Thalia's fertility journey

The big guns

The appointment with Dr Candour was good. Not good as in: I had a good time, we laughed, we shared a glass of wine; but good as in he listened, he said sorry, he gave us honest opinions. He wants to share the letter I wrote describing our experiences this cycle - good and bad - with his staff. He told us he thought they had lost our trust, and that if we wanted to go elsewhere he'd understand. I immediately decided that he was trying to fire us as patients. He insisted he wasn't, just trying to give us an out if we wanted one. Cynical bitch that I am - H. saw no such subtext!

Eventually I decided to believe him. He told me that if at any point in the next cycle I have questions that his staff aren't answering, I should just call his assistant. If he is around, he will take the call. If he is not, he will call me back that evening. He had even found me some additional research papers to look at to complement what I'd read. It's the paper that justifies their clinical practice, I'll post the title some other time.

We came out with a game plan, which is to do IVF. He didn't recommend it, but when I asked about it, he eventually, after much prodding, agreed it was probably the right choice at this point. Since IUI, as he put it, "will not be straightforward for you," I don't see any point in messing around with it any more. At 38.75 I don't feel like waiting around, particularly since they will not do IUI two cycles in a row. That he was most definite about - he insisted that after producing four follicles my left ovary would be twice as large as it should be and it needed time to recover. Of course they could do an IUI with no drugs, but I think he thinks that is quite pointless. I'll ask him. Not because it will change our course now, but because I'd like to know.

So we're booked in for the set-up appointment on 7 September where we get to answer all sorts of questions about our preferences for our embryos, and presumably learn even more about injections, get our prescriptions sorted out. My clinic doesn't do the sniffy Synarel, so it's injections for me from the get go. But no progesterone injections - they use progesterone pessaries. Rectal pessaries. Anyone else do those? Oh, and hand over £1,900. How silly of me to forget that.

I should start a new cycle about 2 weeks after that. Suppression starts on day 21 of that cycle, all things being well and me not being cystic or high FSH, yada yada yada. So we'll be doing retrieval some time in the last week of October. Assuming we don't get cancelled. Fuck. The last week of October. Until I just sat and calculated it I had no idea how far away that was. That's a really really long way away. Damn my clinic and their concern for my health. Why can't we get started now????

I have another post brewing about how I feel about the decision to go for IVF, but it's a post on its own, so I'll work on it tomorrow and post it separately.

Thanks again to you all for your comments on the last post. If I wasn't so fat I'd be baking this weekend and at least able to post pictures of the cookies you requested a few weeks ago. But I gained three pounds in the last month, and am now 10 pounds heavier than this time last year. Enough is enough. I'm not going to kill myself, but I am going to get back into proper, minimum three times a week exercise and eating a lot less crap. I know I feel better when my clothes fit. I know I do.

One batch of brownies wouldn't hurt, though, would it?

What ever made you think there might be even a slim chance of this being in the bag?

I'm bleeding. Yes, it's the 10 day luteal phase again. Almost precisely as it's currently 30 minutes past midnight in the UK. That's the second time my period has destroyed all hope on the stroke of midnight. Considerate, don't you think?

My temperature crashed this morning, our last morning on holiday, so I did know this was coming. Kind of put a damper on our last day of the holiday. But you know how you persuade yourself that of course your temperature could climb 0.6 degrees centigrade in one day? Yeah, I did that a bit today. I didn't really convince myself but I did do it. Because it's never over til it's over, even when you know it's over, right? I'm a moody cow at the best of times, this really really doesn't help. But now, with this blood, I have no choice but to believe that it's really really over.

We have an appointment with Dr Candour tomorrow, now this, morning. I'm going to ask why he's so convinced I don't need progresterone support given this crappy luteal phase I have, as well as going over everything that happened this cycle. Then we need to decide on a game plan. I'm unconvinced that it's worth trying IUI again. We might as well pull out the big guns. I'm also fairly sure that we won't be able to do IVF this cycle as I don't have the drugs ready to go and I'm sure we'll have to have another one of those bloody stupid induction appointments at the clinic before we can even get a prescription.

I'm so very very angry that they didn't do the insemination that it's hard for me to stop being angry long enough to type this. We had FIVE follicles! FIVE! And three days worth of do-it-yourself sperm deposits outside my cervix didn't do any good. So, either my eggs are crap, or there's a problem with my cervix, or the endometriosis has come back faster than expected, or there's a problem with implantation. That's four reasons why it might not have worked, but there were FIVE follicles! Couldn't we have had just one? Five months worth of trying in one go, and it didn't work. What hope do we have of this ever working?

