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Thursday, 27 February 2014

And then there were three...

Today is day three and we're down to three. One embryo didn't progress to the next stage. The other three have, but one of the three is growing slowly. It's a bit of a change from day two where two were spot on target and two were fast growing and already at 7 cells. I'm not sure which ones have survived and which one stopped growing or is growing slowly.

I'm just feeling a bit distant, I'm not upset that we lost one and will probably lose a second one. My clinic has said from the start that not all eggs are mature. Not all mature eggs will fertilise. Not all fertilized eggs will grow into embryos. Not all embryos will make to transfer and not all transfered embryos will end up as a live birth.

I am staying busy and keeping myself distracted. My house needs a good clean (I let the housework slip when the orgalutran was making me feel nauseated. I just couldn't face cleaning the bathroom while feeling so awful) On the weekend I bought a simple but time consuming cross stitch kit and I've got a few others that need to be finished. And I've got plenty of tv shows and movies to watch.

Tomorrow we've got to be at the fertility clinic by 10.30am for an 11am transfer. Then a new kind of waiting begins.
Wednesday, 26 February 2014

Egg retrieval and fertilization report

My egg retrieval was yesterday. I was quite anxious and spent the time in the waiting area watching the clock, my surgery was scheduled for 8am and by 7.45am there were two of us waiting for Dr S to arrive and do our egg pick ups.

I walked into the operating theater by 8.05am and the drip was started shortly afterwards. And it hurt! Holy cow was that painful, I've never had a drip hurt so much. I haven't bruised from it but it felt like the anesthesiologist was scraping the cannula against bones in my hand.

I woke up in recovery and was in a bit of pain and felt ill. I was given some medication via the drip to take care of the pain and nausea. A while later I started to wake up properly and I just remember looking at my left hand for the magic number of how many eggs they'd collected. But my left hand had the drip in it and I was confused. The recovery nurse showed me my right hand and it said five. Five.

My heart sank. How did we go from having 12+ follicles to only 5 eggs. My Dr came around and explained that there was 15 follicles and he'd flushed each follicle multiple times to make sure they hadn't missed any eggs and that was why I was in so much pain. He said it didn't happen to often but occasionally the eggs just don't release from the follicles and that's why the count was so low.

After he left, I got dressed and went into the recovery lounge area to have something to eat. The nurses had already called my husband and he was on his way. They asked me if I'd like the fertility nurse to come down now, or wait until Tony got to the hospital. I said I'd rather wait. I knew it'd be longer to hear from the nurse, but I just couldn't hear that news again on my own.

Tony arrived a few minutes later. He sat and talked to me while my drip was removed and we waited for the fertility nurse. We chatted about which nurse would turn up to talk to us, luckily it was our nurse. She seemed disappointed at the number of eggs too, so I didn't feel so bad about being upset at only 5. (I know a lot of women go through a cycle with 5 or less, it was just the shock of thinking we'd be getting a lot more than that, closer to 9 or 10).

My nurse brought me box of Crinone and the after care instructions. She explained that I'd get a phone call from the embryologist the next day, probably around lunch time. She told me to think quality not quantity and to go home and rest.

I tried to nap when I got home but couldn't. I was thirsty, bloated and in pain. It really felt like my stomach was bruised and that the bruises would start to appear any minute. (But they haven't) I just took it easy for the rest of the night.

This morning I'd gotten up to use the bathroom and refill my water bottle. I was just going back to sleep when the phone rang at 9am. It was the embryologist.

Out of the five eggs, four were suitable for micro injection (icsi) and of those four, all four had fertilized. She said they still weren't sure if we'd do a three or five day transfer, and that she'd have more information for me tomorrow.

Through this whole process my fear was that we'd only get four eggs. I dreamt about the number four before my first follicle scan and was convinced that there'd be only four follicles. Then after the first scan, I dreamt that there was only four eggs.

We were so hoping that we'd have a few more eggs so that there would be embryos to freeze.

I'm hoping tomorrows phone call brings good news, but I'm prepared in case it doesn't. At this point in the game all you can do is wait and see. I don't want to be excited and hopeful, just in case things don't go as planned, but at the same time I don't want to be negative and fall into that negative funk.

It's out of our control at this time, what happens will happen.
Friday, 21 February 2014

Egg pick up is booked!

