Wednesday, August 15, 2007
With the minimum amount of time between cycles, we moved swiftly onto preparing for a frozen embryo transfer cycle. This is a much much simpler procedure than IVF – no needles, fewer visits, and only a few hormones taken orally. I think it was relatively simple for me because my cycle is very regular. You can even do FET with no intervention whatsoever if you want to go natural and your cycle is regular. Anyway, compared to growing 20+ eggs and having them painfully removed (did I mention I was shuffling for the best part of a week after that first egg collection?), FET is a walk in the park. Practically nothing.
Physically speaking that is. Emotionally it's the same old journey of optimism, fear, anxiety and patience. The two week wait is as the first, initially happy descending into your own personal hellish waiting room a la Huit Clos.
As with IVF number one, I started bleeding a day or so before the pregnancy test was due. My spirits fell, although I had tried really hard not to raise our expectations at all. I felt defeated again. Why couldn't I just be one of the lucky ones. Why were my dam periods so irrepressible. It made mockery of all the times in my 20s + early 30s that I worried about being pregnant. I took it easy, again. I went to the clinic for the blood test I knew would be negative, again. I sat there pretending to be light hearted while they took the most important blood test of my life, again. I probably even listened to the chirpy 'you gotta be in it to win it", again. And I went off home to put my feet up, again. At lunchtime, I put in the progesterone suppositories and thought, what's the point, I'm about to get the confirmation that it's negative, what a waste.
And the call came. And she said – it's positive. Very positive. You are most definitely pregnant.
What? Sorry? I'm pregnant? Are you serious? What's my score?
My score was very high, indicating twin pregnancy. Jesus, thank god I was lying down. I called Sue to tell him. I barely got the words out and he said I'm coming home. He came home. Cried. Had a cup of tea. And went back to work. I'm still lying down cos I'm still bleeding.
To jump forward three weeks: the pregnancy didn't take. However I spent three weeks feeling quite blissful. Shoving suppositories up my bum regularly and lying down didn't bother me. I felt special, I felt content. It was Christmas, what a great Christmas present. But deep deep down I think I knew the pregnancy wasn't developing. You're tricked by the effects of the progesterone, but deep down I knew. It's amazing how much you know your own body even during a process where you're in the hands of people who supposedly know more than you.
Sure enough, come the 7 week scan – nothing there.
How low can you go? Oh, much much lower.
Sunday, August 12, 2007
The waiting in between IVF cycles is quite something. Although you are not actually doing IVF at this time, you are thinking about it, planning the next one, so you're not clear of it for the intervening months that's for sure. You pretend to yourself that you're resting, but you're not. For me at this stage, every day that passed was a day closer to becoming pregnant, and another day lost to not being pregnant. But it's a good way to distract yourself from the crushing feelings of the previous failure, so it's useful in one sense....
The waiting during IVF is quite something too. The daily anticipation of needles determined by the almost daily blood tests to check hormone levels. Waiting for the phone call to let you know whether to up or lower the dose, or coast. Waiting to get more injections out the way so you can put a big inky cross through another day on your IVF schedule. Waiting to hear how many eggs they got, waiting to hear how many embryos they got, waiting to hear how many of those are actually viable and waiting for the confirmation that embryo transfer can go ahead. And then the mother of all waits, the two week wait. Aaaaaarrrrggghhh!
The first of those two weeks is strangely pleasant. The culmination of all that hard work is there, in your belly, you know they're there cos they show them to you going in. And for one sweet week you can pretend to yourself that you're carrying babies. It's quite a delightful feeling to those of us that need help with it and have never experienced pregnancy officially. I spent the first week on my first cycle slightly floating, never feeling quite alone. And feeling instantly protective of my belly. It was a lovely feeling, brief though it was.
The second week is hellish. You start anticipating the period. You are constantly evaluating how you're feeling – are my boobs swollen, do they hurt, do I feel crampy etc etc. But you forget that the progesterone makes you feel like that anyway so it's probably all pointless analysis. Nearly every minute that passed I was thinking I could feel my period coming on.
Then it did and my wait was over.
But anyway, onward march to IVF number two which as previously mentioned was to be far easier as it was a frozen embryo cycle. Almost not IVF at all really, hardly worth worrying about...
