Appointment with Dr Candour today to review the cycle. He confirmed that:
They were happy-ish with the stim. Eight eggs is what they are aiming for. Six eggs is pretty good.
Oestrogen levels were good and rose nice and steadily
Lining was good (10.5mm which I thought was a bit on the low side, but there you go)
We had beautiful eggs - six/six fertilised is not usual
The embryos we put back were perfect, they couldn't have been better - particularly the fact that one of them was compacting
Because everything looked so good, he said that, at transfer, they were very "gung ho" about our chances of success. He was therefore very surprised that I started bleeding at 8dp3dt. Given that I started bleeding so early he thinks my beta of five on 10dp3dt was a false positive result rather than a chemical pregnancy. Apparently the false positive level goes up to 8, so it's hard to tell either way unless the number is higher than that.
Responding to all of this, the protocol for next time would be:
Long day 21 again. Although this is slow, it got us some high quality eggs so they don't want to mess with it. His experience of antagon protocols is that they produce fewer and less good quality eggs. I tested the antagon/letrozole protocol with him that Pru is on and he had never heard of anyone in the UK doing it other than for breast cancer survivors. So now he wants to meet Pru's doctor.
They will start me on 200iU of Puregon next time, instead of starting at 150
Much against clinical evidence, which says that there is no difference in pregnancy rates between PIO and suppositories, he wants to respond to my early bleeding and use PIO next time. Oh joy.
He is not in favour of assisted hatching or 5 day blastocyst transfer as neither show any improvement on 3 day transfer rates. Assisted hatching does show a small positive improvement in pregnancy rate for women over 39, which I will be, but he says it's not enough to risk it yet. Blastocyst transfer improves success rates per transfer, but not per cycle started. They have not found it worthwhile to do the "survival of the fittest embryo" on a regular basis for that reason. If I had six good embryos on day 3 next time, they'd be prepared to have the discussion, but he wouldn't recommend it as a starting protocol.
However (you could tell there was a 'but' coming, couldn't you), he first needs to scan me to see how bad these endometriomas are on a non-stimulated cycle after my ovaries have calmed down. Which means a scan in the first half of January, after two unstimulated cycles. Then he'll decide if we should do a lap or if we can go straight to IVF. Broadly we have four options re the endometriomas:
Do nothing. They'll stay there, and will gradually get bigger. Hence not a very good option long term.
Aspirate them. They fill up again pretty quickly
Drain them and laser clean the walls. They are likely to reform, but more slowly and in 10% of cases they are gone for good. This is what he did last May for the one I had then
Drain them and ablate the cells surrounding them. This removes them for good 90% of the time. It also destroys a significant chunk of the ovary that surrounds them. Hence not a good option when, in his words, "we are trying to preserve fertility."
He will therefore consider either option 1 or option 3 depending on how they look in a couple of months time.
Again we had a very good discussion. Although he kept us waiting for 30 mins, he did then gave us an hour which was double our appointment time. He did stop at one point and ask me if all the research I had done was helping me or making me more stressed (after I asked him a question about the effect of androgenising hormones on endometrial quality and egg quality in the context of an antagon cycle), which I thought was a good question. H thinks that at the margins the research makes me more stressed, but I do feel I need to know stuff, and I have stopped myself on obsessing on some things which only make me feel worse like the success rates for women with endometriosis. I told Dr Candour that and he said: "well, as long as you've got it under control, you should do what helps you the most."
I asked him about the effect of endometriosis on implantation. He says that the evidence is equivocal. Because they still don't understand the basic biology of implantation it's hard to say what this problem is, but his sense is that it there is a link, given the lower success rates for IVF for women with endometriosis even when they have the same quality eggs and embryos as a couple coming in with, say, male factor. I forgot to ask him about beta-integrins and whether it's worth testing for a problem there, possibly linked to implantation.
Other questions I forgot to ask him were:
Was I not a bit oversuppressed after 17 days on Buserelin before stims began? In fact I did ask it, but we got distracted half way through his answer
What does he think about immunological issues as contributors to endometriosis? And what does he think about the work on diet and endometriosis in that context?
So where does this leave us? I have today filled in the form to get my records released to send to the Big Guns Clinic (hereafter BGC). We'll do another cycle at my current clinic, then see where we are. However, I'm desparately sad that all this waiting means we are a year away, at best, from a baby. On the current schedule, assuming I don't need a lap, we'd start at the end of January, retrieval would be mid-March. If I do need a lap, all bets are off.
This just seems so far away. I am less and less likely to have a baby before I turn 40. But I just want a baby. I want to be a mother. I'm sad and mad that it's so hard for us. I want to do this for me, I want to do this for H. I want to bring someone into the world, to love them and help them become a real person. I want to find out what they are like and what they want to do with themselves. I want to watch them grow and learn. I want to bake them cake and have them cover the cake with too much icing and ugly sprinkles. I want to treasure glittery paintings. I want to put sticking-plaster on skinned knees and hold them on my lap when they cry. I want to tell them they're beautiful. I want to watch them sing twinkle twinkle. I want to help them with their homework. I want to watch them play football with H or head off on their bicycles to the park together. I want to worry about them when they're out too late at a party. I want to listen for them sneaking up the stairs, thinking we don't know how late it is. I want to take them to the leaning tower of Pisa and explain to them why it's not straight. I want them to explain how a train works to me, and point out all their favourite dinosaurs at the Natural History Museum. I want to take them on the Earthquake at the National Geological Museum and tell them how their Grandpa used to take me there every Sunday. I want to wach them climb the climbing frame in the park and worry about them falling off. I want to help them buy their first flat and chose something lovely from home for them to decorate it with.
It's not so much to ask, is it? But it all seems so far out of my grasp.
The results are in and...it's negative. Which is good, right? So why do I feel so sad again? I honestly wasn't that bad yesterday, much as my post seems to have come over that way. But today getting the "I'm sorry it's negative" call made me cry.
I keep having these moments where I think, "I get it now." But then I have another one 24 hour later. "Oh yes, NOW I get it." I'm wondering how long this process of getting it is going to take. It reminds me of being in therapy where I'd talk about a particular issue for weeks and weeks, and finally come to the realisation of what it was all about. Then we'd move onto the next issue. And we'd discuss that for weeks and weeks, and I'd finally come to the realisation of what that was all about. And it would be the same thing, again. A couple of rounds of this and I started to feel really stupid. How could I not have made those connections myself? Why did this all take so long?
I came to the conclusion that made me feel slightly better. I saw this as one long process of peeling the layers off an onion. An onion where the spade had made a scar in it as it was being dug up. So when you examined the surface of the onion, from close quarters, you'd see the skin, and then you'd come across the scar. When you peeled off the skin, the next layer down would be different so you'd take time to explore that, and then you'd come across the scar only this time it would look different again. And so on. Each time the angle is different, the realisation is different, but it's still the same onion.
And of course, peeling onions makes me cry, so that's appropriate.
So I'm here, wondering how many more layers this particular onion has to go before, finally, I get it. Before I finally, at a deep emotional level, come to terms with the fact that I was pregnant. Not completely, just a little. But I was, and now I'm not. And there was no baby in between.
It's been quite a long time between posts, for my recent posting rate, at least. Two reasons. One is that I have had a huge amount to do at work. The second is that it's hard to find something to write about. I had a couple of thought-pieces I'd been thinking about to keep me occupied during the 2ww (the ethics of infertility, for example), but it's been hard to motivate myself to write them since my 2ww was so rudely interrupted. I will do eventually, but my focus just hasn't been there.
I have no new news on the cycle. The second blood test is tomorrow and I am hoping very hard that the beta will be zero. I think it will be. I have no particular reason to know that that is the case, but I'm chosing to see that as the most likely option.
It's been odd adjusting to the news that, at some point in the last two weeks, I was pregnant. That's a wierd thought. I've never seen a double line on the peestick, except for the time I peed on a stick after my hcg shot just to see what it looked like. I had never been pregnant. And now I have, just a little bit. You know, I never really appreciated the title of Julie's blog until now. I hadn't really thought about it, I'd focused on her story and her writing, and hadn't considered what the title meant. But now I get it, at least a little bit.
I haven't been unremittingly sad. I was a basket case on Tuesday, not in good shape on Wednesday, but suddenly on Thursday, after I'd recovered from the blood test experience, I was ok. I couldn't quite figure it out but while I was speaking to a couple of friends to tell them the news that evening, I didn't burst into tears and I was able to joke about it, a bit. Friday similarly. Then Saturday I got very sad again. It's all quite odd but I suppose it's just like any normal mourning process, it goes up and down.
Yesterday was a bit of a test as I spent most of the day in a review meeting. A lot of the junior women in our office are pregnant so there was much discussion about part time work and when they were all going and coming back. There was such cameraderie in the room as my colleagues remembered when their first child was born...I was ok for a while and then it started to really hurt. A club that it feels like I will never be able to join.
H has been sad, but he doesn't show it much. He cried, just a little tiny bit, on Tuesday with me. Then on Thursday when he was the one who listened to that phone message, I could see that he had been hoping that they would tell us that I was pregnant, and that he heard the message as if that was still a possibility, hope was still there. I had to disabuse him of any hope after I'd listened to it five times and realised that it almost certainly said the level was 'five' not 'fine'. He, of course, had heard the latter. Because Hope was in his ear. He got very sad again then. He'd been holding a little secret hope between Tuesday and Thursday, whereas I knew it was over when I started to bleed, or even before. I love that he keeps hoping, it keeps me sane. After being sad for a few days he's now back to being a little bit hopeful for the future. I do love him.
