposes since Thursday so I might have to start writing to everyone directly after all to say it hasn't worked and hope I don't scare them off even more?!


Sunday, January 30, 2011

Never give up hope

I'm anxious about tomorrow to see how long I'll have to wait before trying again and what to expect from a frozen transfer so I can make some sort of plan. It's good to know the sort of thing that happens in the UK too so I can ask the right questions and feel prepared. So I return tentatively to the BC website and spot a 'negative outcome group' and not a 'BFN group' I might add! I liked the picture of the burst bubble with hope on it but was disappointed that there was an entry with the same title as this post. My least favourite cliche, it belongs in the pit with 'it only takes one'.

I read most of it hoping it was someone who had stumbled across something useful, new research, techniques, funding and wanted to share it. But no, it was the inevitable story about failed IVF followed by a natural pregnancy. Doesn't say of course the age of the couple or why they needed IVF but you can pretty much guess that she had at least one lovely patent tube, was ovulating naturally and  her partner had some swimmers that moved in the right direction. No doubt they were suffering from unexplained infertility which must be agony, not knowing, however, there is always the chance of a natural pregnancy as of course there are rare occasions when even female/male factor infertility lets one through so to speak, a miracle really. So it's nice to read when this has happened for someone who's journey of disappointment you can relate to but it's not helpful to me as it's not an option and I don't think it belongs in the group for people who's previous cycle has failed.

It may be helpful, for example, to know that someone decided on a 5th cycle and it finally worked so all the ladies reeling from failed attempt number 4 may draw some strength from that to carry on when things around them look hopeless. Perhaps a post from someone who has braved egg/sperm donation and is loving motherhood may a comfort to someone who is coming to terms with not being able to have a child that shares their genes.

But these natural pregnancies, while it's nice to share them, should not be offered as some sort of 'this could be you', rather a post just to let the infertile group know you have had a moment of fertility and thank them for their support, express your shock and delight and no doubt everyone with be genuinely happy for this person What about the couples reading with no sperm and blocked tubes and what about other people who don't know about fertility treatment, when they get wind of these stories I feel they need to be put into context as this is where misunderstandings come from.

Many people venturing down the IVF route will know how frustrating it is when people throw cliches at you and everyone has this friend who had IVF and gave up and now has a child naturally blah blah. Even my friend who is a midwife talks about stress being to blame, delivering a baby conceived through IVF and the couple then having a surprise, natural pregnancy just months later because the pressure to conceive has been lifted. If only it really was ALL stress related, how much simpler and cheaper things would be.

Time to get off the internet. I have a friend coaxing me out today who has given me permission to be miserable which helps. I still haven't left the house and the last 5 days have been really, really awful. I can't face making plans and just want to hide here until I feel better but it doesn't work like that. I know myself well enough, hence the course I booked that starts tomorrow to drag me out the door, without it I will just lie around the house worrying and losing perspective.

Oh and before I forget, on the subject of hope, I mentioned in a previous post that it's impossible to truly grieve the pain of childlessness until you have given up hope. Some couples goo so far as to start using contraception again or the male partner considers a vasectomy. Until them, it's impossible to move on because there is always an element of hope. So being TOLD not to give up hope when you are facing a failed cycle of trying to conceive naturally or using intervention is just daft in my mind and it seems as soon as one shares any signs that their cycle may not result in pregnancy everyone jumps in, urging them to cling to hope. I suspect that the people who write this sort of thing either cannot think of anything else to say or are trying to make themselves feel better. It's hard to see another unsuccessful IVF story so I imagine they are unconsciously writing those words of hope to themselves.

The hope is always there, it's built in and it doesn't truly disappear until there is certainty. What helps is being able to explore how you feel, being able to express your thoughts about what seems to be a failing cycle so you can gather strength and feel positive that you can cope with whatever the outcome will be. That's what I have found helpful. I considered going on the website to announce my failed cycle but knew it would be met with very well meaning cliches and cyber ((hugs)), it's too painful for that. Now I really, really must leave the house!

Saturday, January 29, 2011

Nothing new

Arranged to meet with Dr P on Monday face to face which is sensible but I would have rather chatted on the phone to know the plan. I'm nervous I'll have to wait more than one cycle before the next try or that the Drs holidays in February will eat too far into the cycle after this one because mine are only 26 days. Fingers crossed it will be a plan I like. I could tell he didn't want to go into it on the phone and I didn't have the energy to ask. I just wanted confirmation of a negative result so I could ditch the progesterone and go out.

It will be strange not to have any medication booked in my mental diary, for the last 4 weeks I've had an injection or pessary due at 08.00 so I woke at 07.50 in a panic and had to remind myself it's really over and not just one of the strange dreams I've been having. I hope everything settles down soon, it's all very uncomfortable not like my usual periods. The glass of wine was overrated, I should have remembered from doing a detox before that the first glass is not always as amazing as you hoped, I didn't even finish it. It was nice to choose food and not have to worry and to get stuck into some caffeine at last.

Friday, January 28, 2011

Day 28/Day 2

Thankfully the flow is now so heavy and red I didn't need to waste any time or money on a home test. I was up all night changing pads and only slept an hour but made it in time for the 08.00 blood test. Paid the deposit for my studies and home to bed. I'm sticking to no tampons/continue progesterone rule so I can tick every box this cycle but at least my period is here so the waiting game has come to end. Just be nice to speak to Dr P for closure, permission to have a stiff drink and count yesterday as cycle day 1.

It seems that most clinics stick to the wait until the blood test rule. There is a chance of an ectopic which seems crazy given the tubes aren't used but it happens so I know it's something else to rule out and it will be a relief to hear the final HCG figure, see if there was a whiff of a chemical pregnancy. I feel so poorly, dreadful back ache, sore throat aching legs. It's impossible to keep cool in this heat too so I'm feeling the more 'uncomfortable' than ever before.

What a long, long month it's been. I hope the bleeding will follow my normal pattern once the progesterone stops so I can wear my normal clothes again (most with waistbands have been stuck in wardrobe), get back to the gym and the pool etc. I hope Dr P says we can go again in March, that would be something to look forward to.

Thursday, January 27, 2011


I rang to check the time of the HCG tests tomorrow, I really want it for confirmation (as if the red blood wasn't enough). It's very surreal to be here, the night before day 28 when I thought I'd be a bag of nerves but I'm just fed up, tired and want a drink.

Dr P says come at 08.00 and call him 12 hours later. I asked if it was worth going still with all the bleeding and he told me to increase progesterone from 8 hourly to 6 hourly but as usual was very vague and said wait and see. It's obviously too late for implantation and too heavy. Painful too. I suppose from what I know already that there are always these women who bleed after 2 embryos are transferred but still have a pregnancy from one that decides to stay so that's why you always have to go through the blood test. It will be such a relief to know and be able to enjoy a big glass of wine. I had really got myself together but this tiny element of doubt is really killing me, as I sit here bleeding, it's ridiculous.

Roll on the next 24 hours!


Well it doesn't feel as bad as I thought it would and I feel better than yesterday in fact, the usual brown spotting and unmistakable hot, crampy feelings arrived early this morning. I couldn't bear to wait another day to find out if it hadn't 'worked' or not so I'm feeling very relieved after the last few awful days when I started to deflate gradually like a slow puncture. I knew bad news was coming and the wait was very distressing.

Also, while my Dr has been right about everything else I wasn't convinced the progesterone would hold bleeding back for 14 days because my luteal phase is only 12 days normally so this spotting makes more sense to me. I felt as though I couldn't face the journey to the clinic tomorrow for the blood test but it will be good to get confirmation, there's always an element of doubt at the end/beginning of a cycle. So the phone call I have been waiting so impatiently for will be permission to uncork the wine. Fantasies of Dr P calling and me interrupting with the gory details of my brown spotting and him saying 'well, your HCG is quite high so let's see on Monday shall we'...or similar, drift in and out of my head. It doesn't sway me though. It's time to put my back up plan in action.