I know you're all going to tell me that there's much more that we can do, not to give up hope etc. And I know that others have gone through so much worse than this so this is going to seem incredibly self-pitying and insensitive. I do know that. But right now I can't feel anything but hopeless. If I couldn't get pregnant with five follices and a two week holiday to do nothing but eat good food, relax, do yoga and swim a lot, what chance do I have of ever getting pregnant at all?

It's either in the bag, or it isn't

After another deposit last night, and a truly stupendous temperature rise over the last two days which I'm assuming is due to the drugs, there's nothing much more we can do. We leave tomorrow for a week of sun, sea and...whatever else you can imagine. I'm very definitely not taking the computer with me, so I will check in with all of you when I return.

Deposits are on their way

Good for H. We had a great romp in the hay tonight, at pretty much the perfect time - ~28 hours post detecting the LH surge and post the HCG shot. Although he did get tense he handled it really well, just chilled out, then tried again. He's getting better at this! We'll try again tomorrow night, just to be on the safe side, but I feel like we're already in good shape. Or as good shape as we can be in, given we didn't get to do the IUI.

I wrote a very long letter to the consultant (Dr Candour) detailing my concerns with our treatment. I found his email address via a research paper he wrote and sent the letter through electronically today. I didn't expect to hear back, since we have an appointment to see him on the 19th (the day after we get back from holiday). But when I logged on just now there was a response from him saying he took our concerns very seriously, and did we want to come to see him sooner as my points were too complex to discuss over email. We can't do the dates he offered since they are when we're on holiday, but I really appreciated him getting back to us. I was nervous about sending the letter since I thought it might label me 'trouble patient' but so far he seems to be taking it exactly in the right way - seriously and with respect. That's a relief.

The other thing I did today was acupuncture. Never done it before. I got a recommendation via a newspaper journalist who went through IVF very publicly last year and gave birth to her daughter a month or so ago - NB daughter was conceived on a rest cycle between IVFs! I enjoyed the experience. The therapist was very respectful, and listened well to me. He didn't half go on about the 'relaxation' thing, but also told me that things like cooking or gardening might help - nurturing exernally helps the yin energy, apparently. Nothing like confirming female stereotypes through chinese medicine, is there? I'm actually quite open to this in a way that my 25-year-old self would have laughed at, cynical scientist that she was, but it has left me wondering if societal attitudes to women came first, or if the medicine did? Anyway, I enjoyed the deep relaxation and laughed at myself for the slow pace I was walking at on the way home from the appointment!

Let's hope those sperm know where they're going. My ovaries hurt, and have been doing so on and off all day. Never felt that before. In a way, it's encouraging to know that something is going on there, and more so than in a usual cycle. Reminds me to keep focusing on doing good things with my body. Yoga tomorrow, and more sex. This might actually be fun!

The fruits of my labours

I've realised that I need to change the category on these posts, since the IUI isn't happening. Something to do later.

Well, the amount of research I've done in the last 48 hours has surpassed the intensity of many days when I was writing my PhD. Funny how things are different when you have 'skin in the game'. I thought it would make sense to write it up here so someone else can benefit if they find themselves in the same position.

Where indicated with a star, the full article can be read for free by going to Pubmed. Where not marked with a star, just the abstract is available on Pubmed, unless otherwise indicated by the link.

IUI and multiple follicles

1. A multifollicular ovarian response to clomid/HMG (ie FSH) resulted in better treatment success than a monofollicular response. Other factors contributing to success included female age of less than 40, infertility duration of less than 6 years, and no evidence of endometriosis. Nuojua-Huttunen et al. Human reproduction 14.3, 698-703, 1999. *
2. Risk factors for higher order (ie more than twins) implantation after FSH stimulation and IUI are serum oestrodiol >=862 pg/mol, female age =<32, and total number of follicles. For a woman over 32, with 4-5 follicles and eostradiol >862, the risk is 13%. If oestrodiol is <862, the risk is 4.3%. I was in the latter category (although only just). Tur et al. Human Reproduction 16.10, 2124-2129, 2001*
3. More recently, Tur et al have applied the methodology indicated above to manage the cycles at their clinic. Application of these three variables has resulted in an 8% reduction in pregnancy, but a 290% reduction in higher order multiple pregnancies. Tur et al, Fertil. Steril. 2005 (don't have the rest of the info)
4. For patients 35 or older, pregnancy rates in hMG and clomid+hMG cycles doubled when six or more follicles were =>12mm, or E2 levels were >1000 pg/mol, but incidence of higher order multiples was not increased. In women under 35, the same conditions did increase the incidence of three or more implantations. Dickey et al. Fertil. Steril. 75.1, 424-426, 2001