So to keep this post from being entirely one long whine, here are a few people you should go and see. S just found out her IVF (within a day of mine) didn't work. April's IUI didn't work. Megan, on the other hand, has some good news. So whether you're in a congratulatory mood, or a sympathetic one, you have a destination either way.
I thought I'd seen the end of this category. But no, got to resurrect it because it's not over until the fat lady gives me a beta hcg level of less than 5. And yes, the level was five. I said to Dr ICU that he should speak more slowly when he leaves messages on people's answerphones. He said he'd take that into consideration which was nice of him. He also asked me how many IUIs I'd had, which showed a little carelessness since (i) it indicated no one had bothered to get my file out this morning, and (ii) it's proof positive that the doctors don't remember us as he's the doctor who did the pre-transfer consult with us and told us about our lovely embryos. Oh well.
So, as Susan predicted (unfortunately from personal experience), the story is that if the level goes up, it is almost certainly an ectopic. If it goes down, it shows that the poor embryo tried to implant but was too defective to get anywhere, as Summer suggested. So for heavens sake please let it go down. Having an ectopic really would be the final kick in the teeth to this stressful and somewhat pointless cycle.
Obligatory bloodtest this morning. It felt so pointless and reduced me to a quivering wreck again on the way home. We've never been to the hospital before where there's no possibility of good news. I persuaded them not to call either of us on our mobiles but to just leave a message on the home machine, which we can't check remotely. I didn't want either of us to have to hear more bad news in the middle of a work day where we were just getting back on a sort-of even keel.
Around six my mobile rang. I saw it was H and ignored it as I was in a meeting. It rang again. Then my desk phone rang. Then the mobile rang again. I excused myself and answered it. We all know what I thought it might be. Instead it was :H saying he was locked out. I promised to be home by 8 and he went to a cafe to work.
I spoke to one of my best friends on the way home to tell her our sad news. I was still on the phone as I walked into the house. H met me on the steps and carried my bag in. I kept talking while he listened to the message. He kept making faces at me to get off the phone but I didn't want to cut my friend off. Eventually we said goodbye and H handed me the phone. I listened to the message. It was Dr ICU. Which meant it was hard to understand.
So the message? Well the nub of it is that my blood test is either “five” or “fine”. It is definitely “weakly positive” (indicating that “five” is the more likely), and I have to come in again in a week to see if it has gone down to negative level, which is “more than likely” or “maybe likely”, or whether it has “continued to rise.”
No hopping about, please. I will put money on it being 5. I am clearly not pregnant. Honestly I have bled too much for it to be anything but a negative result. But I wonder where that 5 came from. Does this mean that a poor embryo was trying to hang on while its environment disintegrated around it? Could it mean that if I'd had mega doses of progesterone it might still be there?
I will call them tomorrow and attempt interpretation. It would have been better if it had been negative. “Or positive,” H said. I asked if he had been hoping for that. He had. I had not. Sure, I'd experimented with the idea but I just can't imagine how an embryo could be hanging on through this deluge.
So no, I'm not pregnant. But it looks as if, for about five minutes, I was.
Diana Wynne Jones's book, Fire and Hemlock, relies for its denouement on two stone pillars which rotate. On each pillar are the letters, N, O, W, H, E, R, E. Between them then they can spell No where, Here now, Where now, Now here. That's what this feels like. Rotating spheres of meaning, coming and going, and in the end signifying not that much. It's hard to make sense of this.
I knew on Monday that it was over. Those pangs I wrote about were clearly period pain. Of course knowing and believing are two different things. Certainly my subconscious knew it. I dreamt all night that I wasn't pregnant. It was one of those dreams where you are completely convinced that it's real. It was horrible. When I woke up at 04:15 it took me a minute to orient myself again. Then I tried to feel relieved that it was just a dream. That I might still be pregnant. Then I felt the pangs again and knew that I wasn't. I slept on and off until about 07:15 when I gave up and went to the loo. And found blood. I wish I could remember the precise words of the ending to The Peacock Spring. Una gets her period and it's the end of her final clinging onto her relationship with Ravi. But my copy is in a box somewhere and I don't want to murder Rumer Godden's words. So let me try. It felt like the end. It felt like a final full stop on a story. A sharp cut to the thread of hope I'd been finding it increasingly hard to sustain for the last 18 hours. "The curse has come upon me." (My mother and her generation called their period "The curse". Do you think they got it from Tennyson or is that something from time immemorial? Do Americans of a certain age ever call it that?).
And while we're on the topic of hope, let me be clear that there is no hope for this cycle. Nothing could survive the total destruction of its habitat like this. I refuse to call a period Aunt Flow, but boy is this flowing. It's dark and red and heavy and hot and angry. Of course I guess I could have an ectopic. But since I have no symptoms, even though I've been told by the clinic to continue the suppositories, I very much doubt that I'm going to be subjected to that particular trauma. Which I suppose is one lucky break I've had. But it is full on. I'm having the worst pain I've had for years, which is leaving me nauseous as well as crampy. Which at least has the bonus that I wasn't tempted to drown my sorrows in food yesterday. I did eat some of the HUGE box of chocolates that H went out of his way to buy from the best chocolate shop in London (I don't think he realised how many chocolates they can pack into a box, or how much it would cost!), but my heart wasn't really in it. Nor did I fancy breaking my wheat-fast and so while H had pizza for dinner, I had a salad. I think I'm too sad even to want to over-eat. That's a rare occurrence for me.
I'm crying at the drop of a hat. It's not easy as, unlike Susan, I can't hide under my desk to do it. Luckily yesterday I was able to turn all my meetings into phone calls. So I did everything from home in my pyjamas. It got the work done. Today I have to be chirpy and present in person again. I reckon I can do it in 30 minute increments. I'll have to find some reason to duck out when I need to.
I still have to go for a blood test, but I got the nurse to let me go in tomorrow instead of Friday. I just want this to be over with. I have an appointment with Dr Candour on the 29th. We have to wait that long because, get this, "It takes two weeks for the clinic doctors to look through the file and return it to Dr Candour." Two weeks. No worries. How about I walk over there and just help them with that little task, huh? Or don't you think they'd apppreciate that? While I'm there tomorrow I have to sign some kind of consent form for them to release our records so I can get a copy for big guns clinic. My intent is still to do another cycle where we are and then see what happens. In the meantime I want to get going with BGC as they have quite the waiting list. Not surprising given their figures.
I'm not ready to start hoping again. I know that this cycle was not the end, but it is so hard to let go of the thought of our perfect eight celled embryos and the perfect boy/girl twins they were supposed to turn into. I had already imagined their summer birthday parties and chosen a few potential names. I know. I'm a sap and an idiot. When I noticed myself doing it I stopped myself, but it's hard to keep control of your brain all the time. I keep telling myself that doing another cycle is a good idea because it gives us the potential of a few more frozen 38-year-old embryos for future reference. Actually, they'll be 39-year-old since my birthday is in January and there's no way they'll let us cycle again before then. I never thought I'd be 39 and not even pregnant. Life wasn't supposed to be this way.
I haven't tested. I don't think I'm going to. I'm too scared of it being negative and being inconsolable more than once this cycle. H confessed to me today that he's really stressed about Friday, too. I'm sorry that this has got to him, as well. He's usually my rock, and he still is, but I hate to lean on him so much when he's clearly having his own tough time.
I am really scared. I want it to work so badly, and I'm close to being sure that it hasn't. I know it's all non-sensical but I had period-like cramps today, and other than the sore(ish, not very much) boobs which I know are down to the progesterone, I have no symptoms. I know it's probably too early, but still. Every time I felt a cramp today my brain completely disconnected from the meeting I was in and I wanted to shoot whoever was talking: "Don't you know that my body might be rejecting our baby as we speak? How dare you babble on about HR?" Only I didn't say any of that. I just smiled and nodded and tried to keep going.
I think the final indignity would be to start bleeding before Friday. I'd rather it held off until after I know the cycle is a bust. Please keep your fingers crossed (because we all know that that does a lot of good!) that I am allowed that little concession.
The good news is that I now know I can do IVF. It's not so bad. I will do another cycle as soon as they'll let me. One more cycle at my current clinic then we pull out the big guns and go to the UK's most successful clinic - where they treat you like cattle but get you pregnant, about 38% of the time. For four times the cost, but you know, it will be worth it if that's what it takes.
In the meantime my cycle buddy Lindy has some hopeful pee-stick results that I'm sure a bit of congratulations would make all the more satisfying.
I've run out of creative ideas for titles. Feel free to suggest your own.
Thanks for all the advice on the last one. First, re the baths. Persephone and Lynette are not to worry, the bath I took was on Sunday, before the transfer. Although none of the doctors told me not to take baths, I'd seen that particular advice before and so have resisted since the transfer on Monday, despite being sorely tempted due to the only alternative being a lukewarm shower. Let me tell you, that word lukewarm is highly misleading. When you're in it, it feels pretty damn cold. It's been like that, or getting worse, for a month and our bloody useless plumber has procrastinated, until a tearful fit on my part on Friday morning encouraged H to get another plumber in today. It will still take a week or so to get it fixed, since the problem is that a part is broken and the shower we have is so obscure there's no way to get a replacement part, so we have to get a replacement shower, but at least we are on our way. But no more baths, I promise. I'll just go and have a shower at the gym tomorrow, I think.