I have a nice long weekend now before I start a full time course on Monday. I'm so shy I hate meeting new people and find it exhausting so it will use up most of my energy. The course leader is organising a meal on Thursday so it was nice to say 'yes' put my name down with out having to tell more white lies. I would have postponed the course if I had been pregnant as it's a month long and I wanted time to rest in case I felt poorly. It would have been nice to postpone it if it had been a happy outcome of course but even though it's a sad ending to the cycle it comes with the return of perspective as all new cycles do when the state of limbo is over.

These past two weeks I've moved from a desperate urge to prove this had worked, it's almost hard to believe that 2 top grade embryos implanted into a uterus with a primed lining could not turn into at least one pregnancy but gradually I moved towards a desperate urge to prove what felt like an inevitability, that this cycle wasn't going to be successful. I would find it very hard to face starting a cycle from the beginning again so I feel very grateful that we hopefully have 2 cycles left.

Wednesday, January 26, 2011

Symptom spotting

I'm going to note my symptoms for the record, for future cycles too just to remind myself. It's true anything goes. I cracked and went on the website today and read and read all the predictable stuff. One poor woman was bleeding and HCG was clearly dropping yet there were still replies saying don't give up hope, I'm sure your levels will go back up. Who is she trying to convince really? Then of course one stumbles over the inevitable m/c and I remember why I'm staying away. Before I log off I spot one post that says 'the 2 week wait either consists of pre menstrual symptoms, early pregnancy symptoms, supplementary progesterone symptoms or a never really knows' true! So I made a swift exit.

I had to wee on an old test I have in my drawer, it's sensitivity is 50mUI/ml, it was late afternoon and I had last passed urine an hour earlier so the chances of 2 lines was zero, I just couldn't bare it any longer and worried I might use it tomorrow which would be inconclusive due to timing and low sensitivity so now it's gone in the bin and I feel like it's proof trigger shot gone too. Such a relief. I then bought a & 25mUI/ml test for Friday to give me an indication of the phone call coming on Friday night. I have such a lot riding on next week, people are waiting for a few decisions and I need to decide by midday. Anyway, if its negative on Friday, first wee of the day then am going to commit to a few things and having to wriggle out of them if I get a surprise positive on the blood result 12 hours later is unlikely but a welcome dilemma.

Symptoms; boobs and tummy are much more comfy since 2-3 days post ET, I've had no spotting post ET or at all yet. I am hoping that I my tummy with get it's bloat back and boobs will reinflate but I know it's not the end of the world. Bowels are a bit crazy, I'm so used to progesterone decline after day 21 on a normal cycle it's weird not feeling the inevitable relief from constipation and big cramps. I've had lots of cervical cramps which is always the ultimate sign for me that period is coming but nothing due to progesterone, feels strange, usual I start spotting day 26 so I'm checking a dozen times a day and every time I wake to go to the loo at night for spotting, it's impossible not to expect blood. Headaches, nausea, you name it I've had every symptom I normally have this month minus spotting but in a different order so hopefully next time this will remind me how it's impossible to tell!

The above link is good. It's a reminder that even if you don't do a urine, home test, that the blood HCG level does not confirm anything but it takes 2 at least to say with any confidence a pregnancy is there and one alone can just be a chemical pregnancy, then it's all a matter of waiting for more tests and scans. I can completely understand now the women who say that it's not until you hold a baby in your arms after IVF that you can even start to breath a sigh of relief, even if confidence creeps in after the 12 week mark it's mixed with fear and doubt. A chemical pregnancy is a good sign anyway so I'm still hankering after a positive test on Friday that this is isn't over yet.

Monday, January 24, 2011


I promised myself I wouldn't use acronyms or abbreviations on this blog in my very first post where I get stuck in to fertility websites and the reasons they irritate me. Of course they are creeping in, especially in the comments box and I am to blame.When I began my love/hate relationship with fertility websites, (Baby Centre uk mainly), I just thought what on earth is this? Pure jargon, posts looked something like this;

Hi, POAS with FMU and BFP....OH :) !!!!! Grrr but AF showed, old witch and got BFN later. We BD'd loads this month. 

I've got a pretty good understanding of medical jargon from working in hospitals/clinics for 14 years but I was truly lost and really quite frustrated in my hunt for information in English from a distant Spanish speaking country. I google searched a few of the acronyms which just led me to other websites where people spoke the same strange language. I felt like my 90 year old Grandmother might on seeing a text message saying WTF LOL CU L8R ;), it takes me a while to translate 'text speak'.

So here are a few explained. You will see there is nothing fancy or complicated about them. What bothers me most is that there is nothing logical about them. I would particularly like to meet the meet the person who came up with number 1.

1. AF = Aunt Flo (or Flow?). Any ideas? Yes this is the bleeding at the start of a new monthly cycle, or period, on the blob, got the painters in, old witch. It's bizarrely sharing the same name as a character from Bod. That old catchphrase from the much loved children's TV programme from the 70's takes on a whole new meaning. 'Here comes.......Aunt Flo' and always spells bad news for people TTC.
2. TTC = Trying To Conceive. You can add to this..TTC #1 2yr or something similar.

3. DH/DP/OH = Darling Husband/Darling Partner/Other Half. Again, I use this on the websites but somewhere inside my stomach turns a little.

4. BFP/BFN = this one had me foxed for ages, it is Big Fat Positive/Big Fat Negative...pregnancy tests of course. It is possible to reduce the best news/worst news on a monthly basis to 3 letters BUT not until you have POAS.

5. POAS = peed on a stick

Here are some more acronyms that are not commonly found in the notes of Midwives or Obstetricians

  • 2WW - 2 Week Wait before testing
  • AKA - Also-known-as
  • PMA - Positive Mental Attitude
  • BD - Baby dance (sex)
  • BF - Boyfriend
  • BH - Braxton hicks
  • BIL - Brother-in-law
  • BTW - By the way
  • DD - Dear daughter
  • DF - Dear fiance
  • DH - Dear husband
  • DS - Dear son
  • DSD - Dear stepdaughter
  • DSS - Dear stepson
  • DW - Dear wife
  • ETA - Edited to add
  • FIL - Father-in-law
  • FT - Full-time
  • FWIW - For what it's worth
  • FYI - For your information
  • HTH- Hope this helps
  • IMHO - In my honest opinion
  • IMO - In my opinion
  • IRL - In real life
  • IYKWIM - If you know what I mean
  • JMHO - Just my honest opinion
  • LMAO - Laughing my arse off
  • LOL - Laughing out loud
  • MIL - Mother-in-law
  • MYOB - Mind your own business
  • (((Name of person))) - Hugging that person
  • OMG - Oh my god/gosh/goodness
  • OT - Off topic
  • RLT - Raspberry leaf tea
  • ROFL - Rolling on the floor laughing
  • SAHD - Stay-at-home dad
  • SAHM - Stay-at-home mum
  • SD - Sperm donor
  • SIL - Sister-in-law
  • TMI - Too much information
  • WAHD - Work-at-home dad
  • WAHM - Work-at-home mum

And some useful ones to know, that you might find in medical notes:

PG = pregnant
MC = miscarriage
OPK = ovulation predictor kit
IVF = in vitro fertilization (a 'washed sample' of the best sperm are introduced to a single egg)
ICSI = intracytoplasmic sperm injection (a more specialised form of IVF, a single sperm injected into the egg)
IUI = intrauterine insemination (a washed sample of sperm is passed into the uterus with/without a woman taking drugs to stimulate the ovaries to produce more than the normal 1-2 eggs).
HPT = home pregnancy test
-(i)ve/+(i)ve = negative/positive
DPO = days past ovulation
DPT = days past (embryo) transfer
EC = egg collection
ET = embryo transfer
CD = cycle day (1 being 1st day of light/red flow)
CM = cervical mucous
EWCM = egg white cervical mucous (a good indication of your fertile window)
BBT = basal body temperature (to help predict fertile window and luteal phase)
LP = luteal phase (second half of cycle post ovulation)
S/LLP = short/long luteal phase
LPD = luteal phase defect
HSG = hysterosalpingogram (Xray to examine uterus and patency of fallopian tubes)
HCG = human chorionic gonadotrophin (pregnancy hormone measured on HPT's with urine or in blood, with any value greater than 5 being classed as +ive).
FMU = first morning urine (when HCG levels are at their highest.

