Saturday, 22 March 2014

And then there were none...

There are no words to describe how we are feeling. Our worst fears have come true...our embryos do not grow to blast. With our other cycles we always transferred Day 2 embryos but the fact that we never had a beta result over 0 made me fear that they just stopped growing not long after they were put back. I counted how many eggs we have retrieved since our first IVF and was shocked that it was over 50. While not all of them fertilised I couldn't believe that that many eggs had resulted in nothing.  That's also in addition to the two years of trying to conceive naturally. While I think my doctor will probably want to cycle again I just don't know if I can do it. We've spent more than $50,000 on assisted reproduced (including natural medicine) and the emotional and physical toll have became almost too much. We have very little savings left and my body feels like it doesn't even belong to me anymore. Adoption in Australia is almost impossible so our options are to continue with IVF or look at third party reproduction (donor sperm, donor eggs, donor embryos). We were concerned that the fact that our embryos arrested mostly on day 3 and 4 may indicate an unidentified sperm issue but I just don't know how I feel about sperm donation in the sense that I would be genetically related to the child but my husband wouldn't. For some reason I feel more comfortable about embryo donation.  I know it eliminates the possibility that I will have biological children but I just feel that with everything my husband and I have been through I want to go through the next step together. 

I'm tired. Very tired.  I feel 100 years old.  Our friends lives seems so simple and straight-forward. I am jealous and angry and so desperately sad. I wanted 2014 to be our year...and maybe it will be...but maybe it won't be too...

Thursday, 20 March 2014

We lost 10 :(

I'm so upset. Yesterday we had 19 embryos but today I got the bad news that 10 had arrested. Only one of the remaining 9 embryos was an 8-cell with the others at 6-cell, 5-cell and 4-cell. The 8-cell isn't excellent quality with approximately 1/3 fragmentation. Sigh. Infertility is such a roller coaster. I was so happy yesterday and was actually starting to think we might end up with multiple blastocysts. Now I just hope we'll have something for transfer on Sunday. I've been nauseated all day from the Cabergoline but luckily my doctor is happy for me to stop it as I don't seem to be showing any signs of OHSS. My lower back is very sore from my progestone in oil (PIO) intramuscular injection but I think it may be more painful because I am trying to do them myself and I wiggle the needle around a bit trying to get a good hand position. So today I'm flat. My husband is missing his sporting grand final on Saturday so that we can head to Melbourne the day before transfer. If we make it down there and pay for travel, accommodation, food and acupuncture only to find out we have nothing to transfer I'll be absolutely devastated. I just hope we have some good news from the embryologist tomorrow...

Tuesday, 18 March 2014

19 eggs fertilised!

Yay! Such great news this morning to hear that 24 out of the 26 eggs retrieved yesterday were mature and of those 19 successfully fertilised! This means we are officially on track for a day 5 transfer this Sunday. We won't know until tomorrow how the fertilised embryos are looking from a quality point-of-view but I'm hoping that as many as possible will continue to multiply and we will end up with some blasts to freeze. In other good news I am pleased to note that my pain, swelling and nausea have significantly reduced since last night and I don't appear to be developing OHSS. It's so nice to have some great news to share and I'm staying positive about our little embryos. Please, please, please keep growing and dividing :)