As for the constipation, if I'd posted yesterday I would have written something virtuous about how much water I drink and how my diet is entirely composed of leafy green vegetables, brown rice, and fruit, and it's had no effect. But after a couple of days of upping the water intake to nearly three litres (that's 101.442 fluid oz to you wierdo Americans) a day, and consciously eating even more spinach, kale, cabbage, peppers and brown rice than I thought was possible, this morning the bowel movements were exemplary. Of course, this probably just means that I'm not pregnant, but I'm hanging on to optimism while there's still time.
Speaking of whether or not I'm pregnant. I'm pondering the stick peeing question. I'm sorely tempted. Partly because I have a very busy day at work on Friday so I haven't figured out how I'll cope with getting the test result. But I know that getting a negative result any day is going to kill me, so I'm not sure why I think Friday will be any worse. Perhaps because before then I can tell myself that it's too early? By the way, those of you with short luteal phases normally, were they longer on IVF or on progesterone? Or should I be starting to worry about whether I'll start bleeding from Monday onwards?
Oh this is so much fun! I can't understand why more people don't do this!
2dp3dt. Wow. I feel all grown-up writing that. My first post-IVF signifier.
But seriously, folks, let's talk about the progesterone. How do you get through the 2ww, let alone a pregnancy, on this stuff? The constipation is AWFUL. And constipation when you're inserting rectal suppositories every evening is NO JOKE. I need to pick up some prune juice tomorrow. Are those fibrogel type drinks ok to take when you're, ahem, trying to be pregnant?
The progesterone, as all of you who have gone before me know, is also a fun provider of other symptoms. Like sore breasts and a crampy uterus. I had to give Hope a serious talking-to last night as she kept saying: "4dpo isn't too far off a normal implantation day. Maybe it's implantation!" Then I kicked her down the stairs and locked her in the cupboard. I can still hear her banging on the door, but I'm trying to balance tuning into her moanings with a good dose of scepticism. I had a moment of too-convincing scepticism earlier, though, when I remembered how I didn't get promoted the Christmas before we got married. I was absolutely devastated, thinking about how I would never be able to plan a wedding and get promoted in the same period. After I got over the devastation I just focused on having a good six months and enjoying the wedding preparations, and on the runway after we landed back from honeymoon I got the text that told me I'd been promoted. I decided that the IVF might be like that, just because the Powers that Be don't want to hand out fulfillment and happiness that readily. They like us to suffer first.
Oh shit. I've just realised I wrote the "just relax" story of my promotion. I take it all back!
Of course that analogy also implies that I'm now thinking I'd get pregnant the next time we did IVF. Which of course is nonsense, but honey, this is my brain on progesterone - you can't ask too much of it.
I've also retreated to the guest bedroom as the stonkingly vivid dreams wake me up, and H just being in bed with me then disables my ability to go back to sleep easily. H is a bit unhappy about this and accused me of secreting George Clooney upstairs. Sadly, no. Somehow I don't think George would see me as much of a catch.
Oh and did I mention that I decided to have a nice relaxing bath and was having a lovely time until H came running upstairs to tell me that water was pouring through the ceiling? Nice. Not sure where the leak is but hopefully the insurance will pay up.
Sorry this is so random. I think that's just where I am right now.
All six fertilised. One arrested at two cell stage.Transfer of two perfect 8 cells went v smoothly, done by Dr Condescending who was positively chirpy. One was starting to compact. Freezing one good 7 cell, one good 6 cell, and one less good 5 cell. It could scarcely be better news. Off to acupuncture and then nap as did not sleep at all well.
I decided yesterday to write the whole story of retrieval, since it seems that all too often we are too zonked to do so and I thought it might be helpful to someone. Yesterday's attempt was of course witty, hilarious and quite above my usual standard of writing. Today's may be less inspired, but I'm determined. Got the 'draft' feature turned on on Typepad, H is watching Man U beat Chelsea which is keeping him happy and occupied, so there's nothing to stop me. Here goes.
06:55 H and I arrive at clinic. H goes off to buy a paper. I wait outside with a lovely woman who is on her fourth IVF in hopes of conceiving number two, and an Asian woman who already has two older children and is struggling to conceive with her new husband. They talk about the longing for a child that no one else can understand, even if it is number two or number three. It is cold. We all shiver a bit and wonder why the bloody hell if they ask you to show up for 7am they can't open the doors at 0650 or so.
07:00 Clinic doors open. Nice receptionist tells me to go sit on the sofas til I'm called.
07:02 H shows up with the paper, all anxious in case he's missed anything.
07:05 Nice nurse (Nurse Cheery, I think would be appropriate) shows up and starts calling out names. We are the only ones there. That probably should have told us something. Nurse Cheery shrugs and says she'll get started with us, then.
07:08 Nurse Cheery ushers us through to the egg retrieval area. It's in a portacabin off the side of the clinic. There are six beds spaced around two walls of an L-shaped room. The theatre entrance is to the left hand side of one of the other walls, next to the door to the women's loo. I try not to worry about that. Nurse Cheery seats us in bed area number three. There are curtains that can be drawn round, but they aren't fully closed - just about 2/3rds of the way down the bed so that we won't be able to see the faces of those in the beds next to us, but we will be able to see their legs. I'm in bed #3, which makes me patient #3 for today. Unlike beds #1 and 2, which are tucked down the narrow bit of the L, bed #3 faces into the main part of the room, directly opposite the theatre door, so I can see everything, including straight into the curtain areas for beds #5 and #6. Lucky me. No seriously. I'm very nosey so I don't mind this at all.
07:10 Nurse Cheery takes all the usual info - name, DOB etc. She shows me my bracelet and asks if it's accurate. I say yes and she clamps it on. Does blood pressure and heart beat. Asks if I have caps, crowns, allergies, etc etc. Tells us we'll go in at about 09:30 or so given we're #3. I begin to wonder what the hell we're doing here so early but decide to be a good patient and don't complain.
07:15 Nurse Cheery goes away and comes back with two more sets of patients. Patient #2 is v glamorous and I immediately hate her. She's wearing a lovely embroidered skirt, her hair is all blond and lovely and clearly blow dried. Her legs (which I can see in my sideways view) are tanned and her feet are tiny. I'm wearing black yoga pants, white t-shirt, and a big grey sweater that zips up the front that H bought me on our trip to Stockholm a couple of years ago. My feet are not tiny. Feel like a bad patient. Patient #1 looks pretty normal, as does patient #5, who arrives about 15 minutes later and then goes away again in disgust at how long they're going to have to wait. I figure out that patients 1, 2, and 4 are on their first cycle, like us. Patient #5 is clearly a veteran. I never get a good look at patient #6.
07:15-07:45 Nothing happens. H goes to get a coffee and something to eat. I read the paper. Nurse Cheery does all the entry stuff for the other 5 patients, which takes her about 10 minutes. Then everyone sits around.
07:45 Dr ICU arrives and sits reading everyone's notes at the table that is between my bed and the theatre. He looks quite smart today. Nothing happens to us. Nurses chat and other doctors come and go. A very shy looking woman who seems to be about 14 shows up. I assume she's a trainee nurse as the nurses are all being v nice to her and showing her where stuff is.
08:00 Dr ICU starts doing the rounds of the patients, starting with patient #1. I can hear the words: Risk, consent etc being bandied around. I start to get tetchy as by now I have finished the paper, and am v hungry, bored and thirsty. H is working. I complain to H that I don't want Dr ICU to do our transfer even though he's reformed. I want the star-retriever Dr Condescending. H tells me indulgently not to panic. I panic. H tries to look as if he's not laughing at me.
08:05. Dr ICU is on patient #2. H is working. And eating, and drinking coffee blast him.
08:10 Dr ICU arrives. He tells us that although he is doing everyone else's retrieval today, Dr Condescending will be doing our retrieval, he's just here to do the consents. H tries a bit harder not to look like he's laughing at me. Dr ICU goes through the rigmarole. What's my name and DOB. Do I have any allergies or crowns etc. The procedure may result in perforating my bowel or other internal injury causing them to have to open me up. He points. I sign.
08:15 I try to read the crappy chick-lit novel I brought with me. Only it's really not very good, and hence it's not very distracting. Dr Condescending appears in a tight grey sweater dress that clings to what looks like a four-month pregnant belly, and knee high black boots that make a lot of noise as she strides from one end of the portacabin to the other. And back again.
08:15-08:45 Nothing happens except some milling around and some more striding by Dr Condescending.
08:45 Dr ICU appears again in theatre gear. Dr Condescending does some more striding.
08:48 Anaesthetist comes to see me. Asks what my name is, if I have any allergies or crowns, etc. She is nice, so I forgive her for being the 75th person to ask me that today.
08:50 Nurse Cheery hands patient #1's partner a sperm collection kit and sends him off. Patient #1 has the curtains drawn so she can change into her theatre gear.
08:55 Nurse Cheery comes over and gestures towards the shy young 14-year-old I saw earlier, who is now in scrubs. "A medical student would like to observe your procedure," she says, "is that ok?" I nod yes, and feel strangely flattered that I am the only patient who is asked. The fact that this means that my ovaries are almost certainly more fucked than anyone else's in here today does not occur to me until later.
09:00 Nurse Cheery hands patient #2's partner his sperm collection kit and sends him off. I wonder if there are two wanking rooms, and if so, which one is better.
09:04 Nurse Cheery hands patient #1 a grey cardboard tray. All I can see in it is a rubber glove. Patient #1 goes off to the loo, clutching her gown closed behind her.
