Preparing for an embryo transfer… again

Here we go again… today’s Day 13 of my cycle and we’re going to try and defrost one of our five guys and pop him in the (metaphorical) oven next week. I’m excited. We’re doing a natural cycle, which means I don’t need to take any drugs, but they still need to figure out exactly when I ovulate so they know the best time to put an embryo back in.

So far I’ve had two blood tests to see how my hormones are tracking. They’ve both come back low, which means it’ll be a few days yet of the human pin cushion. It’s likely I will need to have one every day from tomorrow until after I’ve ovulated. In a text book situation they put the embryo back on Day 19, but that presumes you ovulate on Day 14. Mine’s likely going to be a bit later than that.

It’s summer here where we live, and we’re supposed to be going camping in the weekend. There’s only one place that does urgent blood tests on a Sunday morning, and while its only 20 minutes away from our place, its an hour and a half away from our campsite. Damn! But! Perspective. Having to leave our camping trip half way through versus possibly having a child that we’ve been hoping for over three years now…

My colleague that used to sit next to me had her baby last week. I saw a lot of very pregnant photos of her on Facebook, in a bikini, at parties, that sort of thing. I felt twinges of sadness and “I wish that was me”, but what was hard was hearing that’d she had called her baby girl exactly the same name as we had pinned for a baby girl. And it is an unusual name too – the only one we agreed on.

It’s a bit of a pickle, really. Maybe it means that name was not meant to be. And who knows if we would still be as keen on it if we did eventually have a girl. Or maybe it means talking with her and explaining why we’d like to use that name too. Maybe we’ll have a boy one day and it will never matter!

Just another one of the less obvious things that people with secondary infertility face, I guess.

Anyway, back to the next couple of weeks. Let’s keep our fingers crossed.

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2018: it’s our year!

Today I got a call from our gynaecologist. I wasn’t expecting a call, so it caught me a bit off guard as I sat down behind my desk at work.

“We’ve got the results back from the re-biopsied embryos from your first round of IVF”, he said. “Oh! And?” Given that our first round of IVF had yielded two normal embryos out of the ten biopsied. So I was expecting him to tell us, “sorry, but there were no normal embryos” or at best, “we’ve got one normal embryo”.

Imagine my surprise then when he confirmed that, “two out of three of the embryos are normal.” I was so shocked, in a great way, that I sort of muttered, “oh, really! Well! Umm, that’s great!” Before I knew it I was calling my husband and texting my family about the ridiculous result.

Just before Christmas we’d also been told that three out of the ten embryos from our second round of IVF were normal. I’d taken that as a victory, given we got two out of ten last time.

Now we’ve got five embryos!! Five!! Bloody hell! I immediately and irrationally started dreaming about having six children. Silly, but hey, I think I deserved a little daydream.

This is going to be our year, I just know it.

Having a HSG (hydro-salpingo-gram)

This year we’ve lost three pregnancies – two naturally conceived guys lost between four and five weeks and an embryo from IVF at around five weeks. We’re not 100% sure what defeated our third guy. I’m adamant that it was parvovirus, which I caught the day after (the DAY AFTER, WTF!) we had our successful pregnancy test. I am still really devastated about that. It put me in bed for days with aches and a spectacular rash. But, given our other two losses, moving forward we want to be 100% sure I don’t have an implantation issue.

My gynaecologist had encouraged me to read a medical study earlier in the year. It reported that women with unexplained infertility, particularly endometriosis, experienced impressive implantation results after having an oil based solution”flushed” through their uterus and fallopian tubes. Because at that stage I’d been pregnant six times, and had carried three babies past nine weeks, we didn’t think that implantation was “our issue”. But, I had also had four surgeries, and following my most recent D&E my  lining was completely destroyed. It took months and months to repair. Maybe I had some sort of scarring that was preventing implantation?

I’d tried an HSG once before. It was the single most painful experience of my life. I don’t think I’m exaggerating when I say that (I had a c-section so I’m not sure if giving birth would be as painful!). It had transpired that there was a blockage right in my cervix, so the HSG had failed completely. I’d had surgery for Ashermans since then and hopefully, fingers crossed, there was no further issue. Needless to say though, I was really, really anxious about the pain factor.

I changed into my hospital gown and climbed up onto the doctors table. They have to insert a catheter right through your cervix. It’s entirely undignified (as is basically everything infertility related). Then they blow up a little balloon inside the cervix to hold the catheter and inject the solution. The first three or four times they tried to insert the catheter, it failed. It was beginning to feel a lot like groundhog day.

Then, the doctor suggested a different style of catheter, perhaps I had a curved cervix, she suggested. After a couple of tries, and feeling as though things were looking a bit futile, it suddenly worked. My uterus cramped something unbelievable. Aaaaahhhhhhh!!! The pain was awful. The doctor adjusted it slightly, and suddenly it was still working, but not painful. This might just work!