There are many more of course (apologies for any spelling errors) that have yet to feature on this blog so I will try to update it as I go. While I understand the need for abbreviations I think RLT (raspberry leaf tea) is taking things a little too far!

Sunday, January 23, 2011

Day 23

Such a lot has happened in just 23 days but the time has passed so slowly. Staying away from websites has really helped, I'm ultra sensitive at the moment and even avoiding my daily FB checks, just keeping up with messages when they land in my email account is helping.

This blog has been the most useful tool to me as a safe space to talk about how I was really feeling. At first I didn't share it with anyone and when I did I was encouraged by how supportive people were so I'm glad I did. Perhaps, I didn't anticipate the effect my blog might have on the readers. I didn't want to keep apologising for my feelings all the time like I had to on the websites, especially being self indulgent, it's not a commercial blog. So I was amazed when (almost) uninhibited ramblings were vaguely useful to the readers. All I know is that I am very touched by all the emails and comments people have taken the time to leave, each and every one.

So before I go on I suppose I should warn readers that I am not feeling very positive at the moment. We had such a good response to our treatment that I do feel lucky, of course but I will have days when I feel blue and half empty and I suppose that might not be useful to others. My feelings have really taken me by surprise but I know myself well enough that I have a delayed reaction to things. The first half of this treatment was so intense, I lived by my diary and left no time for feelings, no time for doubt, I had to keep going, keep setting my alarms to prepare, inject meds, visit Dr and have 24-48hr scans. A welcome distraction, so much activity after so many months of waiting, it felt really good and almost like I had some control given back to me.

So one week on I've had time to process everything, let it settle, I've watched every film in my collection, caught up with all my work and emails and now is the time to let myself take it all in. I didn't think I'd feel like this about our fertilized eggs but I'm preparing myself for the weekend and it's utterly terrifying. I can't think past this stage. This is no longer a 'try' or even just 'a cycle' it's 2 tiny potential lives made up of bits of me and N and I'm very attached to them already, the idea of loosing even one of them feels very strange indeed so I think that's what the tears are about, I think I'm just tired and I'm very much back to taking one day at a time.

Saturday, January 22, 2011

Small world

Since my post on Tuesday I've wondered about all the other people out there who have infertility or secondary infertility. Yesterday I went to the clinic to pick up a prescription and saw the familiar face of the lady who sent K one of the emails to recommend health plans that I mentioned in Tuesday's post, the one who said 'IF number 2 ever comes along'. I couldn't believe it. Ours is not one of the well known clinics either. I felt really sad watching her walk through reception but at the same it was a small comfort to know she chose the same clinic as us. If only finding fertility services was as easy as finding maternity services and you could simply send out an email to friends saying 'anyone know anywhere?'.

So I was surprised but distracted as I was running late to meet my friend outside the agreed spot by one of the cities big hospitals. I knew she had been trying to sort health care out but I wondered if she may be pregnant. She mentioned acupuncture last time we met and said it was for post op care but didn't say why. I've been so absorbed with our treatment none of it added up but before the waiter had brought our drinks over suddenly she was shaking and saying 'ectopic pregnancy....nightmare....IVF' and I noticed the bag next to her was bulging with test results. Our conversation about frustrating hospital systems turned to gynaecology and as we'd both gone that far the rest unfurled. I didn't say I was in the two week wait, we just talked about the testing stage. When I woke up this morning I thought I may have dreamt the whole thing. She was as amazed as I was and couldn't believe that when we were out on the girls night 2 weeks back that I was one week into my treatment already.

I'm nervous that another person knows but I know I can trust her as she has only told 4 people and seems to share a lot of my views. I hope we can be supportive to one another even though we are at different stages in this and the future may hold very different things for us.

Day 22, fue

It's gone. That feeling. I've been so bloated since I was pre menstrual at the end of December, it feels very strange indeed. Yesterday I was out and about and met a friend for a good catch up. I almost didn't notice until I got on the bus to return home and felt comfortable for the first time in weeks. Bra looser. No more cramping and twinges when we hit a bump in the road. I tried not to think about it too much in the evening but I slept worryingly well overnight, no trips to the loo to empty my squashed bladder and as my hands fell on my tummy I let them lay there. I haven't been able to touch it for weeks but now my pelvis is easily palpable and the heat I've been carrying around has turned to shivers and goosebumps.

Anyone who has waited anxiously for their next menstrual cycle hoping it won't arrive will know the signs. I could go on BC and find someone I'm sure who had symptoms that match mine and still turned out to be pregnant, there always is and plenty of people to reassure me and tell me not to give up hope which I've never found helpful. Again, if you have done the 2 week wait more than a dozen times you will know that in the last thing you want is to keep hold of hope. It's better to be realistic. So maybe it's good to have a reminder today of the odds, they are not in our favour after all. This treatment can work but for most people it takes several tries and I should keep feeling lucky that we have 2 more chances from this cycle.

Here's the rest of the growth stages because it's quite interesting, shame there isn't one for when it doesn't work.

6dpt.. Implantation process continues and morula buries deeper in the lining
7dpt.. Morula is completely inmplanted in the lining and has placenta cells &
fetal cells
8dpt...Placenta cells begin to secret HCG in the blood
9dpt...More HCG is produced as fetus develops
10dpt...More HCG is produced as fetus develops
11dpt...HCG levels are now high enough to be immediately detected on HPT

Thursday, January 20, 2011

5dpt.. Implantation begins - the blastocyst begins to bury in the lining

How lovely it would be if something was burrowing away. I'm so constipated from the progesterone I'm not sure I'd notice anyway! I'm sure being bunged up to the hilt is to blame for sending false hope to symptom spotters everywhere. How surreal to still have traces of the HCG (pregnancy hormone) trigger shot and supplementary Progesterone just to mask any symptoms and keep me guessing right up until the very last minute! I definitely have lost all the post EC and ET sensations which I sort of miss now.

Wednesday, January 19, 2011

Accidental sperm donor

15, more or less, years ago, N was an accidental sperm donor which is really ironic on so many levels. I was going to call him an unknowing or unwilling sperm donor but as it takes two to fail to use protection, he can keep his share of the blame. He's never missed a payment to the child support agency but hasn't seen M since he was a few months old. The surprise pregnancy that resulted from a one night stand at university did not bode well for paternal bonding and the decision this girl made to leave university and keep the unplanned pregnancy was not good news for a lot of people. So N went to visit baby M for the first few months of life but due to an opportunity to work abroad for 6 months of every year, pressure from his then fiance and an attempt to do the right thing long term, N walked away. 'She' got on with her life, met a new partner, had more children. She has never asked for more money, just that she and N keep a recent contact address for each other for M's sake. There is a genetic link after all but that's where it ends.

I wasn't pleased to find out about M either but it didn't feel like a problem when we first met, just a potential problem should M want contact in the future, it would be something I had to deal with. N and I had only been seeing one another for a week or so when I jokingly asked if he was secretly married with kids,( after so many destructive relationships I was determined not to get involved with someone who had huge issues), my mouth fell open wide when he said 'no wife no but there is a kid actually'. So M sounded like an issue but as we talked it out over several bottles of wine I decided I could cope with it. Once I realised N hadn't seen him, or her, for 8 years I realised it wouldn't impact on our lives too much and N assurred me he still wanted kids with someone he  actually wanted to spend his life with. They were lovely days.

I can remember deciding not to tell any of my friends about M, it would be seen as gossip to them and it was N's business one he had dealt with privately with M's Mother. I knew straight away though that the only potentially unbearable consequence would be if we couldn't have our own genetic children and I assumed the responsibility lay with me. This laid the foundations to my paranoia about fertility problems but I was reassured that N must have potent swimmers. His friends rarely mention M but when they have it's almost with pride....'good shot N, good shot'.