IUI in general

1. A good summary of all the factors contributing to IUI success, too much info to summarise here. Duran et al, Human Reproduction Update, 8.4, 373-384, 2002 *
2. Another overall summary, not as good and I had to pay $35 for it - won't do that again! Email me if you want to know more about it. Balasch, Reproductive Biomedicine online: 9.6, 664-672, 2004

Use of HCG versus LH to trigger ovulation in IUI
To decide what to do today after Pamplemousse's comment on the last entry, I looked into this in detail. Sadly, the evidence is not conclusive. Here are the better articles that I found, you'll see they have somewhat contradictory results. After reading this, and realising from an OPK this afternoon that the LH surge was beginning, I went ahead and gave myself the shot. Let's see. The downside some authors have mentioned is that HCG may have an effect on the receptivity of the endometrium. However, it's not clear and I wanted to give every chance to those 5 (or 4, realistically) follicles.

1. Across a wide range of stimulation protocols, administration of HCG (whether with an LH surge or without) leads to increased pregnancy rates. In most cases (although they didn't get statistical significance with all the differences) the LH surge plus HCG shot was the most effective method. When FSH is used in the stimulation protocol, an HCG shot was beneficial. Mitwally et al, Reproductive Biology and Endocrinology, 2.55, doi:10.1186/1477-7827-2-55, 2004* (this seems to be an online journal so usual page numbers don't apply)
2. No statistical difference between LH-timed IUI (measured through urine) and HCG-timed IUI. However, many authors have commented that urinary monitoring is v inaccurate and will miss the LH surge in about 35% of women, so this study is probably not well designed. Zriek et al, Fertil. Steril., 71.6, 1070-1074, 1999. Several other studies published, all the ones I've seen say no difference between the two methods
3. Possible effect of HCG on endometrial receptivity. This relies on the longer half life of HCG in the blood than that of LH, as well as a slightly different effect on endometrial physiology. Fanchin et al. Seminars in Reproductive Medicine, March 2001. I had to sign up for medscape access to get this, but I didn't have to pay. I just said I was a doctor. Hell, if all this googling isn't good for something...

I hope that helps someone. I will make sure we have sex tomorrow night, which will be 28-ish hours after the HCG shot and LH surge. This all feels like such a mess, I have no idea whether we have a chance. But we have to try, right?

I've also used this research to write a long letter to Dr Candour, describing what went right and what went wrong from our perpective with this cycle. I'm going to email it through and hope he doesn't just see us as trouble-makers. Let's see.

Thanks again for all your support.

I feel just like a lesbian

Wow. Thank you so much for yesterday's comments. Your ideas were gratefully received. Last night, we tried fooling around for a while but H was just getting more and more tense. I offered him the cup and syringe method, and he at first declined as he felt like a failure for doing so. After 30 minute or so he gave in and went away and did the deed, returning with what he called a 'special delivery'. As I injected the sperm (5ml syringe, no needle), I thought of our lesbian friends, T and S, and how they'd done something like this for a few months each before conceiving their son and daughter (2 years apart).

I haven't yet had an LH surge, so we have time for more tries after H can get the drugs on Monday. Blood on Friday said my LH level was 3.0, and I've been peeing on OPKs ever since, and they are all clearly negative. I bought the wrong brand unfortunately. I've always used the digital ones, although I take them apart afterwards and examine the lines. This time I picked up the basic ones by mistake, which was a bit irrirating. But the test line is clearly shadowy - almost invisible until 5 mins or so after I've taken the test, so I'm pretty sure I'm reading them right. Should I give myself the ovitrell shot? I thought I might as well wait to have my own surge.

Re wessell's question on H and ambivalence. No, he's not ambivalent about having a baby. He is, however, messed up about the impotence. He's seen a counsellor on and off about this problem for nearly 2 years, and I've also gone with him on a few occasions, but once it starts working for a few tries he stops going. Then the problem recurs - which might be ok if he could just forget it and move on - but instead he freaks out and the problem is back to stay. That's happened twice now. The counsellor got very cross with him the first time it happened, because he had told H to keep coming and discussing the issues, but H had heard: "You're fixed, don't come back". The counsellor said that H was a lazy thinker who just wanted the difficult things to go away, and so heard what he wanted to hear.