Wednesday, August 8, 2007
Where was I? Oh yes: sat in park having lunch with colleagues. See lone magpie. Salute it, say good morning to it, nod three times (etc etc). Then feel my period hit. Go to loo. Blood. Dammit.
Phone clinic who tell me it's not necessarily bad news and to go home + put my feet up. Deep down I know my period is here to stay, but I opt to go with their opinion that it may be ok, and I go home to put the feel up as instructed. The feet stay up for two days, but the period keeps on coming. I go to the clinic two days later for the pregnancy test, knowing by now it's a negative, but somehow there's an optimistic bit of me that's saying - don't worry, it might be ok, you might get a nice surprise. But I don't. It's negative. I find this out in a phone call a couple of hours after test. The nurses deliver this news god knows how many times each day and they are used to being sensitive to the recipient. However they do still say bland things like "You gotta be in it, to win it".
... I have no response to that other than a feable nod.
I take a few days to crumble upon failure of IVF number one. I was so optimistic. I was so sure I'd be lucky and get it right first time. I'm slightly numb at the news that my body has failed me. Then almost immediately I shift into looking forward, planning the next round, letting go of the disappointment in favour of forward movement. Well, hardly anyone gets pregnant first time do they, it's usually 2nd or 3rd time because the clinic knows how you respond to the treatment better. I presume they will alter my hormone doses next time as I responded so quickly to the stimulation. I can't wait to book the follow up appointment in order to make my plan with the doctor. I am now officially on a mission. And I say 'I' on purpose. What about Sue? He is pretty much just caught up in my back draught from here on in. Despite being told "Don't put your life on hold, Don't become obsessed, Pay attention to your partner, There is life beyond having babies" and other helpful advice, I do of course put OUR life on hold no matter what husband wants, I do become obsessed despite thinking I am not and as far as I am concerned if I don't become a mother, I am nothing.
At this point there is a two month hiatus while I have the period, have another period, excercise, "get myself back" and vaguely focus on work. I am still firmly fixed on the next cycle of IVF, which will be much easier as we have some frozen embryos. Oh yeah, here's the summary of IVF number one: 25 eggs collected under anaesthetic. 10 embryos fertilised. 2 discarded within a day. 2 put back at embryo transfer and 6 frozen.
Thursday, August 2, 2007
When will the pain stop?
That's the first I say when I come to, a bit groggy, but I don't come to enough. My husband is there with me and the nurse looks a little concerned that I am still very woozy. Suddenly my pulse and my blood pressure drop considerably and she has to give me something to pep me up. I pep but I stay there a couple of hours recovering. We're told the doctor collected 25 eggs. Apparently that's a lot. My belly tells me it is a lot. The taxi ride home is painful, London is full of speed bumps.
I spend the next couple of days before embryo transfer shuffling around, mainly to the loo. Any pressure on my bladder is killer so I am peeing constantly. Turning over in bed hurts. It all hurt. But I didn't care, I had ten embryos busy hatching.
The embryo transfer (ET) is easy. I was still very tender from the egg collection, but the ET is fine. It's quick, the doctor gets a good view of the uterus and pops in the two selected embryos without complication. Before they go in, the embryologist shows them to me on a screen. How wierd. I imagine them with little faces. And from that moment on, for most of the next two weeks I never feel that I am alone, and it's a lovely feeling. I immediately felt protective of my belly, not wanting anyone to bang into it, not wanting to move too much, stretch, or make any sudden moves in case I disturbed them. That's the problem with knowing the embryos are there, you feel more fragile than you probably do if getting pregnant naturally.
The first week of the two week wait is fine, I feel optimistic and I enjoy the sensation of wondering what they're up to, imagining them implanting. However the second week, that's hellish. Every day that passes brings you one day closer to your due date for the period, you scrutinise how you are feeling all the time - do the boobs hurt, do you feel premenstrual, can you feel the arrival of your period, it's endless. It becomes a minute by minute watch, time crawls by.
Then I'm having lunch in the park the day before I'm due to go the pregnancy test and I feel my period come on. You know instantly don't you. Bugger.
Wednesday, August 1, 2007
On Monday this week, 30 July, Sue and I made a very important decision. I won't share it with you just yet because it would mean revealing the outcome of all this fertility lark (to date) and I kind of want to avoid that because part of the slog of fertility treatment is not knowing what the outcome will be, so I would like this blog to be read without the reader knowing too. I hope that makes sense...?