I didn’t get my hopes up too much, but focussed on each instruction. Suddenly, I was looking at the screen and the fluid was showing in my fallopian tubes and in my uterus. I wondered if that meant everything was alright.

After being told to shower and get dressed, I went and talked to the doctor. She said there was nothing she could see that meant I couldn’t conceive. I was so relieved. I shed a couple of tears. All of a sudden she opened up. She had second infertility as well. Her second child had been conceived through IVF. “People just don’t understand with secondary infertility, do they?” she said. We talked about the pain of secondary infertility, of colleagues asking you why you haven’t had a second child, of desperately wanting a sibling for your one child. She was so kind, and sincere when she said she hoped our turn was coming. It was a really special conversation.

 

 

 

 

 

 

IVF round two – the waiting game

We’d started with 23 eggs. The day after, I received the call that 18 had been fertilised. OK, so that was a lot fewer than last time, but we were still going alright. Then, two days later came the next call. There were 12, although one wasn’t looking very strong. Then, on day six, there were nine and maybe one more that might come through. Nine didn’t feel quite enough to ensure that one of those guys would be chromosomally normal. Ten did, but nine…. I began to worry a bit, realising that this was a risk we had taken but not expected. Finally, the following day came the next call. We had ten. Maybe we would be OK.

I was told that our ten had been biopsied successfully and then frozen. The biopsied cells would travel to a lab to determine whether they were chromosomally normal and, as a result, whether they would be put back in.

I asked about our other three guys that were on ice from the previous round of IVF. The lab claimed that there was nothing on my notes about them. I explained – we talked at length with the lab and my gynaecologist about re-biopsing the three guys whose results had come back as “inconclusive”, and had decided to send them together with the guys from the latest round.

I was surprised that they’d clearly forgotten about them. If I hadn’t of asked, who knows when they’d have been biopsied. Then came an issue with our consent form. We had to sign another consent to re-biopsy the three guys. But I was back at work and couldn’t do it in person, so sent it by email. Delivery failed… Delivery failed…. Delivery failed… What was going on?! I called the lab who said if they didn’t get the consent they couldn’t go through with the biopsies.

Eventually I managed to get a small sized photo of the consent through to them, but now the issue for them was that our signatures were too small to compare. I was so infuriated. This was their stuff up in the first place, and now they were getting pissed off at me because the only image their email system would accept was too small. I told the nurse I could send the photo to her personal phone and she scoffed at the idea. I rang the gynaecologist who said not to worry and he would sort it out. Thank God.

Later that day the lab called again. Only one of the guys had been successfully biopsied. The other two hadn’t expanded properly as they had thawed. They would check them again the following day again to see if they had expanded. I was dumbstruck. I told the nurse I was shocked, because we were told that the procedure was relatively straightforward and the success rate should be in excess of 95%. What had gone wrong? She snapped at me, “you know when you signed the consent form that you were taking a risk.” I said, “yes, but it seems extremely odd that we are looking at a 33% success rate instead of a 95% success rate!” She snapped something back that the risks were higher with fewer embryos, but it didn’t make sense to me.

I was quite upset. My husband was angry. He wanted the nurse off our case and rightly so. Had they stuffed up the thawing process? My gynaecologist was also quite shocked and said he wanted to speak with the lab in the morning. When I received a call the following day though, things had worked themselves out. All three guys had now been biopsied and were sent of for testing. What a ride. Now we had 13 embryos. Lucky 13, again.

 

IVF round two – eggs, eggs, eggs… and throwing up

Starting a second round of IVF was always going to involve a comparison to our first round. The first time around we’d had around 26 eggs, 23 fertilised, and 13 tested by PGS. Knowing we only came out with 2 normal embryos made me anxious.

My first scan (with what another IVF sufferer has hilariously referred to as “dildo cam”) revealed that we were looking at around 15 eggs. Had I been told that on our first round I would have been over the moon. But with the knowledge of our previous round fresh in my mind, 15 didn’t seem many. 15 seemed too few. I went and saw the nurse and couldn’t help becoming upset. The nurse tried to reassure me but she didn’t know what I knew.

My second scan was more positive. My gynaecologist did it himself. We were looking at around 20 follicles. He said he felt positive about our progress and so did I. I took my trigger injection the next evening at 11.30pm and my egg collection was scheduled exactly 36 hours later.

I was nervous heading into the egg collection. Last time it had hurt quite a lot, and I’d keeled over in the car park afterwards amongst dead leaves and cigarette butts. I really hoped that this time would be better. I became teary going into the surgery. It’s bloody hard going through this stuff sometimes. In my gown my legs were popped into the horrendously unattractive stirrups. I was given oxygen and an intravenous line of drugs. Sweet sedatives. I relaxed.