So of course I am thinking about M at the moment more than usual. I have seen one photo and  the resemblance to N is painful. As sometimes genetics skip a generation I have decided that M has inherited N's Dad's genes, who really is a wally. Poor M. At least he has nurture on his side which I strongly believe is more powerful than nature.

4dpt.. Blastocyst attaches to a site on the uterine lining

Now I can interpret or misinterpret all my signs and symptoms. If only I could see inside, take a look at what those little things are up to. I am sticking to my website ban, so far so good. I'm going to keep track of the daily predictions but of course there is a chance nothing at all is happening. I feel a bit calmer anyway and seem to be catching up on my sleep.

Tuesday, January 18, 2011

3dpt Blastocyst hatches out of it's shell

I've managed to tackle some really dull jobs with big deadlines (tax mainly) today. I've been procrastinating for months but decided the 2 week wait would be a good time for it. I found myself trawling through old emails and came across a stack of replies from a girl called K in November 2009. She was one of the first people I met here and she was truly lovely, chasing after her daughter toddling around, I hardly noticed her bump. She told me she was in my situation a few years back, new to the city. When work was hard to find her and her husband decided to bring family plans forward and she was pregnant before they knew it.

I was so excited, everyone, including my acupuncturist told me they had a 'feeling' that it would happen really quickly when I arrived here and a few weeks after meeting K I found myself expecting my period to start but no sign, none of the usual cramps. I was only a whole day late but this was unusual. Terrified but excited N and I scoured the net looking for health plans, joking that I may have to return to England to have the baby and I wrote to K asking her to recommend a health plan, agreeing with N to share our plans with her and her husband.

So today, there were all the replies forwarded to me by K, very excited by my family plan, she said, she looked forward to having more young people around with kids, I didn't tell her I was 33 about to turn 34. There were nearly a dozen emails forwarded from friends of K's saying 'this plan was excellent with number 1 and I have kept the same obs dr for my current pregnancy' and that sort of thing. I noticed one of them said 'here's the details of our plan, we would definitely use them again if baby number 2 ever arrives'. I checked the name at the top and realised that baby number 2 had not yet arrived for this couple as far as I knew on good old FB. I had seen the couple a handful of times last year with their gorgeous son and suddenly my perspective of there situation changed as I imagined their potential disappointment 14 months later. Over the course of last year I deliberately distanced myself from K and the gang who all had kids or enormous bumps as I began to feel self consious and wondered if K was checking to see if I was saying 'yes' to a glass of wine or not and anyway we naturally drifted and I made my own friends. I dread bumping into K still. Bumpless. I am completely aware of course that this is classic projection and K has more than enough to do with her 2 beautiful daughters than worry if I am failing to conceive.

I suppose I just hadn't considered secondary infertility for the people I know with one child, especially one grown up child. Some people decided one child is just right or do not want children at all but I know of another couple we meet with often who have a daughter via ISCI and are trying for number two and the pressure is immense. Her daughter asks 'where is my brother/sister?'. It must be hard.

I find it very hard to hear people saying secondary infertility is 'worse' or 'harder' than primary and find these are people who have not had to struggle for number one at all, so it's the first time they are faced with tests, treatment and uncertainty and friends falling pregnant with number 2, 3 and 4. I would bet all the money in the world that if it came to it they would not swap secondary for primary. To clear their childs bedroom out and turn it back into a study, to wipe the amazing experience they have had and the future they share, to be robbed of their title as parents. No, I'm sure childlessness scores higher on the pain scale than having one child without any brothers or sisters. It's just that today it may me wonder how many other people there are out there who conceived number 1 as a fluke and are struggling now.

Monday, January 17, 2011

2 dpt embryo is now a blastocyst

Thinking about the whole testing process and the confusing signs one gets, has reminded me of the perils of symptom spotting in the 2 week wait. I haven't been in a 2ww since last August, not one with any real hope anyway so I think it's worth noting my symptoms for future cycles. I know that a year ago before I got the knack of my pattern each month, the slightest twinge or swelling had me rushing to the chemist to buy a stick to pee on. Now it seems as soon as you start any sort of fertility treatment you need to start interpreting or rather trying not to misinterpret everything.

The daily report on the cell growth has helped me be realistic about the cramps or rather twinges that I have been getting, that my uterus is still settling and probably a bit confused to by the 8 hourly progesterone doses. It definitely feels different to a normal cycle and I've been waking a lot in the night, uncomfortable every time I roll over. I suppose it feels like day 22-26 of my cycle normally with the swollen boobs and bloating.

I must admit that these past few months I've barely noticed pre menstrual symptoms at all and I realised how exaggerated everything became when I started charting everything. Some people advise against it, saying it makes stress worse and therefore (literally) counter productive but it gave me the confidence to know that we were trying our best each month, that I had a fertile window and that it really was taking too long, I couldn't just keep wondering. Imagine if I had waited as two of my doctors advised me. I'm glad I went after 9 months and started telling white lies!

Apart from checking blogs, which I find very comforting, I have stayed off BC website for 24 hours now and I feel better for it. I've blocked the notifications and daily updates and while it's the last thing I feel like doing, I'm organising to meet up with people in the week.

Sunday, January 16, 2011

Day 16 1dpt (day past transfer) the embryos should be growing and tomorrow become blastocysts

I feel so much better today and it feels nice to look in the mirror again. Usually I just check for left over toothpaste marks and try not to spend too long examining my lines. I used to feel fine about getting older but as motherhood was to be denied for a while, the ageing process seemed to speed up. Now we have a chance even though it's small, (I am very bloated and crampy), I can rub my tummy and conjure up the black and white image of my uterus from yesterdays scan, with tiny speck of grey hope in the middle. And I actually feel 'fertile' for the first time, even if it doesn't last, it's worth enjoying. I'm almost tempted to wee on a pregnancy test just to get a positive from the trigger shot on Monday in case it's my only chance but I'm saving it for next week.

Dr P has booked me in for an HCG blood test on Friday 28th, Day 13, at 08.00, so he can call me in the evening with the result. There is absolutely no way I'm waiting that long. People on BC website seem to test on 11dpt so I plan to take a test in a few days to check if the HCG is clear and then do another on Day 13 (maybe sooner if I'm honest). At least then if it's negative I know that good news from Dr P is unlikely and can prepare myself for his call and if the urine test doesn't quite pick up the HCG in the blood (more sensitive of course) and it shows positive in blood it will be a welcome surprise. Hmm...I mustn't waste all my pesos on false reading either so will try to wait until 13dpt.

1dpt (day past transfer) the embryos should be growing and tomorrow become blastocysts

Saturday, January 15, 2011

ET continued...

It's nice to have made it this far and this afternoon I slept a lot once I'd managed to get my head round the fact that the active treatment phase really is over. No more clinic visits. No more injections. Just progesterone 3 times a day to remind me that there are 2 clusters of cells floating around.

The part I was most nervous about today was having and holding a full bladder as it's not my strong point. I only need 250ml before I'm dancing a jig with my legs crossed so 1L was a challenge. I was anxious too that we still hadn't paid so we arrived early and surprise, surprise the transaction wouldn't go through. N had to go off and use a phone somewhere to call the UK and let the bank know that we were genuinely trying to pay out an enormous lump sum. Still no joy so N managed to collect the daily limit from a nearby bank as a sort of deposit and no one seemed worried about it.

So it was still only 11.00 and I was ready to pee. I stopped drinking in preparation for 11.30. Couples came and went. We were obviously at the end of the list and eventually (while N was chasing the bank) I found myself sitting alone in the waiting room. The receptionist went off and changed out of her uniform and the security guard finally woke up, rolled up his paper and left his stool. I became obsessed with the somewhat irrational thought that I would either have to wee or I worse I would leak all over the sterile area and ruin everything. What could be taking so long? Maybe the embryos had stopped growing overnight and the Drs were shaking their heads next door, tossing a coin to see who would break the news.