Egg retrieval and early signs of OHSS

It's been a LONNNNNGGGG day. After negotiating the Melbourne traffic and arriving early at the clinic the morning crept by in a series of consultations, paperwork and waiting before I was led into surgery. It all started off well with the anaesthetist getting a vein almost straight away and after a short nap on the surgery table I woke to the news that we had got 26 eggs! I was groggy and sore but was expecting to feel better as time went on. Unfortunately the pain got worse and I starting feeling quite nauseated. I got my husband to retrieve a looser pair of pants from the car in the hope my tummy would feel less squished but when I was attempting to put them on I had a sudden urge to vomit. The lovely nurse quickly got me a spew bag and sat me down with a cold washer on my forehead. She put an anti-nausea drug under my tongue and it started to work almost straight away. I followed that up with a lemonade icy-pole and after speaking with another nurse about the possibility of ovarian hyper stimulation syndrome (OHSS) and a script for Cabergoline we were eventually allowed to leave about 2pm. We had to find a pharmacy to fill the script and then a lunch place that had gluten and dairy free options for me to eat. I moved very gingerly when walking around and was relieved to finally get in the car around 3:30pm to start the 3-4 hour journey home. My poor husband was criticised every time he went over a bump or slowed down too quickly and I felt like a week had past by the time we finally arrived home a bit after 7pm. So now I'm resting up in bed and hoping like crazy that I don't develop OHSS. I'm nervous about our fertilisation report tomorrow but will hopefully have some good news to share :)

Friday, 14 March 2014

Tracking ultrasound and blood work

Yay- I have follicles! 25 to be exact; 16 on my right ovary and 9 on my left ovary. I had my ultrasound done yesterday at a regular radiography clinic close to where I live rather than with my IVF clinic and unfortunately the lady doing my scan didn't really know what she was doing. She complained about her back hurting and how the receptionist didn't allow enough time for the appointment and I just lay there hoping that she would be able to work it all out. After more than 30 minutes of poking around with the vag wand and much counting and recounting to ensure she had measured everything she informed me that my endometrial lining was 12.6mm and my larger follicles were all around 18mm. I asked to have a look (pretending I was interested) but I really wanted to make sure she had measured everything correctly. She wrote down the 3-D measurements e.g.18 x 16 x 14mm of the follicles when I am used to just the one measurement but I figured the more information my doctor had the better. I was a bit sceptical about the 12.6mm endometrial lining but I tried to reassure myself that the results would at least be close even if they weren't exact. I was also surprised by her announcement that my uterus was retroverted as I was sure that in all my other scans that I had been told it was anteverted. It made me worry that my previous embryo transfers may have been effected as my first doctor had never used ultrasound guidance. Again I tried to push that stress out of my mind and focus on the fact that everything was looking pretty good. The clinic faxed my results immediately to Monash IVF and my nurse contacted me not long after to let me know that my blood work (taken the day before) and follicle results indicated I was ready to trigger this Sunday night for egg retrieval on Tuesday! I had expected another ultrasound and blood collection on Monday so was excited that it was all moving along much quicker. My nurse told me to continue with gonal-f and menopur and that I would be called with my trigger time on Saturday. I hung up without realising I didn't ask whether I needed to continue with my HGH and when I needed to stop clexane and start my antibiotics. I tried calling back without luck but did manage to get onto a different nurse after 5pm. In the middle of all of this my sister rang to say that the post-office did not inform her that my menopur had arrived so that she could put it straight in the fridge and had left it out all day. At this point I figured I could hardly stress about something I couldn't change and after double-checking with my clinic I just asked my sister to put in the fridge as soon as she could. I have to say that it has been very difficult trying to make and take so many phone calls and emails while working full-time...especially when I work with children and it is very obvious when I need to leave or check my phone for emails. Being further away from Monash IVF has meant that I need to be extra-prepared and triple-check all paperwork. I'm sure I have well and truly annoyed my doctors main nurse with all the queries and requests I've made in the last few weeks. Luckily it all appears to have paid off as there has been a number of problems that would have become bigger issues if I hadn't clarified them or followed them up. Now I just hope we have some good eggs next Tuesday after my intralipid infusion on Monday. I'm hoping the luck of the Irish helps me at egg retrieval as it just so happens to be St Patrick's Day :)