I discussed that issue with H last night and he agreed. Every time I try to discuss what's going on with him and this issue, he tells me he doesn't want to talk about it - that this is not a good time. But it's never a good time, that's the problem. On the occasions we have been able to talk about it I've said so much to him about this: that I love him no matter what, that it's worked in the past (on our wedding night and on honeymoon he had no problem, even without drugs), that I'll do what it takes to help him. Nothing seems to help.

He has an appointment with a new counsellor when we get back from holiday. He's cancelled it twice for work, I just hope he doesn't cancel it again. It's not about the conception, really, we can do that other ways as you guys pointed out, it's about us having a strong marriage which can survive anything. I am convinced he is the man for me, but I think a marriage needs a sexual connection, and he's lost that confidence.

This sadly meant that he was in a bad mood for the rest of the evening because we'd resorted to using the syringe. It is the old cliche - he felt like less of a man, having to do that. In the end I left him to watch motorbikes, and came upstairs to read some more blogs. I'm sad for him but don't know how to help him with this. In the end, I can't make his brain ok about this. Only he can do that.

We've decided to cancel your treatment on the grounds that you might actually become pregnant

Well, the title says it all. Lining 10.5mm. On the right, one at 22mm, on the left, four - 17, 16, 16 and 14. They consider (now they tell me) anything above 14 as possibly fertile, so that gives us five follicles, and the cycle is cancelled.

We saw yet another doctor this morning, and lo, she was pretty much as bad as Dr ICU. Let's call her Dr Condescending, for the sake of argument. Before she even scanned me she sat us down to give us the speech. When I asked her very calmly about all the research I'd done, she told me that of course she'd seen lots and lots of patients, and therefore she knew that there was a high chance of multiples in my case. I asked her why, she told me that it was because of my lining and because the follicles kept growing, "even in the absence of the Puregon". I pointed out several times that since I had been taking Puregon in the evenings, I'd only been without it for 12 hours, so it was hard to tell what my follicles would do in the absence of it.

Given the research I'd done, I also asked about converting the cycle to IVF. She said not possible since I would have had to have taken the GNRh agonist by now. Not according to one article I read, but there you go.

We got the whole, "It's policy" speech, and most maddening of all the: "I know how you feel" comment. I really wanted to deck her at that point.

Eventually I gave up and we left, and I sobbed. As we were leaving she threw in the point about: "and no unprotected intercourse, either."

I know you guys are going to tell me to just have sex. But it's not that easy for us. H, remember, has a problem with impotence. This situation is pretty much guaranteed to make it impossible for him to perform. He also informed me this morning that he hasn't renewed his prescription for the impotence drug so we don't even have that crutch.

I really do feel devastated. I know it's nothing compared to what many of you have been through. But I really felt this was our cycle. We'd have a May baby, just as I always wanted (and fantasised about this time last year). I've taken two weeks off "to relax". HAHAHAHAHA. I won't be able to keep taking days off when treatment comes up. I feel like this was our chance and we got it snatched away from us. This month I put a moratorium on any travel for work, and mostly my clients understood. I don't know how I can manage to organise another month where I don't have to travel for work.

I know there will be another cycle. It just doesn't feel like it right now.

It's the all the fun, all the time show

IUI#1, Day 10.

Dr ICU is slightly less unpleasant in person than he was on the phone. Yes, it was he who did my scan this morning. A bit of the racing driver phenomenon (nyeeeeeeeaah, round the corner, vrrrrroooooooom, vrrrroooooom, nyeaaaah (sorry cannot find the right way to type racing car noises, but basically it's lots of vigorous moving around the corners without much warning)), but not as much as the one I had on day 2. He also did the v disconcerting thing of frowning a lot at the screen, looking worried, and at one point turning to the student who was in the room to say: "Can you see the endometrium? It's not very well defined..." Given the numbers below I think it was a screen thing rather than a problem with my lining, but who knows. He also said nothing for the first 5 minutes or so, which is also very disconcerting. So I was very disconcerted.

H eventually saw I was a little tense, and asked if I was ok, at which point I got up the courage to say: "I just need to know what's going on". Then Dr ICU started letting me know what he was doing, frowning all the while.