Ok, back to the story – no doubt very good, but personality defficient private doctor number 1 is now out the window. No way am I going to pay someone to treat me like that, there are far too many emotions involved already for that sort of messing around.
A bit of research with the HFEA's clinic guide and a personal recommendation or two later, we make an appointment with another private clinic in London. We go, doctor is lovely. He even has a book on the shelves behind him with a title something along the lines of "The Emotional Side of Infertility". I'm sold. Even if he's pretending and hasn't opened the stupid book. The whole question of Hydrosalpinx is raised again and although Doctor No. 2 knows Doctor No. 1 and Scan Man, and has no reason no doubt either of their findings, he decides to scan me himself to verify the condition of my tubes. Hydrosalpinx is very visible (I believe) even with a 2d scan. He sees no evidence of Hydrosalpinx. To be sure however, he asks me to come back a week or so later at a different point in my cycle, to double check that it is not present. I do. It isn't.
Your first cycle of IVF (or ICSI or whatever) is almost great. Because finally, after months of tests, results and appointments to discuss things, you are doing something that may result in a baby. You discuss the protocol with the doctor, you get your schedule, you collect the hormones, they show you how to inject yourself with a fake belly, you stick the timetable on your fridge and you start marking off the days, one by one.
The first injections are terrifying. I was obsessed with the air bubbles and making sure the syringes were bubble-free (almost impossible especially when with sweaty nervous fumbly palms you drop them on the floor a few times) in order not to die from an air bubble making it's way to my heart. Dramatic, yes. But those are the places the mind goes when suddenly you are immersed in a medical world. But I was also surprised, pleasantly, at how thin the needles are and how easily they slide into your flesh. Like a hot knife into butter. For the next 2-3 weeks this is what your life is about: injections, scans and blood tests. Work is something you do along the way. I was very VERY lucky to have incredibly understanding bosses (one of whom had experienced infertility therefore knew directly what I was undergoing) which meant I didn't have to lie and cover up why I might be behaving oddly, and why I was coming and going every other day.
At this point, cycle number one, you are filled with hope and that hope carries you a long way. It carries you through the pain of sticking needles in yourself every day and having little bruises all over your legs and belly, of going for appointments, of having your life governed by this medical procedure when other people just get to have a shag. In my case, having been told by all doctors that I was a great candidate for IVF, I was brimming with hope and optimism, certain that I was on the path to having a baby, that it was now in my reach. I specifically waited to do it during August so that it was warm and life felt more relaxed.
I responded well to the hormones, very well in fact, to the point where toward the end of the hormonal stimulation phase (and I was on the short protocol anyway) they had to coast me to avoid Ovarian Hyperstimulation. I apparently had a 'beautiful' uterus and ovaries that looked like the surface of the moon, follicles a-go-go. I was drinking enough Evian to pee pure mineral water and I was feeling frankly good all things considered. They told me I was ready for the egg collection, the final injection was given to me with strict instructions on what time to have it, and told me to bring myself in on Sunday morning 7am, food and drink-free from midnight.
LESSON No. 3
Apparently drinking lots of water helps during the hormonal stimulation, especially when you have lots of follicles. It's something to do with pockets of fluid left behind when the eggs are harvested, being well irrigated means you are less likely to suffer ovarian hyperstimulation following the egg collection. Drink 2-3 litres per day. Treat yourself, buy in Evian from the supermarket to make it easier.
Saturday felt like a national holiday. A day without drugs. No blood test, no internal scan, no toing and froing between the clinic and work, no needles. But it was the calm before the storm. I had never been under general anasthetic, but because I had so many follicles they would have to knock me out completely as egg collection would take while, too long to be kept conscious. I arrived with Sue, we're both incredibly nervous, you kind of don't know what to do with yourself. At this point you realise how important it is that you trust the clinic in whose care you are, it's imperative.
I get called, I say bye to Sue as he goes upstairs to have his special moment. I go to the room attached to the surgery room, I undress, go in, lie on the bed and see nothing but the shiny metal stirrups staring at me. You start lying flat on your back but you know that very soon, your feet will be up there... it's a very wierd thought that you will be unconscious and someone will whip your legs up and be fiddling around, down there, with your mimsy. I'm a strange mixture of calm and terrified. The anasthetist chats inanely and I feel the cold curtain of blackness descend.
... Next: post-egg collection and all that goes with it.