After the longest 15 mins ever I was called through by the theatre Nurse and given the same outfit and instructions as Wednesday, pre EC. I changed and then sat on the bed feeling more lost and lonely than ever before since we started this thing...and where was N? Tears were stinging my eyes and as I don't do public crying if I can help it I found myself taking deep breaths and concentrating on the fixtures and fittings in the room. Dr P walked in and started showing me a chart with loads of numbers and I eventually realised that '44-44-33-x' was our 6 embryos which had grown from '33-33-22-1' yesterday. It slowly dawned on me why he was grinning so much and I suddenly felt like I could do it after all.

Same room, same table, same number of people except instead of an anaesthetist I met the embryologist and for the first time, ever, I was asked to confirm my full name. I was relieved that the sonographer hardly needed to put any pressure on my bladder to get a good view and I was reassured I wouldn't leak or burst in a very bored 'everybody says that' sort of way. In went the catheter through the cervix (always the worst bit for me) and then I was doused suddenly with cold liquid which made me wonder if I had been falsely reassured but no just sterile water. Lots of incomprehensible mumbling and I watched the second hand go round the clock twice, then the embryologist came in and she wasn't really in view but she was carrying 'them' and I felt really strange, the room was dark by the point to and everybody was whispering then silent. 'OK' said Dr H, now we need the embryologist to just confirm the catheter is empty and he laughed....'yes, very sensible' I said. Silence again...................then a very nonchalant 'Muy bien' came from the embryologist, hidden from view and everyone started chatting and the lights came on. Show over. Dr H and Dr P swung the screen round and showed me a tiny speck, like a grain of rice. 'There they both are, that's your uterus around them, they're suspended in X-ray contrast so we can see them'. Wow.

Next door, still no N, I signed a form to give permission to cryopreserve the remaining 44 and 33...with pleasure. I couldn't wait to pee and I was surprised that I didn't feel the need to relax afterwards. I had anticipated bargaining with staff to let me lie flat with my legs in the air post transfer but it felt different, after all that pushing and pulling, they were definitely where they needed to be. Finally N appeared looking deliriously happy and signing on the dotted line below. Dr P said ' now we freeze for the brothers' which sounded funny but amazing. I can barely entertain the idea that this will work, let alone have siblings but I'm trying to let myself just feel happy which is hard after building up a protective wall against disappointment.

I pottered when I got home and wished I had a print out of the scan today just to make it seem real, instead I tidied up our results pile in the hall and ended up laying it out and taking a photo of it to put on here instead. So many tests. It's not over yet but we've come such a long way I felt quite proud looking at it, that we have navigated our way through all the uncertainty, I'm sure we will mange the two week wait now, together.

Day 15 Embryo transfer

I'm very relieved to pass this stage and after another nights growth 4 of the 7 embryos are now classified as Grade 4, which is amazing. 2 are Grade 3 and 1 decided not to keep growing. This gives us 2 more cycles of 2 which is a dream come true. And so I'm very grateful to be in this position after so many months of hopelessness. We have had 2 grade 4 put back. The rest is up to nature.

Transfer due today

Thank you all for reading and your lovely messages and comments. Dr P was fairly reassuring about blood stained CM but as my love-hate relationship with websites continue I learned that the progesterone pessaries make you feel very crampy and as what goes up must come down, it's normal to get some 'residue' and post EC very normal to have a little bit of blood.

Dr P said they had graded the embryos and all 7 are still with us. I wondered how many were Grade A but of course it's different here and they use numbers. 1-4 with 1 being worst and 4 being best. Dr P said he was pleased, there were 4 level 3, 2 level and 2 and 1 level 1. I'm disappointed there are no level 4's but he couldn't see why and said it was fine. So we shall see...vamos a ver!

I tried to relax yesterday but found it too difficult and ended up feeling worse. I had planned to have acupuncture as this seems to be thing thing to do. I always thought I'd give myself every chance and take all the advice. But, as anyone living abroad will know, trying to find a reputable practitioner in... anything, at short notice, in a foreign land, is not easy and can be very stressful so in the end I decided it would be counter productive. It took me months to find Dr A (when this blog began) and she really was a one trick pony, there's no way she would understand what I needed. I suppose I'll just save that for next time, if we are lucky enough to get a future frozen cycle out of this. I can imagine that leading up to that without all the injections and EC it would easier to prepare my body, optimise my chances etc.

So if it all goes ahead as planned today (what is the plan? no one even knows yet) then maybe I will feel relief when I get home safely and surely relaxing then is important. I really need to stay off those websites they wind me up OR even better, learn not to get so wound up and not take everything I read to heart. At the moment, distraction is my relaxation and so I'm off to watch some downloads from the UK, the more ridiculous the better!

Friday, January 14, 2011


Well I'm taking my 8 hour progesterone faithfully (orally post EC), as of yesterday it's a pessary. I noticed a little trace of 'brown' yesterday and thought that was probably to be expected. Post EC things were a fresh red colour for a few hours when I went to pee but otherwise I didn't notice any spotting. This morning I woke up and I must have still been dreaming because I saw the clock said 08.45 and I rushed to the loo to administer the 08.00 pessary. It was then I spotted the trace of dark red this time.

It's actually only 07.30?! Dr P is due to call at midday with the final plan for transfer tomorrow so I will wait til then to mention it and try my hardest not to wind myself up on google. I just worry that now I'm egg-less, the progesterone is not enough and my uterus is breaking down already. So much for my relaxing day pre transfer! Phew...deep breaths.

Thursday, January 13, 2011

A very tentative booking for embryo transfer

So far things are going well but we won't know until Saturday morning how many of the (7 out of 9 fertilised) embryos have grown. It's comforting to know we have a few and it's worth celebrating this next hurdle of fertilization that other couples sadly fall at. I have wondered if perhaps we would be told we needed donor eggs or donor sperm as one never knows, so anyway it's another box to tick. For that, I feel very, very lucky and grateful.

Clever doctors and lab people who performed the ICSI, 'icksee', (intra cytoplasmic sperm injection), I just hope nature carries on behaving so they can divide and multiply. A pat on the back for us too to get this far as it's taken a lot of organising, money and patience. It's not over yet by far, I still have my fingers crossed that on Saturday we have a really good cluster of cells to transfer and some more to freeze, please!

Mind the bump

I've managed to build a little world in the southern hemisphere where I'm safe from exposure to bumps and babies. People with grown children, fine, or at least easier but otherwise it's difficult. I have hidden all new Mums and Mums to be from the daily news feed on FB. Those that have battled infertility to achieve parenthood are permitted of course, in fact I rather enjoy their photos and updates.

I read somewhere that even if you have one, maybe two or more, lovely children following infertility that news of a couple who are (effortlessly) expecting is painful. I can't imagine being at that stage, however, I agree that I find pregnancies without a struggle to conceive difficult and those who have a rough ride initially are easier and sometimes hopeful to hear about.

And so I need to vent about one particular expectant woman, if not on this blog I may make enemies in my small world. Let's call her Tontita. We met last September and found we both shared a similar expat timetable and initial feelings towards this city. It quickly emerged that we had some big differences; her budget is 10 times the money I get by on, she thinks in pounds and I think in pesos, she misses her job and status in the UK but I don't, she has never lived/travelled alone before while I have, she only likes to go out with her husband while I often enjoy time with others away from N and finally, she really didn't choose to be here while I couldn't wait to accompany N and his work. I'm not judging this, living abroad in your 30's throws you in the path of all sorts of chatacters and so I enjoyed our meetings but felt I wanted to keep some distance too. Mainly, my concern was that we were the same age, trying to conceive without success and one of us was going to be the first to get there.

I wondered how I might break the news to Tontita if I got pregnant first, it was a nice fantasy, perhaps we would be pregnant together and I would enjoy telling N about her luxurious pregnancy while we got cosy in our 2 room apartment. Anyway, I knew I would be nervous about telling her if I was lucky enough to be next in line. Tontita was fed up, she said she didn't know what she would do if she couldn't have kids. I inquired about any testing they had considered or any known conditions that may be hindering their efforts. I was careful not to tell her about our early steps towards IVF but said I had a polyp (I did) and I may need lots of gynae exams before we got anywhere. I gave her a few expat tips, where to buy cheapest OPKs, some online stuff for basal temps and tools to predict fertile window.