09:10 Patient #2's partner returns clutching his paper bag. I feel bad for patient #1's partner.
09:15 Patient #1's partner returns. I feel relieved.
09:17 Patient #1 is walked off to theatre. Dr Condescending does some more striding. I am bored. And hungry.
09:18 H is sent off to do his bit. Plastic cup with a lid, he has to write his name and DOB on both lid and cup. And fill in a form that goes in the paper bag with the cup.
09:19 Patient #2 does the curtains closed, change into gown, disappear off with grey cardboard tray thing.
09:26 H returns. Feel v proud of him for being such a performer. He tells me there was a porn film playing with the sound down but he didn't turn it up, partially for fear that the sound of panting would reverberate through the clinic.
09:35 Patient #1 returns on her gurney. She looks out of it. I get a bit tense. H holds my hand.
09:37 Patient #2 walks through to theatre. She is so skinny that she doesn't have to hold her gown closed. Hate her a little bit.
09:38 I get to do the curtains closed, get changed thing. Nurse Cheery says she'll be back in a minute with my suppository. Aah, light blossoms.
09:40 Dr Condescending does some more striding. My stomach is rumbling.
09:45 Nurse Cheery has not returned with suppository. I am anxious. And hungry. H volunteers to go and get her, but I feel bad about making him ask for my suppository so I say no.
09:50 I am worried still. H goes and reminds Nurse. She immediately shows up with suppository equipment tray. Apparently it's a long acting pain killer to help after the procedure. I go and play in the women's loo. It's not difficult but I am glad of rubber glove. Wondering if they'll give me some to take home for the progesterone suppositories.
10:00 Patient #2 is wheeled out of theatre. She is sitting up and laughing and joking. Long blonde hair is spread over her pillow. Hate her a bit more.
10:05 Theatre nurse comes to get me. She asks me my name, date of birth, checks my bracelet, asks if I have any allergies or crowns, etc. I decide hitting her would be a bad move. She walks me into theatre. H kisses me goodbye.
10:06 The theatre looks just as scruffy as the outside room. There are at least six people milling around including Dr Condescending who has at least changed into scrubs. She says hi. One nurse undoes my gown while another helps me climb on the table. I scoot down and someone helps me put my legs into the holders. A blond woman leans over me and introduces herself as one of the embryologists. She checks my wrist bracelet and asks me to say my name and DOB. I want to kiss her for not asking if I have any allergies. Decide not to.
10:07 Anaesthetist starts looking for a vein. I point her to the good one. She puts the IV in, then adds drug number 1. I feel tingly. She then starts to add drug number 2. She says it will make me feel like I'm drunk. I comment that I'm a cheap drunk, and will the anaesthetic have the same effect. She laughs and says maybe.
10:35 I wake up when they ask me to move from the theatre table to the gurney. I am amazed to have slept through it all. They wheel me out to a visibly relieved H, who says that since I'd taken over 30 mins he was convinced I was bleeding out on the table. Nice to know I'm not the only one who freaks out like that.
10:37 Dr Condescending appears and tells us we got six. I feel a bit sad, and ask about the others. She explains that they were either too small or too hard to get to in the case of two of the ones behind the endometrioma. She is nice. I decide her bedside manner is much improved by her scrubs, and perhaps by doing something she is really good at?
10:38 Dr Condescending leaves. I cry at the thought of my hopes for eight. H holds my hand.
10:40 I try to nap but the bloody blood pressure cuff keeps going off just as I drop off.
10:50 Nurse Cheery says she'll bring me some water in a minute. H points to the bottle of water he'd already bought for me. She smiles at him. I drink water.
10:55 Patient #1 leaves with her partner. I hear her talking about four eggs. I feel guilty for worrying about six. I drink some more water.
11:00 Nurse Cheery offers tea and biscuits. I say no to biscuits (no wheat, don't you know) and yes to a hot chocolate (hang the no sugar). I sip hot chocolate. It's not very nice.
11:02 Patient #4 returns from the theatre. She seems to be sleeping. I read the gossip magazines H has bought me and think about posting to you guys on my blackberry. Only my handbag is on the floor and I can't face picking it up and asking H seems too hard, too. H is so bored that he is also reading a gossip magazine. I promise not to tell anyone (except the internets)
11:15 Patient #7 arrives with her partner, they are ushered towards bed#1. They both look frighteningly young, and scared. I want to give them a hug and tell them it will all be ok, but I realise that it might not be, and it's none of my business.
11:20 Patient #2 has her exit discussion. I hear her ask, "If we are lucky enough to have three on Monday, will they let us put three back given my age?" I don't hear the answer but feel a new kinship for her humility and her worry about Monday. Also am glad that I figured out that they wouldn't do their usual two day transfer if it fell on a Sunday, and so last night called my assistant and cleared my diary for Monday. Wish I could have cleared it for Tuesday, too, but that just was not to be.
11:25 Nurse Cheery offers me a sandwich. I ponder the no wheat thing and then refuse. She says I have to eat something. H points to the nuts and raisins he bought me earlier. She says I can eat those. I eat them. They are delicious. I drink more water.
11:27 Patient #5 is wheeled out of theatre. She is crying. I hear the nurse saying: "But 15 follicles doesn't mean 15 eggs." I can't hear how many she did get but it's either six or eight. Get cross with her for crying, then realise that I'd be the same way if I thought I was going to get 15 and I only got 6. Feel sympathetic instead.
11:30 Patient #2 leaves with her partner. She still looks v glamorous, but feel a new sisterhood with her given what I overheard. Don't hate her any more.
11:35 Dr Candour shows up. He looks very dapper. He comes over with my notes and says he's happy with six. I say eight would have been better. He says yes, they were hoping for eight but six is the best they could do given my anatomy. That he was on the phone to Dr Condescending during the surgery and agreed with her choices. That six good ones are better than 20 poor quality ones, and all we can do now is hope. We find out from him that the embryologists will only call if something goes wrong. I think this is a policy designed for maximum tension in us, but decide not to bring that up as am already the patient from hell. Dr Candour smiles and pats my hand, and leaves. He looks dapper from behind, too.
11:45 Nurse Cheery says we just need one more measurement, then I can get dressed.
11:50 I've passed and can get dressed. Do so. Am in considerable pain. Nurse Cheery notices and comes back with some painkillers and suggests I get back on the bed until I feel a bit better. H goes to put money in the meter.
12:00 H returns. He tells me that patient #4 got no eggs. He's just met her husband in the car park. I heard in their intake discussion that they've been trying for six years. I feel terrible for them. Start to cry again. Distract myself by reading about the new Spanish princess.
12:15 Am feeling better. Nurse Calm comes to do the discharge discussion. She draws our curtains and does the whole discussion by pointing to the piece of paper she's carrying, so as to protect the feelings of patient #4. H and I comply. I realise later that this means that H has understood nothing of the discussion, but that doesn't matter as he and I both retain the observation that we need to bring £400 on Monday or else they won't freeze anything. Nurse Calm reiterates the 'no news is good news' mantra, and affirms that we need to come in on Monday at about 10, and I need to have a 'comfortably full bladder'. I try to figure out what that means. Antibiotics are to start tonight, Progesterone pessaries on Saturday night.
12:20 We leave. I feel ok about the six. Am a bit surprised at myself. I post from my blackberry to you guys.
12:30 Home. I sit on sofa. H makes smoked salmon and scrambled eggs on (wheat free) bread. It is delicious. He goes upstairs to work and takes my mobile with him so as I don't have to panic when it rings. I watch America's Next Top Model. It's one I've seen before but I don't care. I sleep.
There you go. It's now Sunday night, and no one has called. Which means that barring anything bad happening overnight, which I'm sure can happen, we have some embryos to transfer tomorrow. I am very excited. I know it's ridiculous, but this is the closest we've ever been to being pregnant. It feels good to have got this far. I still feel a bit uncomfortable, enough so that I'm glad they didn't do the transfer today, much as that would have given me two potential bed-rest days.
I am worried about not doing bed rest. I know the studies say it makes no difference, but it's a bit like some of the dietary stuff. I don't know if it will have any effect, but I want to do everything in my power to make this work. But I have stuff in my diary for Tuesday that I cannot move. So tomorrow I will go into town to do acupuncture, go back to the clinic for transfer, go back into town to do acupuncture again, then go home in a taxi and rest for the rest of the day. Then on Tuesday I will get up and start to live my life again. I'll post another blackberry post tomorrow just to confirm how things went.
S, despite your kind wishes I'm afraid I'm going to have to kill you. I wrote a very long post about yesterday, and was just ready to post when I went to your site and got your address to put into a link. I clicked 'back' and internet explorer crashed. It's the sixth or seventh time it's done that, and I've now realised that it's always when I'm coming back from your blog. So I'm sure it's not your fault, but it's very very frustrating! Next time I'll save as draft before I do anything so daft...
I've tried to write it again, but I don't have the will right now. I'll try again tomorrow. For now just know that we haven't heard from the embryologists, which is good. At our clinic they only call if there is a problem. So at the moment we have no news, which is good news. I'm feeling a lot better than yesterday but still quite uncomfortable. I'm chanting my new mantra, which is: Two to put back. We just want two to put back.
Thanks for all your good wishes. They mean a lot to me. Transfer is Monday.
They got six. Dr condescending and Dr candour both came to see us. Others were too hard to get at or too small. Six seems ok, although candour said they were aiming for 8. Am quite uncomfortable so will sleep now and write more later.