Saturday, 8 March 2014

A stressful start to the cycle

Well we are officially stimming however our doctor nearly delayed the cycle another month. I started spotting earlier in the week and was supposed to ring the clinic on cycle day 1 (i.e. when my period started). Now anyone else who spots before their cycle would know that it's not always easy to tell when your first day is and so I called my clinic on Thursday when I thought my spotting was getting heavier. They instructed me to start clexane that night and start my Gonal-f and Menopur the next day. My husband was also supposed to start his antibiotic the Friday morning. This was all well and good until Friday when my spotting basically stopped altogether rather than getting heavier. I was checking every half hour or so to see if I had started bleeding and even tried running on the treadmill in an effort to get things moving- so to speak. It is so ridiculous to want your period to start when you're trying to seems a cruel irony. Anyway I rang the clinic and was told the doctor would call me back. I waited very impatiently all afternoon and received a phone call finally around 6:30pm. Dr L was as quick as always on the phone and after telling him about my spotting he said quickly "well we'll just put you on the pill for 21 days and then start stimming afterwards". WTF! I was nearly in tears as I had specifically asked about BCP for this cycle as I've taken them for every other cycle and he said this cycle was different. I even reminded him about my spotting and he didn't seem phased. Aaaagh. It is so hard when doctors make decisions so quickly without understanding how crushing it is. The doctor explained that if they started stimming me when I was spotting then I may not recruit enough eggs. I asked if I could see if I started full flow in the next 24 hours and he agreed to this and the phone call was over. I was so upset afterwards and angry with my body for not doing what it was supposed to do. I was also angry that I wasn't put on the pill in the first place. Seriously for the money we pay for IVF you just wanted to feel like everything has been thought through properly. So anyway I went to bed that night hoping that my period would start and luckily around 11:45pm I woke to cramping and full flow. I was so stressed about whether the cycle would still go ahead that I didn't get back to sleep until close to 4am! It was a terrible night of tossing, turning and catastrophising that I woke exhausted around 7am when my cat considerately decided it was time for me to get her some breakfast. I paged the doctor around 8:30am and he rang me back about an hour later. I explained that I had definitely started full flow and he said matter-of-factly that I could start stims that night and to count it as cycle day 2. I was too happy to ask any more questions and he obviously wasn't up for a chat so that was that. So simple but so enormous. It's not that a delay of one month is a long time for a normal person but the emotional investment you make to prepare for a cycle in addition to all the scheduling changes you make means that the thought of moving that forward another few weeks feels like such a mammoth effort and disappointment. So all was well that we were going ahead until that night when I had to start all my stim meds. I was confident with the gonal-f as I had used it before but I thought the Menopur would in a similar pre-filled pen and got quite stressed when I opened the packed at saw a vial with a powder cake that obviously required some sort of mixing. I also noticed that the Omnitrope/SciTropin (human growth hormone) didn't have a dosage amount written on it and didn't say whether it was a sub-cutanous or intramuscular injection. Aaagh!! Luckily I was able to speak with the pharmacist who instructed me how to inject the HGH and even though she said she couldn't tell me the dosage initially I was sure that I had just enough for 8 injections out of the 2 vials (10mg each) and she eventually found some information that confirmed that it should be 2.5mg per injection. Phew! So after much reading, instructional DVD watching and nervous double-checking I injected my 112.5 units of gonal-f, 75 units of Menopur, 2.5mg of HGH and 40mg of clexane all sub-cutaneously in my abdomen. I know I should have looked over my med plan earlier but I was so focused on the spotting that I didn't take the extra time to see if I had all the information for my meds. So today I was feeling less stressed until I started reading about my Pregynl injections and realised I would be taking it alongside the progesterone in oil (PIO) injections I had requested as well as the crinone suppositories and I started to become concerned I had asked for too much progesterone not realising that the Pregynl injections also had a similar effect. I'm sure I've lost all readers by now with all the med talk so congrats if you're still with me ;) So now I'm waiting until after the long weekend and will contact the clinic again (I'm sure they'll be delighted) and query the need for the PIO, crinone and Pregnyl after egg collection. I would love to trust that it is all ok but the has seriously been so many times that I have identified an error with my cycle details that I feel the need to double-check everything. So now I'm going to try and relax as best as I can and enjoy what's left of the long weekend :)