Well Tontita had never heard of the fertile window, nor timed intercourse each month, tracked her cycle, taken folic acid, googled anything about how a sperm meets an egg. For 18 months she and her husband had stopped using protection and that was it. So, Tontita said she might have a read on line and sent me a message to say she had predicted her mid cycle and was going to have a good try on those dates. Two weeks later she told me she had taken a home test but it was negative and she felt really low.

This lulled me into a false sense of security and so 2 weeks later when we met for coffee and she said "Well......I have NEWS...I am PREGnant" with an odd smile I felt like I'd been punched in the stomach and for a moment I was utterly speechless. I burst out a "Owww, ohhh congratulations, how ....lovely" but I couldn't get the muscles in my cheeks to work and all I could muster was "So have you been eating anything different since you found out...any nausea?" It turns out she was 6 weeks and when we had met a fortnight ago she had been testing too early and at the wrong time of day. She said "Yeh they tested my HG or something, I've just ordered loads of maternity stuff from home, I've got so much to buy, I'm huge too but not sure how big the little thing is". At this point I asked the waiter for the bill and thought to myself...It's HCG, what's wrong with the maternity clothes here and ever worried that it's still early days and it's about the size of a grain of rice perhaps if you stopped shopping online you might learn something AND for what it's worth at this late stage, please start taking folic acid.

So anyway, she's stopped asking me if I'm free to meet (on her terms near her house) and I'm relieved. Her posts on FB are out of view, which included 'Had enough of morning sickness now', 'Got issues with flat ...are we the most unlucky couple in the world', 'had to wait 2 hours for appointment' and 'sick of being poked and prodded'.

I need to get on in this city and cross paths with people in her social circle a lot. I've learnt that others find her half empty outlook hard to endure too so I need to let it go. Tontita is the epitome of all that upsets me in this unfair process and I hope after this vent I can leave her be, her ears must be burning and it's a waste of my energy. Deep breaths. At least I can appreciate this opportunity to live in such an amazing city and I never suffer from 'boredom', my time here is so precious!

Wednesday, January 12, 2011

So far so good

Roll on Friday when I should know if any of the eggs have matured, been fertilised and multiplied appropriately. The next step is obvious but I haven't even dared pencil it into my diary yet so as not to temp fate. They managed to extract 9 eggs from 11 follicles, more than anticipated, which helps the odds somewhat and so for at least today I can breath a quiet sigh of relief that I can tick the box next to egg collection.

I found the whole experience less painful than anticipated. It hurt as I woke up and I had a lot of twinges, like really bad trapped wind that makes you wonder if perhaps you have appendicitis but then it eventually passes. A few hours on I have cramps and twinges but nothing more than a bad menstrual day. I haven't taken any pain killers, I think I'm still high on relief.

I enjoyed the anaesthetic as much as my last one during a dental op. I can remember drifting off and hearing Dr P say...'are you OK', I know this tone, it means 'are you asleep yet...can I start?'. 'Yes', I said proudly, 'I'm still awake but it's so lovely, like being drunk but lovelier...'. I woke up back in recovery and took some persuading that I had been there for half an hour already. Allegedly, I even managed to walk from the theatre to the recovery room where N was waiting and with out fully opening my eyes I asked 'Did you do your 'jizz' yet?' and just to be sure the non English speakers accompanying me to the bed could understand I followed the question with a griped hand and back and forth motion of the wrist. I don't recall any of this of course, I then threw myself on the bed with one arm and one leg dangling over the side and the Anaesthetist said to N, 'I think she's still drunk' to which he replied, 'I've seen worse' and he has too!

I wished I could stay asleep until the end of the month, at which point someone could wake me and say 'yes' or 'no'. Still such a long way to go.

Tuesday, January 11, 2011

Egg collection tomorrow

I timed my trigger shot perfectly and in it went bang on 9pm. There's not much more I can do now except be very organised for tomorrow. ECG and cardiac assessment, HIV tests (arrived yesterday!!! both negative), pot for N's contribution waiting by the door. Now off for a long bath and some preening for my close up tomorrow. I attempted to prepare the flat, stripped all bed linen, covers, pillow cases, every dish cloth and towel and left them at the laundrette, which sadly shut for a medical emergency (according to a post-it note on the door) and so my washing is still in the machine getting a good soak until who knows when.

I have more than an average case of OCD and often draw strength from rearranging inanimate objects. I have been careful not to get too attached to anything except the colour pink, which I have worn in some shape or form since I went for my baseline scan on 31/12/10. I have made a little woven bracelet to wear, in pink for tomorrow and so I'm nearly done. Cheese and meat sandwich (there is no other in this country) and now I'm nil by mouth for tomorrow.

I feel some excitement to have reached another hurdle but I know we are not over it yet and so I feel more fear than anything. I'm so nervous about the success of this and potential embryos that I can't even contemplate the anaesthetic and procedure. It's on a par with waiting to get on the plane when we moved out here, the night before a final exam, collecting the exam results and going for a job interview that involves public speaking. The prospect of success, peoples kind words and my trusty pink band will get me through, I know it.

Monday, January 10, 2011

The plan so far...Day 10

I have 11 folicles and half a dozen eggs of a good size that hopefully will be joined by one or two more and so this mornings Gonal F was my last shot to stimulate the ovaries. Tonight I take the final Cetrotide to inhibit ovulation followed an hour later by the 'trigger' shot of HCG (the pregnancy hormone) to trigger ovulation in 36-40 hours time...that precise...even in South America! So I will have a needle-free-keep-your-pants-on day tomorrow and start nil-by-mouth from midnight...........Then, on Wednesday I will go to the clinic at 08:00, 35 hours post trigger shot and get gowned up for egg collection while N works the magic into a pot next door. I can't even entertain the idea of a potential embryo transfer, that hurdle is not quite in terrifying.

Today I was struck by the surreal-ness of it all. Legs akimbo, staring at the shadows cast by my giant knees from the spotlight and Dr H wandering in to count with Dr P and I translate, heart beating too fast, 16, 17 and a 20...good sizes but some are still 'chiquitito' and probably won't grow much more, there are 11 follicles but I will be lucky to get half this number. Vamos a ver!
Dr H, is pleased as Dr P say's get dressed I'll be waiting next door as he pings the KY jelly filled condom off the probe and flicks it in the bin.

N couldn't make the appointment this morning and it feels rather strange doing this without him, there are 3 men in my day to day life at the moment all trying to get me pregnant and I feel like a clucky old hen with it's head lopped off, running around in all the confusion being chased by men in white coats. Now it's time for my trigger shot and hopefully the last needle for a while. I've nearly done my bit, I've stuck to the rules and hope to be duly rewarded.

Saturday, January 8, 2011

Yesterday & today

Yesterday was long but good on the whole. Woke. Usual Gonal F Injection. Bus. Clinic. Eggs still growing. Book another USS for tomorrow (Saturday) at 08.00. Prescription for more Cetrotide to inhibit ovulation. Big queue in pharmacy. Skip pharmacy to make it across town for ECG and pre surgery cardiac assessment. Tube. Walk. Take ticket. Check in. Take another ticket. Check in on 1st Floor. Leave request form in pigeon hole on door. Knock door as advised by sign and take seat. Wait 20 mins. Go through and have ECG on machine older than I am. Then wait again for rude Dr 'Whitney dressed as Britney' to assess me with her expressionless, plastic face. All OK. Leave. Tube. Pharmacy. Injection bloody expensive and not enough cash. Go to cash point. No money. Another bank 4 blocks away. No funciona! Next machine works. Pay. Bus. 6 hours later arrive home and try to psych myself up to go out this evening with people I don't know very well for sushi and cocktails at 20.00...when Cetrotide is due, shit.