If you can get the song reference in the title, I will be your eternal fan. But then, I'm a huge fan of most of you already, so perhaps this is the wrong incentive...
Ladies, I give you the facts. They're quite good:
On the left: 16, 14, 14, 11
On the right: 22, 19, 18, 17, 15, 14
Lining: 10.6mm
E2 3659 (997 American)
Clearly my right ovary is going for the mid-term performance turnaround, while my left is still skulking in the "could do better" corner. Not to knock it, or anything. I'll take those four follicles, thank you very much indeed. The growth seems very random - a couple have grown just 1mm, while others have shot up by 6mm, and two on the right seem to have come from nowhere. I assume that at least some of this wierdness is due to the follicles being hard to measure accurately. It's fairly miraculous to think that we could retrieve as many as nine or even ten eggs. That is of course assuming they can get all of them, that the little ones keep growing, and that all the follicles actually contain eggs. But still, that's a lot better than three! I bow to all of your superior wisdom on this point, particularly Wessel who took the trouble to write all that detail in the comments.
The doctor took 20 minutes to do the scan, and was very good at telling us what was going on once he'd had an initial look. He showed us all the follicles and described what they'd have to do to get round the endometrioma. I now have three follicles, all on top of each other, all directly behind the endometrioma. That's the right ovary pretending to play nice, but secretly trying to mess us around and still get an A. They'll basically have to go in with the needle straight on top of the camera probe, and try to get one at a time without losing them or puncturing the endometrioma. Sounds like fun. He kept telling me how complicated it was and what a difficult scan it was. Luckily once I saw all the follicles I was in a considerably better mood and was able to crack jokes about what a tough patient I am. This doctor, by the way, was Dr ICU. I think Dr Candour spread my memo around the place as Dr ICU was a different man today than at my last interaction with him.
So we trigger tonight at 22:30, for retrieval on Friday morning. I'm sort of excited now. Of course, they may not get all those eggs, and the eggs may be crap, etc etc., but I think I'm allowed a little excitement after the general shittiness of the news so far this cycle. The good news is that they will (probably) put the most experienced egg retriever doctor on the case on Friday. The bad news is that this is Dr Condescending. I'm sure that her medical skills outweigh her interpersonal ones, or they wouldn't be suggesting this. After all, it's in their best interests for this to work.
And I almost forgot the really good news. From a conversation with a colleague at work where she figured out I was doing IVF, I was pointed to our company's administration office in the US to check on the global health care policies. Apparently since I am now quite senior I'm covered by an additional insurance policy that I didn't know about, and it covers fertility treatment. All our costs are covered - drugs and everything! I still have to submit everything and given all of your experienes with US insurance companies I'm sure it won't be entirely straightforward to get the money, but it will be a great help to get it. Our insurance also covers up to $10,000 of adoption costs. The only thing they don't cover is surrogacy. Since that's not an option we've considered (yet), that doesn't make me too sad. Confused about why that would be excluded, but not sad. I'm thanking my lucky stars and feeling very blessed to work for such a generous organisation.
Picture me breathing a big sigh of relief, and repeating the mantras from your comments on the last post. Grow, follicles, Grow! I'm still working on Ovagirl's image of them "like coloured balloons, blowing up into beautiful rounded globes of goodness." There's no mistaking that she is a writer and I am not, is there? Thank you for all your thoughts. I'm in a much better place today, and even feeling slightly foolish for my trauma at other points in this cycle. No doubt I will be foolish again before this cycle ends.
So althought the follicles are still pretty measly, they are growing, and the E2 has climbed substantially - I assume this is a good thing, even though the follicles are small?
The doctor I spoke to (it was the South African from Friday) was incredibly brusque, tried to get me off the phone with "Come in on Wednesday, thanks, bye." and got quite stroppy when I asked for more information. I became terribly charming, which was a big leap given it was 16:45, they were supposed to call me by 14:30, I'd been trying to get through to them since 15:30, and they turn the phones off at 17:00. He relented a little and gave me the data above.
Instructions are to come in again on Wednesday for blood and scan, when there should be three larger than 17, which is their cut off point for trigger. Don't you think it's interesting that in August the cut off point for fertility was only 14mm, leading to our cancelled IUI? I'll have to ask why there is a different scale for IUI than IVF. I think it's probably the British clinics' absolute paranoia about multiples. Because if the cutoff point had been 17, we could have done the bloody IUI in the summer. Bastards. Not that it would have worked, of course, but at least we'd have had some treatment that might actually result in a pregnancy, rather than messing around which results in them treating us for no good reason.
I tried to ask him about what would happen on Wednesday and he wasn't playing. He said he could not say if they'd go ahead or not based on only having three at 17mm. Please send lots of blossoming thoughts to the 12, 13 and even those little ones to see if they can catch up. Having five would be a lot better than three.
I really hate this. I hate the uncertainty. I hate having work hanging over my head. I hate the fact that my body is screwing me over.
I've written another note to Dr Candour who is due back from holiday today. I hope he replies, I need succour right now.
Good news is that the follicles grew this weekend. I'm not sure how much, but the smallest ones (all the ones on one ovary, I think the left) are at about 13-14mm, and the largest is a big monster around 20mm on the right ovary. There are five on the right ovary, but only three that the doctor thought would be big enough and in the right place to retrieve. There's a lot of complexity as two are (i) on top of each other, (ii) one of the two is small anyway, and (iii) both are exactly behind the endometrioma, so they may not be able to get them out.
When they've got the E2 results they'll see how much longer they want to go on in the hope that the smaller ones catch up a bit, without going over the top and losing the good looking ones on the right. So it looks like minimum three, maximum eight follicles will be aspirated. Apparently they may just decide to pierce the endometrioma and dose me up with IV antibiotics to cope with that trauma. Sounds a bit scary.
And, she said as we left the room, the consultant may decide to cancel and try for a better cycle since, and I quote, "this response is not what we expected from you and if we try again it might be better, and the follicles less awkwardly placed." She did also say, however, that if it was up to her, she'd go ahead, if only for the additional data they'll get about our eggs/embryos from going through the process.
Please keep making the sacrifices to the relevant fertility symbols for me. I'm feeling a bit more hopeful, which of course means that I'll come crashing down when they call this afternoon and tell me it's all over.
My E2 is 482, which is 131 American. Answer is to keep on going, same dose, and go in again on Monday for another scan and bloodwork. I asked why we weren't raising the dose, and got the answer that it wouldn't do any good - any follicles that are going to be recruited, have been, and it's now just a question of ensuring they grow. And apparently giving them more drugs doesn't make a difference. From what I've seen, other doctors wouldn't agree, but there you go.
I feel very frustrated with my body, and very worn out by the worry and the upsetness. H is also now upset - it's the first time he hasn't been optimistic during this process. I'm so sorry that this has beaten him out of his ability to believe that we would be able to get pregnant.
I have a question for you guys. I have booked the whole week off work next week, on the assumption that we'd be doing retrieval Monday or Tuesday, transfer Wednesday or Thursday, giving me plenty of time for lounging around, acupuncture, and recovery before going back to work on Monday. Now there is no way we'll be doing retrieval before Friday as far as I can see (if we do it at all), which would mean coming back to work at best the day after transfer, if not the day of. (There I go again, making plans so that the powers that be can laugh at me. I must have a masochistic streak in there. Or maybe I'm just plain stupid).
Yes, the question. The question is, would you go ahead and take the week off anyway? I have unlimited holiday allowance, so that's ok. And I've cleared my diary, so no one is expecting me. But partly I feel guilty as there's at least one big project I should be helping with that I'm leaving to others next week, and partly I feel as if I'm using up goodwill credits - yes, taking holiday is a goodwill thing around here. Also, I'm worried that if I take the holiday I'll have nothing to do but obsess about this, which would be bad. Yes, I know I'm obsessing already, but I think there is further obsessing potential. Perhaps even an unlimited amount of obsessing that can be done. On the other hand, I really feel stressed out and like I could do with a break, so part of me feels like taking a week off would be no bad thing.
As others have said before me, it's a bugger trying to make decisions when you're all hormoned-up.
So much for being optimistic and letting go all week. My ovaries have done nothing. On the left I have one follicle at 12mm, one at 14, and two under 10. On the right I have four under 10 - between 5 and 8mm.
I had a nice doctor this morning, South African by the sound of him. He did his best to be optimistic but clearly the chances of getting more than 3 or 4 eggs is minimal - in fact, that sounds like a good outcome right now. In which case, what's the point of going through all of this? I cannot understand how my body can produce 5 good looking follicles on 50mIU puregon in August, and absolutely sweet FA in October on 150-200mIU. And let's face it I was really feeling good about this cycle. I kept imagining when the baby would be born - I know it's a horrible case of chickens not being hatched, but at least I felt I was DOING something, and doing something different, and the most likely thing to get us pregnant, so what was wrong with imagining it working?
Yes, I know it's not over yet. But even if it's not over, it's not the cycle I, and the doctors, expected it to be. Why does my body keep letting me down?
I'll update later when I get hormone results and instructions.
Just spoke to the clinic again. Still no spaces tomorrow, although they offered to have me just come and wait and see if they could fit me in. I was dithering, so spoke to a doctor, and actually had a good conversation. Wonders will never cease - although she wasn't exactly sympathetic she was at least nice to me. She said that day 9 would give them much more information, and that given they wouldn't change my dose til after the bloodwork results on Thursday, and I'm drugging in the mornings, it wouldn't change much to wait til Friday morning. Given H can't come with me tomorrow morning, and on Friday I'll need more Puregon anyway which I can get at the hospital pharmacy, I've decided to wait.