• Good news: Lining 9.5mm
• Good/bad news: Right side: One follicle at 20mm, one still at 11
  Left side: Four follicles: 15, 14, 14, and 13mm
• Bad news: My temperature was up this morning

So it looks as if one egg has either already gone, or is about to go, and the others won't be ready. I know that's not a disaster, but it's so much less than I was hoping for. They will wait for the bloods and decide at lunchtime if we should come in tomorrow for insemination or wait til Monday -they don't do inseminations on Sundays.

***********************************************

Update: E2 is 2601 (708 US), LH 3.5.

So I haven't ovulated and don't seem to be about to. Thank goodness. Dr ICU told me that I need to come in for a scan tomorrow, and in the meantime stop the Puregon. If there are four follicles at more than 17mm they will cancel the cycle. If there are three or less, they will go ahead. I asked him if he had any clinical evidence that it made sense to cancel the cycle with four follicles given my age, and he said "It's not clinic practice to give patients clinical evidence". GRRRRRR. I asked him if there was any scope for discussion on the issue, he told me "It's clinic policy, if you'd read the material we gave you, you would know that". GRRRRR.

This conversation went round in circles somewhat until I gave up. Scan at 08:30 tomorrow. Wish me luck. Not sure what to wish for at this point, I guess it's three follicles at 17 or larger, and that the other two stop growing. Wierd to wish for something that the research says is less likely to get me pregnant, but there you go.

Cautiously moving forward

Thanks so much for all your help over the last 24 hours. I'm feeling a little better about it today. The one thing I don't know is exactly how many follicles I have to have before the clinic will refuse to do IUI. But when I see them tomorrow I hope that there will be 4 good ones and that there won't be an issue on that basis. Thinking about all you said and about our lack of success so far, the chances of multiples has to be minuscule, so I'm ready to push for IUI almost regardless of the number of follicles.

I did the injection last night, and tried the stomach after your comments, but actually I think the leg is easier for me, so I'll go back to that tonight. Perhaps since I'm only injecting such a small volume that makes a difference?

I did my fertility yoga this morning and it's a lovely day here so I was feeling all blissed out as I walked to the tube until I mistakenly read an email on my blackberry telling me my feedback from the course I did two weeks ago wasn't good and I should look for opportunities to improve. I couldn't open the attachment there and then so fretted about it all the way to work. Then I opened the attachment and found that actually it's pretty good and with a couple of specific things I can do differently (slow down my speaking, crack a few more jokes so I seem more accessible (help! I can't do jokes!), and make more specific comments in the breakouts). That I can do. So I'm a bit cross with whoever sent the email for freaking me out, as doing these courses well is something I pride myself on. So I'm going to try to let it go with a few deep yoga breaths, then re-throw myself into my day.

Thanks again guys, I really appreciate your help and support. Virtual cookies for everyone - what type would you like?

Speaking too soon: a little known but deadly disease

As you may have guessed from the title, there is now a potential issue. Of course, if you were less optimistic than I, you might have guessed that from the post below. But I was enjoying my happy day too much to want to spoil it with worry, at least for a few hours. For the same reason, I've decided to leave the post below intact rather than spoil it with my new bad mood. So if you haven't already, you need to read the post below first.

Dr I can't understand a word you're saying because my English is crap and I don't want to have a discussion with you anyway (Dr ICUWBMEICAIDWTHACWYA, or Dr ICU for short) just called. I have five follicles. Two on the right, three on the left. Three are at 12mm, one at 11mm, one at 10mm. Hormone levels: LH 4.3, E2 2000. Before you freak out, this is in the UK measurement of pmol/litre as opposed to the US measurement of pg/mol, so the US equivalent number would be 545 (thanks Mare!).

So the good news is I respond well. The bad news is maybe I respond too well. If all five continue to develop, we will get cancelled. If we have three, they will go ahead, but only if we sign all sorts of disclaimers about multiple pregnancy. Now H and I have discussed this, and as an academic option, we have agreed that we would do selective reduction if we have more than twins. I know that's a very difficult point of view for some people, and who knows how I will actually feel if it comes to that, but that's what we think we can handle.

It's a bit ridiculous because given we have not got pregnant for over a year on our own, what's the chance of 5 or even 2 eggs fertilising, developing and implanting successfully this time? But suddenly we have to think about this. If it was up to me I'd go ahead even with 5, but the clinic won't - not sure if that's a legal obligation or not.