Well, I went out and was late but glad I went. I nice bunch of girls, not too young or too many Mums so a good distraction to sit in the penthouse apartment balcony overlooking the floodlit pool and listening to dating stories from the single folk. Met a lovely lady, 41 but looked 31 and after a while she told me she had left her old life with her husband in London 4 years ago to escape the slog and they had travelled all over South America but sadly split up 4 years ago. She wanted to meet someone but was realistic some men may not be interested as she doesn't think she will ever be a Mum, she had grieved, accepted and said she honestly was getting on with her life but it had been hard. I now know better than to say 'but maybe' as she is right so I quietly hoped that she may have a last minute surprise or become a lovely step Mum perhaps. Anyway I felt grateful and went out until 02.00 drinking very little for me just to be careful not to dehydrate and for a moment in the garden of a cocktail lounge it started to rain so we sheltered under a tree and I forgot all about treatment and injections and ultrasounds (due in 6 hours).

Woke on time. USS ok, need more time, eggs still got some growing to do, 2 are almost ready so fingers tightly crossed more will mature. Some are half the size they should be at collection so realistic I won't get more than 6. Persistent taste of Pisco Sour, most of which I tipped in the bushes and flash backs of egg white wouldn't disappear so I eventually puked and slept for 5 hours. I'm quite constipated too which isn't helping. Plus Dr asked today 'Getting lots of discharge?' ...'yes', I said...phew....I have been having a knicker change half way through the day and secretly worrying about it ...these are the things no one tells you about so I'm sharing the gory details.

Thursday, January 6, 2011

A better day

I felt so much better today. I think having a day off from the clinic helped. I swam a few lengths and found myself obsessing over this stage of the treatment. What if the Cetrotide hasn't worked and I release all my eggs. My hips hurt when I swam and I had visions of something dislodging, like frog spawn. Then for some reason I remembered a conversation with my colleague in my old job (she was a Psychologist) about Mindfulness and this turned into a google search of a different kind.

In the afternoon I listened to a Mindfulness podcast and tried to stay in the present instead of constantly worrying about the future. I slept very deeply for 2 hours. Then, continuing my love-hate relationship with BC website I checked in and saw someone had egg collection and got 12 out of 14. Amazing. Was I happy for her? Maybe somewhere inside but I just felt so crap that I'll be lucky to get 6 and even less embryos are predicted. If money was no object I know I could face this again but I'd just love a freezer full of hope by the end of this and I'm already nervous about tomorrow's next USS. That they will insert the probe and shake their heads.

I need to get back to my earlier position of perspective as I've blinded myself with fear again. And so like a mantra here is the quote made famous by Kung Fu Panda, falsely attributed to Eleanor Roosevelt but quite sensible really:

Yesterday is history, tomorrow is a mystery, today is a gift, that's why it's called the present.

Staying positive

How to stay positive? This was the intention for this post after all. I've found ways to keep going but rarely shared anything on this blog so feel like it's become all doom and gloom. I am grateful for many things. Firstly, the opportunity to have this treatment at all as not everyone does. It's better than thinking Why me, why me?, although I think that is a necessary part of the process. Some days it just feels that the whole world has children with little effort and I actually feel sick with jealousy when I look at friends recent wedding photos as they still have hope and excitement about starting a family and this has gone for me, for us, I am clinging to hope of just having a child, that is so slim.

I wonder what someone battling a serious disease would think of this blog, someone who has to inject medications, daily, their whole life. Someone who has an uncertain or poor prognosis and may not live as long as I have already. I am otherwise healthy and I feel I am wasting precious time as weeks go by. I need to find one nice thing to do each day. Taking each day at a time helps, it's the only thing that helps because actually right now, I'm happy, today anyway. I am just terrified of tomorrow that's all and it's overshadowing everything.

Also I need permission to feel fed up too, which sounds a little contradictory. There is a bereavement process that starts once a couple decide to stop fertility treatment and until then experts say it's not possible to move on with life. I am stuck in limbo, grieving that we can't have children without assistance but living in a weird bubble where no one on this earth can tell us that we will never have children (thank goodness) and so we are clinging to a process that is without guarantee and has a 70% chance of not working....or sorry, a 30% chance of working I should say in a 30% full rather than 70% empty kind of way.

If we make to the point of embryo transfer I will celebrate this and it's the next hurdle on the horizon as far as I can see. But today, for the next few hours I'm going swimming as I pass a couple of times a week and today I don't have a clinic appointment to clash with anything. 6

So I went to the clinic yesterday and Dr came out to reception, scrubbed and gowned up, I wondered what he was doing, collecting eggs? Embryo transfer? He wrote 3 request forms, 2 x HIV tests for us and a heart trace for me. "So these are just routine then?", I asked and he uncomfortably replied "It's er yes a serum analysis". Hmmm...another way of saying a test to look at cells in the blood but giving away nothing. Very typical here.

I went across town and managed to make the tail end of the walk in phlebotomy clinic and the miserable woman who normally stabs me was not there and a lovely lady was in her place, chatty and smiley which cheered me up. As usual, on arrival I took a paper raffle ticket from one of those old fashioned red ticket dispensers. If you approach the reception desk without this you will know you have got it wrong from the filthy looks around you but it took me a few visits to figure this out. Now I am a pro. I take a ticket, take a seat and remain unfazed by the empty reception desk. There is half a cup of coffee and a lot of stamps and papers (picture your childhood GP surgery). 10 minutes pass and the receptionist returns and calls number 501? Nothing. 502? Nothing. I am number 534 and the waiting room only has two other people in it. She continues to call out numbers at us as though we are naughty school children until she reaches 533 and an old lady in the corner waves her stick and slowly gets to her feet. (I must point out that the elderly population here are very well looked after and once over 65 are issued an unwritten pass to jump any bus or supermarket queue simply by wearing a head scarf or carrying a walking aid or anything with wheels). She ruffles in her pocket, nothing, other pockets? Nada. Handbag, must be....but no. So as she shuffles over to the ticket machine on the other side of the room to take number 535 and I jump up and announce 534 as I'm English and don't know any better.

Then I book my ECG, for Friday. I feel a bit fed up really. I'm sure I will have a negative HIV result but given my previous job, it's always possible. Maybe I will have some strange heart trace? Compatible with life but not fertility treatment. It just adds to the what ifs?

Yesterday I had another USS and the docs said it looked good but then said they hoped for about 6 eggs? 6? I wanted 6 embryos, just to give us 3 goes at this. I'm not sure I can take the pressure of just 2 embryos as our only chance, even 4 to give us 2 tries at IVF lowers the odds considerably. Can we afford to start this process from scratch again? Can I face it? It all feels hopeless and too much today. I found myself sobbing in a doorway again in one of the beautiful porches of the 'Parisian neighbourhood' trying not to make eye contact with the puzzled doorman.

I had planned to meet a friend afterwards, L. She is a lovely girl and we met only 2 months ago but we clicked and we arranged to go sketching together in the parks. I'd hoped it would distract me but I struggled and after 5 hours of general chat I found myself unable to come up with yet another excuse to wriggle out a social commitment. Because of the treatment I had to miss L's b'day and then 3 days later on mine she came along with a beautiful scarf for me and I felt bad about that. So I bit the bullet and told her in an ice cream parlour. Why I missed her b'day, why I had time off in our voluntary placement and why I have rescheduled my TEFL and why I was rude and sullen the first time we met. She was lovely and it was worth it as she lent me a nice book to read and said she will visit me for tea and cake if I make it to embryo transfer and bring DVD's and things to do. However, a sharp reminder as to why it's important not to tell too many people as she asked lots of questions and made statements I would have made 2 years ago before I knew what I know now and even told me of a friend who took 2 years to conceive in the kindest voice ever.

I told N how lonely I was when I got home and I prepared my new injection, Cetrotide to stop the eggs releasing. N was sweet but admitted he was clueless about the injections and reminded me what a good thing it was that I am a Nurse. And I think my loneliness peaked as I mixed the powder and water and thought back to the last time I prepared an injection when I was in the first heady stages of a new relationship with N and I felt like I had the world at my feet.