My egg pick up is booked for Monday morning. My numbers hit 2226 today and they're expected to rise a little bit more over the weekend. I do my last stims tomorrow morning at 7.30am and then trigger shot at 7pm.

On Wednesday we paid the last installment to the fertility clinic. This morning I rang and paid the anesthetic gap fee for Monday. Then on Monday all that is left to pay is the operating theatre fee.

Monday morning I have to be at the day surgery unit at 7.15am, with surgery scheduled for 8am. It's should take 3-4 hours before I'm out and in recovery. We only live a 15 min drive from the fertility clinic and hospital, so our nurse has said that my husband should drop me off go home for a few hours and collect his sample and drop it off to the clinic when he comes back to pick me up.

I'm a bit nervous, I'm scared that there's not going to be many mature eggs. Or that they don't fertilize. Or that they don't make it to transfer. MFI is an issue for us and we are doing ICSI but it's the unknown and the waiting that gets to me. I'm not scared of the anesthetic or the procedure at all.

We've kept this cycle pretty much a secret and haven't told many people, just two of my close friends and my parents. With the IUI's all our friends and family knew what was going on. But this time around I didn't want everyone to get their hopes up and be excited only to have to break bad news to them, or explain that the cycle is taking longer than we thought it would.

I'm staying positive but I'm also aware that things can change at every step on this journey. I'm just taking things one day at a time and for now, that's doing the last shots tomorrow! And focusing on having a quiet weekend with my husband.

Thursday, 20 February 2014

Follie scan #2

Yesterdays scan and blood work was good. Follicle count is still around 12, Dr S said that there may be one or two hiding he can't see on the scan. And there's a few odd shaped follicles that he said he wasn't counting as they more than likely wouldn't contain eggs.

Size wise, they're all averaging around 15.5mm, with the lead follicle at 17mm. Growing slowly but steadily and pretty much spot on with the 2mm of growth a day. A bit smaller than they were expecting for day 10 of stims but they've been growing steadily and my estradiol levels have been rising steadily so both my doctor and nurse are happy with how its all going. They started at 323 last Friday, were at 625 on Monday and yesterday they'd reached 1197.

I do have to go back again tomorrow (Friday) for blood work again, just to make sure everything is still rising the way it should, they don't want to see my numbers sky rockettoo high or plateau. But I won't need a scan, so no waiting around to see Dr S. Tomorrows monitoring appointment should be nice and quick, just in for a blood test and back home again.

I haven't worked this week, I did miss a call from the teaching agency the day. But it was a day I had to have a scan and I wouldn't have gotten to the school on time. And I probably won't feel up to working until the end of next week. Anesthetic always makes me feel so worn out and shaky for days afterwards.

My original date for egg pick up was to be tomorrow but the way things are going it'll more than likely be Monday. If it is Monday, then tomorrow afternoon when my nurse calls she'll have all the details for checking into the day surgery unit. She'll also tell me the time to do my trigger shot as it'll be done 37 hours before my egg collection. And I'll have to fast for 6 hours.

I think fasting is the worst part of it. I get cranky if I'm hungry and when I'm dehydrated I feel even worse. We've had really hot and humid weather here all week so I've been drinking tonnes of water, it's been around 31ÂșC the last few days so I'm crossing my fingers that the night before my egg pick up won't be too hot and there's not too much trouble having the IV started the next day.

The shots haven't been too bad, and so far every blood draw has been ok. Gonal F doesn't bother me at all, but can't wait to do the last orgalutran. The last two days the nasuea from it hasn't been too bad. But the first few days were shocking. Just a few days of stims left to go!

Tuesday, 18 February 2014

12 is a lucky number!

I was so anxious heading into yesterdays scan, I didn't sleep well the night before and I dreamt that Dr S could only see four tiny follicles. As he was doing the scan, he said "it all looks good" I didn't quite believe him. I was still thinking about Fridays phone call "low range of normal".

After the scan, I went and had blood work done. I saw my nurse for the first time this cycle! I really like my nurse, at the start I found her a bit hard to get along with but as time has gone on we've built a relationship and she has been wonderful. She assisted with my first IUI and was the one to call me with both of the negative betas.

Dr S had come over to his office in between egg pick ups so I didn't really have time to ask him any questions. But when my nurse opened my file and read over the notes from my scan and she was so excited for my husband and I. She said it looks great and that she could book me in for egg pick up on Monday.