I'm pissed off because the doctor was such a plonker. He kept asking me why I wanted to know things, and when I asked him for the units of the E2, just to be on the safe side, he asked me if I was a medic before he would give them to me. When I asked several times if I should continue at the current dose, he said things along the lines of: "I would have told you if we wanted you to drop the dose." Yes, fuckwit, I know that, but I'm asking you a question about what's going to happen if I continue, and what is likely to happen if I reduce or stop the dose? Why can't you tell me why it's a bad idea for me to stop taking the drugs or reduce the dose somewhat. He never answered the question. Do you guys know? Would all the eggs just stop developing?

I'm also pissed off because before we started the cycle I asked if I really needed to do the drugs since I seem to ovulate fine on my own, and they didn't really give me a satisfactory answer but insisted that this was the right way to do an IUI cycle. It's still possible they were right, it just doesn't feel that way right now.

I don't really have any option but to continue as I'm scared all the follicles will croak if I drop the dose. I go in again on Friday for a scan and more bloods. I've gone from being 100% convinced that in 3 weeks we'd be pregnant, (Stupid, I know, but I was enjoying it), to being 60% convinced that we won't even be able to try.

Where's that optimism when you need it??

Ode to a wand monkey

Just had a great clinic experience. We arrived just 5 minutes late, the vampire took me back before I'd even finished signing in. Five minutes later I'd scarcely finished pressing on the cotton wool when the wand monkey called me. This was the dream wand monkey, so lovely that I've decided she needs to be called something appropriate, like Dr Kindness Personified (Dr KP for short, I can't be bothered to type that every time). I think, but am not sure, that she might be the same person whom I labelled Dr Accomodating last week, but I forgot to write down her name then so can't be sure.

So Dr KP did something different than the other wand monkeys. She treated me like a human being. She asked me about how I was finding the cycle. She asked H to move over so that she could tilt the screen more towards us. She helped me get my legs into the supports, and warned me before she inserted the probe. She told us she would look first, then show us what was going on.

The results are good so far. Four follicles on each side, but two on each side probably won't go anywhere, so she's not worried yet about the dreaded multiples discussion. The larger one on each side is about 12-13mm, the smaller about 9-10mm. So I have follicles. I'll upate later with the bloodwork. She thinks IUI probably on Monday. Next scan is Friday.

After the scan, she continued to live up to her name. She told me about how the rest of the day would go, she told us about the lunchtime meeting they have where they discuss everyone's blood test results, and how sometimes the meeting drags...she asked about our holiday. It was a fantastic, 25 minute long clinic visit, and I didn't even have to bake cookies to get it. By the way, does anyone in the UK take baked goods to the clinic? I think they'd think I was smoking something but perhaps everyone else does and I just haven't noticed? Let me know.

Needle schmeedle and other anxieties

Ok, I admit it. I am an insecure comment whore. So Sunday's post is really troubling me. That's the fewest comments I've received in weeks! Of course, nothing can compare to other news, the amazing, the nearly good, and downright astonishingly horrible, in blogland at the moment, so if it's just that you've diverted your attention there, then I completely understand! That doesn't stop me obsessing, though. I've been reading it over and puzzling about why it clearly didn't seem very interesting. I guess I've written a lot lately about not much. I'm not planning on changing that, since, as we've discussed previously, this is my blog and it's here to help me. However, I do get a tremendous kick from your comments and the thoughts they provoke in me. So thank you. Again. And please don't perceive this as begging. I'm just observing, and I think indicating what a big part of my life this online community has become.

First injection was last night. I found the whole preparatory procedure quite stress-inducing. I followed the instructions to the letter, which is not usually my wont. I am the original, let's stick this wire here and that button there and then press this and see what happens, kind of person. But this seemed like the right occasion to actually pay attention to what I was doing. It took a long time, what with resting the needle in its outer case on a clean dry surface, and then swabbing the pen, and then attaching the needle to the pen, etc. etc. I know I sound like a ridiculous novice, but last night it felt like a big, momentous task.

I had a few set  backs. I swabbed my leg when they told me to, but then got distracted by all the needling steps, and by the time I got round to pinching the skin, I'd forgotten what bit of skin I had swabbed. Then I swabbed again, but realised that that bit of leg didn't pinch well, so I swabbed a third bit, stuck in the needle and...I didn't feel a thing! Sure, it stung a little as I dispensed 50 units, but in the grand scheme of things, no biggie. What a relief. Tonight I'll be all: Pen, needle, swab, stick, swab, needle dispose, and OUT!

Now I'm just nervous about tomorrow's scan. Let's hope I get news as good as Nico's.