It was great to hear from you all the variety of clinic procedures on when they want to see you. Mine is clearly at the low-touch end of the scale, but it's not way out there, which is encouraging. It is a difficult line to draw between knowing what's going on, even when you have no ability to affect it, and not knowing and therefore going insane with the "what-if"s.
It's close to killing me, the not knowing. This is part of me, I think. I'm a finder-outer, a curiosity-killed-the-cat kind of person. I like to know stuff, and yes, it is just another manifestation of me wanting to be in control. It's so hard, this process, because I am so NOT in control. There's pretty much nothing I can do to affect my endometriosis (despite being on day 8 of the no wheat, no sugar, no dairy diet), there's nothing I can do to determine how many follicles and eggs my ovaries develop, there's no ability to control whether embryos implant or not. I just have to follow instructions, and hope for the best. I wasn't meant to be a Buddhist, but perhaps a bit of letting go and just letting stuff happen would be a good thing to learn. Any ideas on where to start?
I'm a bit less negative today, thank you for all those comments yesterday. I'm trying not to focus on lots of possible bad outcomes, and assuming that things are just fine. A little slow, but fine.
Finally got through to the clinic to book my next scan appointments, only to find that Thursday is completely booked up. This has never happened to me before. They put me on a waiting list, but I'm wondering if I should just take this as a sign that I'm not meant to have a scan on Thursday?
How often do you guys go in for checks during your IVF? Because having read lots and lots of your stories, and having been through the failed IUI, and having read a couple of infertility books, they collectively give me the impression that you get scanned and blood taken about once every two days. My clinic does blood (usually no scan) on day 5, blood and scan on day 9, and blood and scan if necessary on day 12. Isn't this a bit light? Or does all the blood and scanning lead to lots of anxiety (me clearly a case in point) and not much actual change to or help with the protocol?
Still feeling ok, still not convinced this is going to work, but finding it hard not to lapse into moments of annoying IVF-newbie type enthusiasm about what might happen.
Nine or ten follicles this morning, all under 7mm. Which I think is fine. What we don't want is either too many, or them growing too fast.
Updated to add:
However, we have a little problem with the E2 number, which is only 82. And remember, this is only about 22 in American terms. That is, it's very low. Lower than on day 2 of the previous cycle, before buserelin. They want me to increase the dosage of Puregon to 200 (from 150), and come back on Friday for a scan. I say that seems like a big gap until the second scan, and after much pushing the doctor said I could come in on Thursday if I really wanted to, but I'd have to come in on Friday as well. Frankly, I'd rather do that, hoping that things get started properly and if not, we have an extra day to amend them. They still think I will trigger on either Saturday or Sunday for retrieval Monday or Tuesday, but how can they be so sure?
Should I be worried that things just won't get started and I'll end up cancelled? I assume that would be an overreaction, but here I was, expecting to just stim nicely, no worries, but it doesn't seem to be happening. It is worrying.
Isn't a real bugger how our bodies respond so differently at different times? How could I be an overresponder in August, and an underresponder now with triple the dose of Puregon, and the same starting FSH? Do I have to assume that the buserelin really knocks me out and we have to be careful of it next time?
Blast. Just when I thought things were going well.
Nausea/Headache: Much better. Haven't really had another bout since Thursday, although I did wake up with a bit of a headache today. The water is, I think, the trick. So I'm peeing ALL THE TIME, but you know, I can cope with that
I am, however, very tired. Slept for 10 hours on Friday night, and had a two hour nap today. Not sure if that's the drugs, or just life, but it's hard to cope with during the working week
Diet: No wheat, day 5. I've only had trace amounts of dairy (I ate some asparagus at lunch in a hotel, then realised it had butter on it), and just naturally ocurring sugar in the fruit I eat since then, too. I'm feeling ok on it. I haven't lost any weight but surely at some point I must do, given that this pretty much eliminates most of my snacking opportunities? Maybe that's linked to the drugs? I'm ok to keep doing this for a while, it seems worth it if I'm feeling ok and not too deprived. One reason I'm not feeling too deprived is that I found some good non-wheat bread. It's from the Terence Stamp collection. He's a british actor who had real food issues, and got frustrated with not being able to eat bread, and so experimented until he found a recipe that works. I don't like it straight off the loaf, as it's got a slightly spongy texture, but it firms up nicely when toasted.
Workshop: Went very well, thank you. Didn't go how we expected it to, but that's ok, they never do. The client was happy and I was happy with the contributions everyone made, so that's ok
Next scan is tomorrow morning, keep your fingers crossed for a few good looking follicles. It's only day 5, so I'm not sure what I should be expecting, but let's hope it's good news. I've told everyone at work I'm taking the whole of Halloween week off, just to be on the safe side, and I'll look pretty bloody stupid if the cycle gets cancelled after that.
I think it's time for a confession. I'm obsessing about the infertility/getting pregnant. Of course you are, I hear you say. We all are. It's overwhelming. But I am really obsessing. To the extent that I'm shortchanging my job somewhat. My job demands a lot of thinking time, and is pretty self directed. There are meetings I need to go to, etc., and deliverables to deliver, and I certainly haven't missed any of those, but I'm not going the extra mile in the way I used to. And of course, this makes the job less rewarding. My teams sense that I'm not throwing myself into it in the way I used to, and this makes them less invested in me as a leader. Some of my colleagues clearly think I'm not devoting myself to this as I should. And I am feeling guilty about not volunteering for some of the extra duties that come with my job, I'm letting others do them. This means that I'm mostly getting home for dinner at about eight or so, or sometimes earlier, rather than nine or ten as often happened previously. I'm also not getting in at eight every morning. If I don't have early meetings I'm taking it easy at home and having breakfast, and getting in around nine or so. Before when I got in that late it was because I'd been to the gym first, but not at the moment. I get up and feel as if I deserve to have the morning I want to have, not the morning that my job guilts me into having.
It's not a good feeling. I feel guilty for not giving my job my all, at the same time as I feel resentful that my job demands so much from me. And I feel doubly guilty because I can get away with not giving my job my all. No one is really checking up on me every day. If I coast for a long time, my evaluator will spot it and it will be reflected in my rating next summer, but I don't think I'm coasting to such a large extent right now. As I said, I'm doing what I need to do to deliver good service, I'm just not doing it with my heart and soul. And that feels like I'm not doing a good enough job.
One of my problems is that I was planning on getting out of one of my client situations by disappearing on maternity leave for a while, then not getting back into it when I came back. It's a situation that I find stressful to work in, largely because of one of the colleagues I have to work with. But of course that maternity leave hasn't materialised so I need to move to plan B, but until last week there was no plan B. On Thursday, however, the problematic colleague raised the issue of my long term commitment with me, and I got the courage to bring up why I wasn't feeling 100% committed. We at least started the conversation, and agreed to continue it. Luckily in the first six months of this year I did a really bang-up job with this client so I've got some brownie points to spend.
Maybe what I need to do is to give up the guilt, and just say that I'm going to have a less than stellar year, performance-wise, at my job. They won't fire me, and I'm not even performing that badly. I can perform better when I'm in a better place. And those fantasies I have of having some very non-stressy job? Maybe when I'm in a better place in the rest of my life, it's time to get those fantasies out, think about the consequences for our lifestyle, and start exploring them a bit harder. Until I'm in a better place with the infertility I don't want to do that, however, since it's hard to separate how much of the ennui I'm feeling about my job is related to how down I feel about life in general since not being able to conceive. I need to remember, from time to time, that I used to love my job, and I'm bloody good at it when I want to be. It may be that my job isn't the right job for me any more, but I'm not in any fit place to make that decision yet. And they have very generous maternity leave!
In the time that working less devotedly creates I am blogging more, reading your sites, and spending a bit more time with H, just talking. I've found that this community of blogs is very sustaining, and very absorbing. It's a priority most days for me to check in on you all to see how you are doing. It keeps me up perhaps a bit later at night than it should. It's helped so much to have this online succour, but perhaps it's become too absorbing? When I first moved to the US I got very involved in irc. I was so lonely that I really needed a community, and I found one on irc. I had relationships on there. I don't think it was damaging, but it did become much less important when I found real life friends through bookgroup. I'm spending a similar amount of time each day reading and writing on your blogs to that I spent 10 years ago on irc. I'm worried it's become too much, that it's not really my real life, it's an online community and I should recognise it as such. But I feel that you are my community, my community of people who understand what I am going through, and no one in real life really gets that right now. Should I give up that link? That support?
I'm not ready to give it up, don't get me wrong. But I am thinking about whether I should give it a bit less. Perhaps now isn't the time to make that decision. I need to get through this cycle, then see how I cope with the world that the cycle leads me to. Until then, thanks for being my succour.
Thanks so much for all the advice yesterday and today. I think the water comments may be on the mark. Like Julianna I always drink A LOT of water - at least 2 litres a day - so that may be why I didn't have symptoms until now. But yesterday I was trying not to drink water out of plastic bottles (because of the freakout about the endo) and the glass bottle I found was only 0.5l, and I didn't get the chance to refill it much, so I must have drunk closer to 1.5l, which clearly wasn't enough. I drank a lot when I woke up at 5am this morning, kept drinking through my horrible nausea in the morning, and by lunchtime I was actually sort of ok.