It hurt a lot. Each time my gynaecologist inserted the needle through the vaginal wall and extracted the eggs from my ovary was like having a very painful injection. The worst pain only lasted momentarily though, and it was bearable. We’d come away with 23 eggs. I felt really happy with that number. To me, that was about what we needed to get one or two embryos at the end of all of this.

I recovered for an hour or so and was sent on my way. My abdomen was really tender and I felt a bit dizzy, but OK. About half way home I knew that we had to pull over and fast. My husband nipped down a side street and I basically jumped out onto the berm while the car was still coming to a stop. One quick spew on the grass. A lot of sweat. But instantly I felt a lot better. OK, let’s keep going.

Within minutes back in the car I realised I wasn’t OK. I grabbed a handbag ready to spew again and shrieked at my husband to please pull into a side street. I jumped out again, straight to the berm. Spewed on the grass. Spewed again. Hot, sweaty, dizzy… It was not my finest moment. A concerned looking cable guy asked if I needed some water. I said I was fine. Hopefully my hospital tag on my wrist and sticky plaster over my IV site was enough to let him know I had been admitted in the clinic.

We finally made it home on the third attempt, although again I needed to crawl and lay on the grass for a while. Phew. I spent the rest of the day in bed, in and out of sleep, with a sore tummy but glad it was all over. When I finally got up I wondered briefly why there was so much grass in my bed.

IVF round two – dingy petrol stations and forgetting to inject

It was 8pm on Friday night. Time for my first injection of Puregon, the follicle stimulating hormone. I was sitting in the car, in a petrol station in a dingy town. People mingled outside. My husband awkwardly circled the car with our son, waiting for me to let him back in so that we could continue our three hour drive to our weekend destination. It was about as unglamorous as it gets.

I was anxious. Could I remember how to do this? Which way did the capsule go into the injecting pen? Shit. The light in the car was barely strong enough. The brochure sat on my lap. OK, the capsule was in and now I had to dial up the dose to 200. I put the needle on and squinted to see whether a droplet formed at the tip. Holding my tummy I injected the needle, I realised that my hand was shaking slightly. I slowly pulled the needle out again and then, SHIT! A massive geyser of blood started shooting out of the injection site. What the?! This had never happened to me before. I had nothing to stop the bleeding so I just used my hand. My husband and son peered in the window and I tried to shoo them away whilst also demanding a tissue, or something, to try clean myself up. What a disaster!

I wondered whether the blood would have pushed the medicine back out again, so I called the clinic and left a message. Thankfully the bleeding stopped quickly and all I was left with was a bruise, a worried looking husband and questions from my son about what had happened. The next day a sympathetic nurse rang me and we had a good laugh about the previous night’s episode, apparently everything would be OK and I’d probably just hit a blood vessel. I joked that I was worried I’d hit my liver or worse, but she reassured me that the needles are only long enough to fit under your fat layer.

So that begin my latest egg collection cycle. It was largely uneventful save for a few hormone infused arguments with my poor husband, and one night where I was watching Stranger Things on the telly and totally forgot to inject myself. Thankfully I was only an hour late. I felt awful though, how could I be so careless about something so important?!

 

Another round of IVF – do we even want to go there?

As I had expected, my latest pregnancy came to an end shortly after it began. My period brought both sadness and relief. Sadness that it wasn’t to be, again. But relief that I wouldn’t have to sit through weeks of not knowing whether this baby was chromosomally normal. Relief that there was no chance that I would have to go through that phone call again where I was told our baby had 100% trisomy chromosomes. It’s a pity that my thinking has changed so much over the years to automatically taking on negative slant on these things. But it is what it is, they say.

Despite barely having an opportunity to reflect on a failed embryo transfer due to parvovirus (a fucking virus!!), having the illness associated with parvovirus, and a second failed pregnancy all within six weeks, we believed that it was a good time to undertake a second round of IVF because I was off work until the end of the month. If we didn’t do the egg collection in November, we had to wait until January at least, perhaps February, given the Christmas holidays and our existing travel plans. So, November it was.

Until it wasn’t. I got my period and rang the clinic. They wanted my to take a blood test to ensure that the HcG was out of my system. I came back with a reading of six, and they wanted five or less. So I wasn’t allowed to start. I was not looking forward to the egg collection cycle but, equally, I was upset at the idea of having to wait and do the cycle while I was back at work. We talked to my gynaecologist and pressed our case, but at the same time stressing that we didn’t want to be pigheaded about it if it would impact on the number or quality of eggs.

So there we were, with permission to start our second round of IVF a day later than normal.