Clomid moments

Thanks to Tania for this title. Although, I don't think I've had any (yet). My two BFs from college, with whom I had tea this afternoon, both commented on how calm I seem. I was a bit grumpy earlier, but then I'm frequently grumpy when anyone tries to move me off the sofa before 12 noon on a Sunday, so I cannot accuse the clomid of that. What I think I can accuse it of is making me have horrible acne. Does that sound right? I haven't been this spotty in years, it's really very annoying.

We did go to the party last night, despite me despairing for 30 mins about what I was going to wear as I am definitely too fat for most of my cool clothes. My husband told me I looked fab, and I think I did look good (spent some time on makeup which I normally never do), but it was fab in the one outfit I looked fab in, and the fab-ness was greatly enhanced by the wonderful Emma Hope shoes I was wearing (they look most similar to the pink Boho Fuzzies, here, but not exactly - I bought them a couple of seasons ago).

I'm so pissed off with myself for getting fatter again, when I worked so hard to get thinner, and I so enjoyed last summer feeling good in clothes I never thought I'd be able to wear. But I am not able to go through what I did last year to lose the weight given all the fertility stuff - at least partially because I don't want to rather than simply because I can't, but certainly the exercise schedule wouldn't work right now. Got to stop moaning and do something about it.

We had a good time at the party, and snuck out early without saying goodbye as my friend was busy being chatted up by an extremely eligible nice jewish guy - he was GORGEOUS - so I didn't want to disturb her. I do quite like parties sometimes, but only if I have control over my exit as after a while I simply don't want to talk to people any more. People think I'm a raving extrovert, but at least H understands that secretly I enjoy being quite alone, or with just him or another v close friend.

Finally, hoping that someone in the UK is reading this, WHAT WERE 51.1% OF THE BRITISH PUBLIC THINKING, EVICTING KEMAL OVER ORLAITH? I just stared at the television in horror. He was funny, he was smart, he was great television. She just whined and touched her breasts a lot. I don't get it. Are 51.1% of the voting public men who just wanted to ogle her? Well, tough titty for you, fishface (as my brother used to say), since she walked out the next morning. Honestly. Have you people no sense?

Normal fertility-related service will be resumed as soon as possible. Until then I must go and work. ugh.

Pregnancy

No, not mine sillies. I'm on CD5. I'm just seeing pregnancies, all around me. On the telly, in the street. I know this happens to all of us, it's just that today it is striking me particularly strongly.

Perhaps because the woman manager I was working with on Thursday is pregnant. I looked at her on Monday, having not seen her for a few weeks, and thought: she's pregnant. No, I thought, she's just put on a little weight. That made me feel better. But when I saw her again on Wednesday evening, it was clear. She's pregnant. The other guys on the team were talking with her about it. Now she's a perfectly nice woman and I'd like to be happy for her. I'm not unhappy for her, I'm just mind-blowingly, excrutiatingly, stomach-achingly, green-eyed-monsterly, disappointingly jealous of her. She is, of course, at least 5 years younger than me, very skinny, so the bump is sticking out nicely even though she's only 14 weeks. I want to be her. Her baby is due on 24 December, poor little thing.

In other news, still no side effects although I do have an off-again, on-again headache - could that be related? Or is it just normal dehydration headache after a tough workout? And my sister-in-law, the lovely fertile one, just sent me some flowers to say she's thinking of us as we start this treatment. That was nice of her. They're incredibly ugly flowers - nasty chrysanthemums and lilies which I loathe, but it was still nice of her.

It's been a pretty productive day, since in addition to the tough workout, I've also had my hair done, same balls-achingly expensive place I went to last time. This time the stylist put a few extra layers into my hair, then dried it all cute and flippy, looks quite funky. This is in aid of a party we're supposed to be going to tonight, although I really don't feel like getting dressed up to go. I'm thinking of using sickness from the drugs as an excuse, since the friend concerned knows about what we're up to. Hmm. Guilt over not going vs lovely evening on the sofa with H?

We just got back from the design shop, where we agreed to spend a heinous amount of money on a sofa, three chairs, some curtains, some bookshelves, and some joinery work to build a study for H and some better storage in our bedroom. It's going to be lovely, but some of it won't be done before end October. Oh well. Better late than never.

Blimey. Just took a break there to go hold H's waist while he pushed some leaves out of the gutter. We had torrential rain and the backed up gutter was causing a leak into our dining room. Crisis averted with some wet teatowels and a large broom. H is wet but is feeling all manly and proud of himself for mending something in the house, which is not usually his strong point. Bless.