I've been chugging down the water ever since, and note that every time I slow down my head starts to feel like my brain is just scratching against the inner surface of my skull, so I start drinking more again. How this is going to work when I'm leading a workshop tomorrow, I don't know, but I'm sure it's better than throwing up on everyone, so I think I'll give it a go.
I'm also trying to follow this diet regimen, but realised at dinner tonight (at a hotel) that I'm ending up inadvertently doing Atkins, only worse (no butter and cheese etc), because no carbs I get access to outside the house are legal. I'm very anti faddishness in general, which is one of the reasons I haven't started lots of other remedies and dietary changes earlier, and now here I am sort of following the ultimately faddy diet. Damn. Got to find an alternative. I'm feeling constantly antsy about trying to do this because it seems so faddy. I wish there was some proof it worked because maybe then I wouldn't be so self conscious. It did, however, stop me from eating the lovely looking cookies that were at the business centre desk this evening. I thought nothing would replace the motivation I got from 'fear of the big white dress', but maybe I've found it.
In other parts of the blogosphere, if you haven't already you need to go and show mm and Kath some love, and share Cecily's joy that NBHHY.
If this is how I'm going to feel for the next 12 days, then I'm going to have to find some better coping strategies. I woke up in the middle of the night with a headache, which was still there when I got up and hasn't yet gone away, despite the tylenol I took an hour or so ago. I'm also now feeling sick to the extent that I'm on the verge of tears which is not easy to handle at work. Injecting myself is not hard, but feeling like this is! I've somehow got to pull myself together to lead an important workshop tomorrow. I'm sure I can do it but it doesn't feel like it right now. Any advice on quelling this nausea or dealing with the headaches?
After the drama of yesterday, today seems like a bit of an anticlimax. Got up, injected self, decided to eat breakfast and...what do I eat? All those foods what I am not supposed to be eating suddenly sound very very attractive. I compromised. I had an oat-based cereal with no added sugar, some raspberries, and some milk. I will go and buy some almond milk this evening thanks to Reprogirl's recommendation, but this morning there was none, so I did what I could.
Lunch was better: grilled plaice, steamed bok choy, lots of watercress, some cucumber, carrot and a tangerine. Afternoon snack of pumpkin seeds, dried fruit and sunflower seeds. I'm going to make a big pot of dhal for dinner, so that will be ok too. I wonder how long this virtuousness will last. I think it is close to impossible for me to really give up wheat and sugar. I love to bake. Am I supposed to never do that again? Or just do it so that others can eat it? Dairy is possible. I do love cheese but I bet I could find substitutes. My current problem is that I usually eat yogurt at least once a day as a replacement for more substantial deserts, often with fruit and sometimes with maple syrup (yum). I'll have to switch to just plain fruit, but I already eat a lot of that. *sigh*.
I'd like to think that if I was sure it would make a difference, I'd do it. But I'm not sure. I do appreciate wessel's point that she just feels better when she does this. But I don't know if I do. I feel better when I'm a bit thinner, certainly, and if I stuck to this I would be as a lot of my bad foods would go (ice cream in particular, although I don't eat it that often I lurrrve it). I have very little ability to see if it's affecting the endo since I don't get endo-related pain as far as I can tell (and let me be clear, I am down on my knees thanking G-d as I write that) so I don't know if it's getting worse or getting better...
And it's just so impractical. I eat a lot of lunches in meetings where my only option is some dodgy looking sandwiches. I'm not good when I'm hungry so I've got to eat something in that situation. Also, it seems that I'd have to have a lot more time at home to cook if I'm going to forgo some of the basic meals that H and I eat in the evenings. We do already eat a lot of vegetables, most of which are organic, not much pasta (maybe once every two weeks). But we eat quite a bit of bread, and eggs. Clearly, I have to think more about this. It's a complete lifestyle change if I do do it, and I need to be committed. In the meantime, I'll continue to make the odd substitution, and eat according to the plan when it's not too stressful to do so.
Now I'm off to make a curry. First stims tomorrow, then I have to take the whole paraphernalia on a business trip with me. I had a minor panic about keeping the Puregon refrigerated but apparently it's OK if it doesn't go above 24 degrees, which in this weather should not be a big issue.
If you haven't read the earlier post from today go read that first, or this won't make sense.
Just spoke to yet another doctor. He was nice and helpful, though, which is a good sign. The good news is I can start stimulation on Thursday. I asked why Thursday, he hmmed and hawed a bit then said, that's just how they do it. I asked him "Is it to avoid doing egg retrieval at the weekend?" He laughed and said yes. So at least he's honest. He said that Dr Haughty (the one who cancelled my IUI cycle) was the senior doctor in the consultation today, and she was happy that there was enough good ovarian tissue to go ahead. So, for a change, thanks Dr Haughty.
In the meantime, I would still appreciate any thoughts people have about keeping the endometriosis at bay - or whether that is even possible. Thank you!
The suppression scan this morning showed that I now have an endometrioma on both ovaries. I didn't have them in August - or if I did, no one mentioned them. So they've appeared since my last medicated cycle. According to the doc there is good ovarian tissue surrounding them, with plenty of antral follicles, but she needs to see the consultant (Dr Candour) to see if that tissue will be accessible for egg retrieval. It could be that the endometrioma gets in the way and then they are afraid of puncturing it during egg retrieval.
So I'm feeling rather upset. First, that in less than six months of my laparoscopy, I have developed endometriomas on both ovaries. After 20 years or so with no treatment, in May I only had one endometrioma. How did I get two in five months? What does that bode for future disease progression? Second, of course the fear that they'll cancel this cycle and tell me I need another lap. Which would really make me sad and frustrated.
Third, it re-awakens the fear I had when I first realised what having endometriosis meant (bizarrely, I don't seem to have blogged about this). The fear that I will never have biological children. After our visit to Dr Candour after the lap (linked above) I did a lot of research on endo and saw data that suggests that the average lifetime fertility of a woman with endometriosis is 42%. That's less than half a chance to have a baby in my lifetime. Since then I've managed to push this fear away by thinking about all the good news on my fertility - my hormone results, H's sperm count, etc. But today I'm freaking out again. Even if we do get pregnant, there's the risk of miscarriage.
I'm wondering what else I can do to help me get and stay pregnant despite this disease. Have any of you tried diet to treat your endo? To any effect? I've found websites saying no dairy, meat, wheat, sugar etc. but isn't this just what modern alternative medicine ppl say as soon as you have any kind of disease? What's the evidence? Of course it's worth it if I can have a baby, but will it really help? And these suggestions raise other issues. Some websites say drink soy instead of milk, but since soy is a phytoestrogen, isn't that the worst thing you can do? And where do you get calcium from if you give up dairy?
Any advice much appreciated. I'll update with the doctor's call later.
That was quite a run of posts that didn't talk about my cycle - did you notice? I think that's because there's not much to say when all you're doing is injecting yourself in the stomach every morning, sometime between 0630 and 0715. I actually stretched it to 0725 this morning, because I'm a rebel. I am, by turns, massively optimistic that we'll be pregnant by mid-November, and desperately upset and worried that it won't work and that it will never work. I'm guessing that's normal. H. is doing his usual thing of being constantly, but not overbearingly, optimistic. By day 3 he even managed to look at me while I was injecting myself. I got a kiss afterwards. I think he'd like to do more but he hasn't volunteered to do the spiking, and frankly, I'd rather do it myself, control freak that I am.
H is being quite wonderful. Everytime I read about someone else's partner who isn't being helpful, or think about those who are going through this alone, I thank my lucky stars that H is keen, supportive, and understands me well enough to know what I need. Two recent conversations have earnt him serious gold stars. On the first, we were walking home from the gym a few weeks ago, when the conversation turned to adoption. He explained that he was open to it in the future, although he wanted us to try this route first. When I asked him why his response to adoption was so enthusiastic, he said:
"Well, for someone to give up their child for adoption, it must mean that they really think that someone else can raise their child better than they can. It must be an extreme situation that gets them to that point. And I think, well, it would be a privilege to raise the child of someone who thinks that way. To try to live up to that challenge."
I thought that was a good way to think about it. I'm not in a place when I can feel excited about adoption, but I'm glad that he is. Having said that, I saw a couple in synagogue with a daughter they probably adopted from China. She was beautiful. I thought of all those I know on line who've gone that route, and thought about how maybe it would be as wonderful an experience for us as it is/has been for them. But not yet.
The second conversation with H was where we were deciding on plans for the next few weekends. He loves the country so I asked him if he wanted to plan to be away the weekend after we find out our IVF results. He thought a little, then responded No. I asked him why, and he said:
"Well, if it's positive it won't matter where we are. And if it's negative you're going to want to curl up on the sofa and watch crappy tv, so we should be here." I thought that was pretty smart of him.
I hope this doesn't feel like I'm boasting. I just want to remind myself of how, in many ways, I should count myself lucky. So far so good on this cycle as I don't seem to have gone insane yet. Not sure how he will cope when I do, but I have been warning him so hopefully he is ready. Suppression scan is on Tuesday, then hopefully I can start with the good drugs.
On that point, I've been thinking about how unfair the world is to us - you know, with the vast amounts of money we have to pay to the doctors, and the ignorant comments and the legal barriers and regulation and, and...and I have come up with partial recompense. You know how, during a sirocco, mistral, oppressive hot wind in the south of france they say that after 14 days you can murder your wife and get away with it (I've tried to google a link to this but can't find one. I know I read it in a novel but there's not much chance of me remembering which one - any offers?)? I reckon we need to petition for some new laws that say that after 10 days on stims you can:
Throw plates at your husband
Stab anyone who tells you to just relax
Run your car into any driver who even thinks about cutting you off
Travel without paying on public transport (you think we haven't paid enough already?)