She showed me my file and said that Dr S had seen 12 follicles! 9 on my right ovary and 3 on the left. All measuring between 10mm and 12mm. And the large cyst that was on my left ovary has shrunk down nicely and is now much smaller. I was anxious that it'd taken a few extra days to get to this point, but my nurse explained that with PCO slow and steady is the best way to avoid OHSS.

I really need to just trust my doctor and remember that there is no normal protocol, it's different for every woman at my clinic.

I also asked my nurse about the nausea I've been getting. It only starts about 2-3 hours after the Orgalutran (ganirelix) shot and then lasts for most of the day. She confirmed what I thought and said that would definitely be the Orgalutran. It's an uncommon side effect, but unfortunately a few woman do suffer from it. Small frequent meals, load up on the protein, snack on raw almonds and if I do suffer from vomiting or it's a particularly hot day make sure to have a bottle or two of gatorade or powerade on top of the 2-3 litres of water a day. And if I find that I'm not able to eat I need to be having 2-3 glasses of low gi Sustagen to keep up the protein and nutrients.

I haven't eaten a full meal since I started the orgalutran five days ago. I'm either not hungry at all, or after a few bites I feel ill and think I'll be sick if I eat any more. Or I'm feeling that nauseated that I can't even think about eating. Nausea and vomiting are my biggest fears, I really hate feeling this way.

On the plus side, I haven't had any hormonal mood swings or crying fits. I'm just starting to have a few twinges around my ovaries today but it's just a twinge or two. It's not cramping and I'm not bloated at all or in any sort of pain.

I have monitoring again tomorrow morning, a scan during my doctors regular office hours so I'll be able to ask him any questions (but I think my nurse answered all the ones I had) and another blood test just to make sure everything is still on track.

Sunday, 16 February 2014

Wait and see

On Friday I did my first ever Orgalutran (ganirelix) shot. It gave me a bit of anxiety and I hesitated for a while. My Gonal F comes in a little pen type syringe, it doesn't look anything a traditional syringe. But the Orgalutran was in a single use glass syringe with a longer thicker needle.

It didn't hurt but it did feel different, the needle itself wasn't as sharp as the Gonal F ones and it took a lot more force to push it into my stomach. And I must've hit a blood vessel because I have a shocking bruise from it too.

I also had my first monitoring blood test on Friday, and of course, it was nasty nurse who was taking blood that day. She's the one who kept saying "when this IUI fails" at our last IUI and also is the same one who gave me the progesterone that was out of date. Ugh.

She was pretty nice to me on Friday morning, she was really positive and upbeat. But then she rang with the results of my monitoring bloods. My estrogen levels were only at 323, within the normal range for day 5 stims, but on the low end of normal. Sigh. This is how the IUIs went and this is how we started the "will it be cancelled or will it go ahead" game.

She did tell me that this could be a longer cycle or it may even wind up being cancelled but she wasn't curt or cold in the way she said it. Then she went on to say that she expects my numbers to have jumped up over the weekend and be in the mid range by Monday. A much more positive attitude! She also said that if my numbers have risen nicely then egg pick up could be sooner than Friday. 

I'm booked in for a monitoring scan and blood work Monday morning, so tomorrow we'll get up early and head down to the clinic. Because the scan is so early my husband can come in with me before work. I'm starting to feel a few side effects (hello headache from the Gonal F and today I've been battling with nausea which has to be from the Orgalutran) and I don't really feel up to facing peak hour traffic feeling under the weather.

I'm half prepared for this cycle to be cancelled if my estrogen levels have stalled or dropped. But I'm really staying positive that the news is good news! And that my doctor sees the perfect number of good sized follicles and that my blood work is right on target.
Monday, 10 February 2014

The start? Or do we have to wait?

Oh my gosh. I need to remember that nothing goes as planned with infertility and treatment plans. Yesterday, I was getting dressed and I had a sudden though of "what if there's a cyst on my ovary and this cycle gets cancelled?" My husband was still at his mates house so I sent him a text asking if he'd be able to go into work a little late on Monday and come in to the monitoring blood work and scan with me. As much as I can't stand the company he works for, they are flexible if he needs to take an hour or two off with short notice and I'm so thankful for that.