How many cliches do you think I can put into one post? 

Further things men say

H was looking pensive as we sat in the waiting room yesterday. Eventually, having flipped through the only edition of Country Life in the waiting room at least three times, he turned to me and said:

H: So is my sperm really ok then?

T: Yes, of course, why do you ask?

H: It's just that, it seems so easy. I just had the one test, and they told me it was fine, while you...

T: Yup, not fair, is it?

H: No... and my test involved having a wank, too.

T: Perhaps I should suggest they give you some shots, just to be on the safe side...

In other news, just popped the second clomid tab. No effects that I can spot, yet. Temperature still hasn't returned to usual baseline level but then I am waking up early and tossing and turning so that's probably it. Painters want to paint our kitchen lemon yellow. Not ideal with the dark blue floor we've got (and that we can't afford to change). H is colour blind but told them he thought it was ok. Luckily they only did a test patch and I've nipped it in the bud now.

I got the sense from comments on the last post that (some of) you were losing patience a bit. I'm sorry for that. I was a bit tense yesterday but am feeling ok now. I know that whatever happens I'm going to research the hell out of it. I didn't get that PhD for nothing, now! But anyway, thank you for the thoughts. I'm looking forward to seeing what the next week brings. I am convinced this cycle will work. Hhahahahahahahahahahahahah!

Systems are go...

Results are in:

• FSH: 6.5
• LH: 4.5
• E2: 89

I'm very happy with the FSH as it is down from last time (I think it was 7.8 or so when it was measuerd in November. Certainly it was below 10). I appreciate that this is within the normal variation range, but still, at least it is varying down rather than up. However, Dr Google has made me extremely nervous on the E2 level. I didn't know when the doctor called what a good number was (stupid supid) but now I know that it should have been below 75 and preferably below 50. I did find one google result that had two different units for measuring E2, under one of which I would have been ok, but I checked with our clinic and they are using the standard pg/mL measurement, so that does not constitute a get out of jail free card.

Although it was v hard to get back through to them, I did just manage to speak to the doctor who called me earlier (I was in a business lunch and had to leave the table to do the call - my results are written on the back of a Waitrose receipt from Saturday!), who was incredibly nice about me calling back, and explained that different kits have different standards, and according to their kit, under 100 is fine. She said: "Thalia, trust me if your level had been a problem I would have been the first person to tell you to wait a cycle, or to wait til tomorrow for it to drop further before starting the clomid."

I also had the wherewithal to ask about antral follicles. I had 3 on one side, 4 on the other. That seems low according to Dr Google, but again, my friendly doc assured me that that was good, nothing to worry about. This scan was performed by the wand monkey from hell. He jammed that thing around as if he was waving his umbrella at a friend in the park to emphasise particular points of conversation. He pulled it all the way to one side, then straight over to the other. At one point I asked him weakly if he'd at least warn me when he did that, but he then just did it again with no warning. Now I fully appreciate the horror. Last time seems tame in comparison.

I am chosing to be comforted by Dr Accomodating (don't know her name so am obliged to make this one up!). First clomid tab gets popped tonight, injections of 50units start Monday, next scan is next Weds, day 8.

Poor H. He came with me, and was generally lovely throughout. When I called to give him the test results, he said: "I've been hoping that they were going to tell us that you were really pregnant, and that we didn't have to do this." I had no idea he was thinking that. It made me cry. I asked him why he'd been holding on to that hope, he said: "I don't know, women's bodies seem so complicated, it's more of an art than a science so anything seems possible." We forget sometimes, don't we, how stressful it is for them, too.

Really CD1 this time

Bring on the drugs then.

This morning did give me a beautiful infertile memory, though. One I will treasure. I went back to sleep after the alarm went off and had a lovely dream that I'd got up, peed on the stick, and got lovely strong clear double lines, and everyone was so happy for me.

I woke up again at 650. Took my temperature - it was nice and high. Got up, no blood. Peed on stick. Then started to bleed before the stick had time to react. Stared at stick anyway. Stared at stick some more. Noticed second line but way up the test, away from the testing area. Decided to ignore it. Climbed back into bed with H and demanded comfort. Climbed out of bed and persuaded myself to do my "yoga for fertility" practice. Stared at stick a bit longer. Went to do yoga.

Medicines have now arrived, although painters haven't. Need to call clinic to set up day 2 scan tomorrow. Yaay.

Thanks for all your kind thoughts yesterday. But I guess I need the drugs. Please hope for me that that's all it will take for us.