Monday, January 3, 2011

Day 3...USS to check follicles

Well I hardly slept but managed a few hours before waking up and giving daily dose of Gonal F. This time just the one injection so hope I've cracked the technique now. At the clinic I assumed the position and felt a bit odd being on my period no matter how much the Doctors said they were used to it. This time I felt really tender when he waggled the probe about and started to count, Dr H joined him and for some reason I found it hilarious listening to their accents. It's such a singy accent and they said cinco about 10 times, loads more numbers, left, right and then said all looked good. Conclusion: 10 follicles, 5 each side. I suppose I'd hoped for more but didn't want too many either as I understand it's quality not quantity.

I felt better afterwards and managed to relax in the afternoon, in between googling do's and don't when 'stimming' and realised I have been given about 10% of the information compared to ladies back in the UK who have practice runs with the injector pen and nice, colourful booklets and meetings to attend with other IVF-ers!

Then my phone rings and it's Dr P sounding a bit concerned. For about 3 seconds my heart is in my mouth until he finishes his sentence and it's not bad news but not great either. They need an ECG and some other test pre egg collection (blood test), should really have been done pre-stimming but hey. Tomorrow at 10.00.

My conclusion: the clinic needs some Nurses. Nurses to help prepare patients and run support groups, access information, demonstrate self injection techniques, answer questions about medication, a bit of phlebotomy AND run a check list pre treatment, so they can say 'Um Dr, do we still need an ECG?'.

Sunday, January 2, 2011

Treatment day 2

Well, I managed to stab myself twice this morning, an improvement on yesterday. After jab #1 with 225 I was convinced it had not clicked fully and that 50-75 remained on the dial so I stuck it in for good measure a second time which only confirmed it was empty and gave me my first bruise. Fingers crossed just the one tomorrow. I'm dreading my first USS since starting jabs, due 09.00 tomorrow. Worried Docs will say 'oooh dear no it looks bad'....too many follicles, not enough, too big, too small...scary!

The injections really are OK and I feel a little resentful about the scaremongering I have read on various websites. What bothers me is the responsibility of it all. What if there is a power cut and the fridge goes off/I use the wrong drug/wrong dose/wrong time/wrong day? The 'what if's' are endless it seems on this journey and I have been feeling nauseous all day with pure fear of the unknown. I didn't think I would feel this way, this truly is the longest month ever. I hope my trip to the clinic puts things in perspective tomorrow and that there will be some good bumps, it always cheers me up to see bumps in the waiting room.

Saturday, January 1, 2011

Ist injection

I managed to sleep through my alarm despite my nerves about starting treatment. Dr P said start in the morning, well anytime really, just do the same time please, every day'. I wanted to get 2 doses in before my scan tomorrow at 09.00 so I set my alarm for 07.30. Now I have read on Baby Centre IVF group that evenings are better as the dose can then be altered at the morning scans. Anyway, not the end of the world but I'm still finding it stressful in case I f**k it all up.

I opened the pack and screwed a needle on the end. Checked the drug name (Gonal F or folitropina alpha), checked again, checked the expiry date too. I clicked it round to 225. N watched me open mouthed and a little pale. I pinched a chubby bit of my tummy and stuck the needle in all the way. It only goes into the fatty tissue below the skin but the anticipated pain was killing me. As a Nurse, I've jabbed so many patients in the past with mixed reactions so I wasn't sure what to expect. Well it didn't hurt at all really and I held it just the way Dr P showed me. Like a small child gripping a crayon but with a thumb on the plunger...but it didn't plunge, I pressed it until my thumb turned white...nothing. N looked terrified and I took the needle out saying 'shit...shit...diditgoinIcan'ttellohmygodI'vefuckeditupallthatmoneyandI'vewreckedmyovariesit'sallruined' and I thought I might pass out. Dr P said don't expect the plunger to move much but I'm sure he mentioned a click. There was no click or was there? How the hell will I ever know?

N snatched the leaflet which had a picture of a blonde haired, blue eyed baby reaching for a building block on the front. Surely a diagram of an egg or some ripe follicles would be more suitable than this. I saw the words 'para infertilidad' next to it. The words were swimming. N kept trying to make suggestions and I tried to shove him out of the way determined to go online and google myself stupid. Eventually I listened and agreed that we could try again, to inject mid air with the smallest amount possible that the pen would allow us to dial up.

So I cranked it round to 37.5 and stuck a needle on the end and aimed it at the sofa. Pressed the plunger...nothing! Reassured I had not received a dose earlier, I felt rather stupid that I had failed to use this pen. We looked at a diagram where the tip of the plunger was labelled as a security cap...doh! I pulled it up a notch and saw a band of grey appear, now it looked like the picture. I squeezed, it clicked and a few droplets squirted out. I reset the pen to 225, clicked it out, stabbed my tummy and squeezed until I heard a reassuring click...phew.

2 hours later I am distracted by the leaflet and reread it, it says some thing along the lines of 'ensure safety cap it withdrawn to equal amount as set on pen'. I stare at the pen, still on 225 and pull up and the pen clicks up half an inch to reveal 225 units also. SHIT, there is no way I pulled it out that far the first time...maybe 75 at most. Small panic attack, I don't dare wake needle phobic N who is asleep and so I call Dr P on NY day and explain. We decide I will go again with 150 and so I administer injection number 3, correctly this time.

So I will never be quite sure how much my ovaries received at first dose, hopefully not 600! Somewhere close to 225 would be good and I'm confident about the 150. It just shows how much is lost in translation and I hope that Dr P has forgotten me saying 'oh yes, I'll be fine, actually I used to be a Nurse'.

First step...base line scan to decide if treatment can start in January

December 31st 2010 (written yesterday).

So I awoke on New Year's eve thinking about clinic stats and feeling ashamed for texting Dr P after midnight with some ramblings about live birth rates. No reply. It was 09.00. Then my period started and quite obviously too. These days, it seems to hint it's coming for a day or two before so I was surprised, especially as isn't due until the 2nd Jan. I waited half an hour, nervous about the possibility of starting treatment and still uncomfortable about calling the Doctor on his mobile when he is off duty.

Dr P answered his phone, short of breath from jogging in the park and I said sorry about 4 times and went into too much detail about the colour and consistency or my menstrual flow. He suggested we meet at the clinic for a scan or I could see his colleague there tomorrow. I decided today was the day even though I would have liked more preparation before revealing my nether regions to 2 consultants.

Within an hour I have my legs in stirrups and Dr P is checking out my ovary with a magic trans vaginal wand thingy. It takes several long minutes before he says 'left ovary OK' and then several seconds drag by and he says 'right ovary OK'. Dr H (the big cheese) rises from his chair to look at the screen. Dr P and Dr H switch back to Spanish and all I can understand is 'no but..on the left me the right agin...well....of but and no but' , my heart is racing again until Dr H says 'we can start tomorrow, your cycle has ended the year nicely for you'.

I agree, shoes and knickers back on, I am shown into another room but not before Dr H gives me an obligatory kiss on the left cheek (it doesn't matter who you are here, male or female, if you've met once already you are on 'kissing terms'). Next door, Dr P gets a dummy injector pen out and demonstrates it's use. It seems just like an insulin pen and I feel OK with it. He says, 'you have a box of needles, no?'....'um no', I say. So now I'm worried. We spend 5 mins talking about my concerns regarding live birth rates and reach the conclusion that if N and I make to embryo transfer x2 then we have a 30% chance of a live baby, at this clinic. 5% more than the live birth rate for a healthy couple. I'm happy and want to forget about numbers and get home to the fridge to look for these bloody needles.

Thankfully, the needles are in the box with the pen with plenty of spares and N arrives with parrilla (bbq) food and I tidy the drugs away in the fridge to make more space. We are staying in for the 1st time ever at NY and actually I'm glad. I don't want a whiff of a hangover tomorrow. I have decided to have my last alcoholic drink before treatment too and we share a bottle of red, recommended to us, (which costs around £2.80). We eat, reminisce about our time together and admit some of the disappointments too in not starting a family and facing this treatment. We are definitely lucky to be where we are though, life is otherwise good and we watch the crazy fireworks that people let off from their back yards, balconies and porches.