We got up super early this morning, I made my husband a cup of coffee and let him slowly wake up while I kept myself busy getting ready. Monday mornings are usually crazy busy at my clinic so we got there just as they opened at 7.30am. I didn't have to wait too long to get taken back for the blood work, the nurse I saw was the same one I'd spoken to on Saturday. She's new to the clinic but is lovely. They really needed another nice, friendly nurse.

I also picked up my planner and Gonal F and Orgalutran. And paid the deposit. And got a copy of the new prices for this year, they haven't changed too much. A few things have gone up a little but not a huge amount.

Then we went and waited to see our FS. On Saturday I was told that my FS wasn't in his rooms this week, so I was expecting to see his practice partner or one of the other FSs that work with our clinic. But when I saw the nurse she said that Dr S had been called in today and he'd be doing my scan in between egg pick ups.

Dr S came in about an hour later and did my scan, unfortunately my left ovary has developed another large cyst. I had a gut instinct that this had happened. Dr S warned us that the cycle may be cancelled. He wasn't ready to cancel it just yet, he wanted to wait for the blood work to come back first. He gave me a script for the pill and explained that if the cyst was producing hormones or my hormone levels weren't perfect, I'll go on the pill for 28 days and then we'll start again with another baseline check.

We walked out of the clinic and I made it as far as the hospital carpark before I burst into tears. Poor husband, it seems that every time he comes to an appointment with me I wind up walking out in tears. But I was so glad he was there to give me a hug. By the time we'd driven to my husbands office I'd had my little meltdown and had stopped crying.

I got home a short time later, I was upset at myself for not staying positive and thinking the worst. So I went into my work bag and got out my whiteboard markers and wrote "Stay positive!" on my bathroom mirror. I also wrote up an AA Milne quote that I love. I know it's silly, but I need a reminder and I'm willing to try just about anything!

Then I had a snack, then went and took a nap.  It was the most wonderful nap. I don't know if it was because I was just so tired and disappointed, or because I'd gotten a new pillow, or that the morning sun had warmed up my side of the bed and it was just so cosy, but I slept really well for two hours.

Just as the waiting was really starting to get to me this afternoon, the nurse called me. She'd spoken to my FS and the blood work was perfect! I was to do my first gonal f shot this afternoon and then starting tomorrow do it in the morning.

On Friday I add in the Orgalutran and go for another blood test and then they take it day by day from then.

Here we go!
Saturday, 8 February 2014

CD1 - first IVF+ICSI cycle

Finally! After a 36 day cycle I woke up early this morning to some cramping and sure enough, when I got up it was CD1. I had a busy morning and didn't get to call the clinic after I got back home from dropping the husband at a friends house in the Hinterland, about a 30 min drive away.

The receptionist said to keep my day clear as I might have to come in to pick up my medication but the nurse would call me back to confirm. (It's Saturday and they're not open on Sundays). I'd made plans to go out to lunch with friends so instead of catching a lift with them, I drove my car at met them at the restaurant. I'd just ordered lunch when the nurse called me back.

It was a nurse I haven't spoken to before. Nurse R, but she said she'd reviewed my file and the protocol my FS had ordered and that I didn't have to come in to pick anything up today, it was fine to wait until CD3. She's booked me in for my baseline blood work and scan nice and early Monday morning. I'll pick up my medication then, do my first shot as soon as the blood work is back and everything checks out. And of course, pay the deposit of $2500 when I pick up my meds.

I'm glad that the friends I was with are ones that already know that my husband and I are going through fertility treatments. It made things a bit easier. They asked a few questions once I got back from taking the phone call. I don't mind answering questions, infertility and fertility treatments are a foreign concept to healthy fertile people and with close friends I'm quite happy to answer any question. Even the more tmi or personal questions, like "so how does a SA work? They retrieve the eggs how? They do an internal scan on CD2 or CD3?!?"

But I did get my first "Why don't you just adopt? My cousins-stepsisters-best friend did IVF and it didn't work so they adopted" comment. Sigh. I know it wasn't said with malice, but it did make me want to roll my eyes. I've also had the "Would you consider using a surrogate?" question from another well meaning friend. I know they mean well, but we're not at that stage yet! Those options haven't even crossed our mind. We're still so far away from taking that journey, especially when we haven't even done one IVF cycle.

I'm going to stay positive this time around. Staying positive and thinking positive!