Get out of any difficult situation (what parking ticket, officer?) by bursting into tears
Feel free to add your own
I'm only speculating, mind you, given I haven't yet experienced this joyous state. But I'm taking a signal from my trainer, who, this morning, told me that she didn't want to see me for two weeks while I'm on the good drugs. "You can come back as soon as they've done the transfer," she said, "but I'm not going to have you running around here while you're insane." I thought that was very encouraging of her.
What have you guys done about time off work at the egg retrieval stage? My diary is filling up but I don't really know which days I should be worried about. Did you block off a week and just fill it up later if you didn't need the time off? Or go sick at the last minute? I haven't got anything in there yet that I can't cancel, but obviously I don't want to let people down. I did tell one of my clients last week that I might not be able to do the workshop he wanted me to do on 2 November. He asked if I was ok in a very concerned tone, and I said yes, nothing life threatening, and he looked relieved. He made it clear that he either wants me or no one from my company, which is quite flattering but not so easy to explain to my colleagues.
Have to go so we can finally choose our cutlery - wedding present from my father. Wedding present company sent the wrong stuff, now we get to choose again. Not a bad deal.
On a day when Ovagirl gets not good, not bad, not sure news, Persephone has wonderful news. Both events follow by two days the news that Susan's fourth IVF was a bust. LEB just heard that her pregnancy may, after all, be viable, and Kate #2's sneak peak looks good, so I'm hoping that the luck will hold through for Heleen and MM in about 12 and 10 days' time. Thinking about this, about the fact that in the midst of someone's best day of their life, someone else is having their worst day, I started to think again about your responses to my post a while back about wanting to see another upturn in the fortunes of the infertility blog space. I went and did a bit of research on Boethius to see what the wheel idea really meant. I found this:
"It's my belief that history is a wheel. 'Inconstancy is my very essence,' says the wheel. Rise up on my spokes if you like, but don't complain when you're cast back down into the depths. Good time pass away, but then so do the bad. Mutability is our tragedy, but it's also our hope. The worst of time, like the best, are always passing away." -- The Consolations of Philosophy, by Boethius*
Anyway, I'm taking issue here with my friend Mr Boethius. Without having read him properly, for which I apologise but you know, it's late, and I have to go to work tomorrow and earn the big bucks, and I got up really early this morning, and I have to stab myself in the stomach every morning right now, and, and...
Sorry lost the plot a bit. Back to Mr Boethius. Pinched from here:
It proclaims that there is order in the universe and that a wise and benevolent God is in charge. We earthbound men and women are limited in wisdom and vision. If we could but see the full truth, we would know that there is order in what looks like chaos, that things have a way of working out for the best, and that all stories have encouraging endings.
I can see why the early Christians liked him so much. After all, doesn't this sound awfully like: All things work together for good for those who love G-d? Which, if you read that link, is really about explaining how everything will be ok in the end - in heaven. This sentiment, and the Boethian one expressed above, only make sense if you are viewing life from an eternal perspective. Because we all know, and we've all written, about how the perspective that all our experiences mean something, is pretty hard to bear when you've just had your 9th miscarriage, or the child you thought you were adopting has been snatched from your grasp, or you've finally realised that you will never have biological children, or the father you never really knew has just died. Telling any of us at that point, hell, telling any of us on the day we start to bleed, again, or the day we pee on the 2,000,000th peestick only to see acres of white open space, is not going to cut it. It does not help in that instance to be reminded that in the end we will see that all this happened for a reason, or that in the end, our fortune's wheel will turn up again. It may not turn up for some of us - at least on this issue that we are all struggling with - within our current life span. So if you don't believe in eternity, what then?
The wheel concept does grab some people - or at least, that part of it that says in the end, you'll get what you need, just maybe not how you thought you needed it. My client who went through infertility, who now has a son (conceived between IVF cycles) and a daughter, adopted after THREE adoptions fell through, he's clear that this was the family he was meant to have. If those other IVF cycles had worked, if those other adoptions had come through, his life would be different. And he cannot imagine his family being any better than it is.
But really, doesn't that say more about our incredible resilience as humans? Our ability to learn and adapt. I know (in my arrogance) that my client would have been different, but probably equally delighted, if one of the IVF cycles had worked. He would not have known his son, so there would be no need to regret not knowing him.
We will constantly, most of us, look to make the best of a situation. We will learn to adapt to the shit that life throws at us. So while it's clear that my client's Fortune's wheel turned up, it could have turned up earlier or later and he would have learnt to love in that environment. By hook or by crook, he and his wife were going to be parents. Their life would have been easier if it had happened with less pain. But it didn't, and he's happy, no delighted, with the family that they have.
I'm left a bit lost. I wanted to end this on an up note, and I'm ending it instead in mid air. I cannot bring myself to buy wholeheartedly into this G-d who knows what will happen to us, and lets it happen anyway. Because somehow in the end that's better for us, we just can't see it yet. That paternalistic world view just doesn't wash with me. Instead I think that we just have to keep trying. G-d isn't playing dice with the universe. The universe isn't playing dice with us. Some of us are just shit out of luck. For some of us that luck will turn, and for others it will take a long long time of loss for us to come out the other side, in a different shape than when we started, and see how we want to shape what we have left.
I want this to be ok for me, and for all of you. I know for some of us what we want right now won't happen. And that hurts. I think we'll replace it with another want, another way of loving. And in the end that will be ok. It will hurt, but it will be ok. I'm with Mr T.S. Eliot. It's not that the wheel will turn, it's that life will be different. It will look different, but it will be home.
We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time. Through the unknown, unremembered gate When the last of earth left to discover Is that which was the beginning; At the source of the longest river The voice of the hidden waterfall And the children in the apple-tree Not known, because not looked for But heard, half-heard, in the stillness Between two waves of the sea. Quick now, here, now, always— A condition of complete simplicity (Costing not less than everything) And all shall be well and All manner of thing shall be well When the tongues of flame are in-folded Into the crowned knot of fire And the fire and the rose are one
* Feel free to research further(although wikipedia wasn't that helpful in this instance, and their entry was precisely the same as answers.com, which was clearly pinched from Brown.edu (see link above) which does actually correctly reference the original author - does that happen often?)
So do you think I can ascribe this evening's crabbiness to the fourth day of suppression, or is it due to what seems to be the last day of my cycle (if you can even call it that now it's all disrupted by vitamin deficiency and drugs), or should I just own up to my profound character flaws? Let me give you the unvarnished facts. On the way home from work, my husband tried vainly to get me to agree to various dinner offerings. This sorry interaction ended with me going to the supermarket and buying my own dinner. And there was whining involved.
Having made and eaten my (very tasty) dinner, I iced the chocolate gingerbread cake I made when I got fed up of making lekachs a few days ago. Then I cut us both a piece for tonight, and made two packages - one for each of us to take to work tomorrow. Then I picked a fight about whether he'd appropriately thanked me for the cake and told me how delicious it was (he had, but only after I asked him).
It's a fair cop. I'm just a crabby person. I can accept my character flaws, they've got me this far.
And while I'm owning up to that, Katie and Tom. Having a baby. I'm so outragedbemusedjealousrepelledfascinated pleased for them.
The first injection did go well. After I managed to break two needles and gouge a line into my little finger, by trying to penetrate the vial through the protective plastic lid. Yes, the one that's labelled "Flip Off". I clearly thought the manufacturer was just being a little punchy. Day 2 went not so well as I went back to my preferred leg injection method. Bad choice - you were all correct. The fluid seemed to hang around under the skin, and it got pretty itchy. I've gone back to the stomach and am now amusing myself each morning by what kind of pattern I can make with the dots of old injection sites. Only 36 or so more to go. That figure is a little higher than anticipated since (i) I'm an idiot and (ii) my clinic is idiotic. Re (i) - If you start on a Monday, day 14 is a Sunday, stupid. Re (ii) - My clinic, says the receptionist, only does suppression scans on Tuesdays and Thursdays. Oh well. I guess it can't matter that much or they wouldn't do it (look at me being all philosophical about the clinic. I must have some patience in me after all).
The buserelin vial is ready. I've pulled out a 1ml syringe from the pack I got*, and a nice delicate looking needle. I'm a little nervous, but very pleased to be getting going. I'm particularly nervous about side effects. But then, there's nothing I can do about that now. Just got to bite the bullet and get on with it.
Yes, I decided to start on day 18, that's tomorrow, Monday. Because it more closely fitted Dr Candour's suggestion in the last email, without being potentially too early if Dr Sarky was right and I didn't really ovulate that early, and because I need a scan on day 14 of suppression, and I'd rather not have to have a scan on either a Sunday, or on Tuesday 18th because I already have an 8am meeting booked that day. That clear enough?
There were a lot of other topics I was meaning to blog about, but they've all dropped out of my head. So there's just this. I hope it works.
*By the way, my drug company is so adorable that they've sent me enough syringes and needles that I could set up my own needle exchange program. Anyone in the UK running short (I'm so not volunteering to send these to the US(!), let me know.
I heard back from Dr Candour. Why he can't train the people in his clinic to speak like this, I don't know. Here is his email, verbatim, as I thought it was clear, to the point, and told me something I didn't already know:
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A day 21 start really means a mid-luteal start ie in between ovulation and a period. Our nurses are advised to keep it as day 21 as this will cover the vast majority of patients. Strictly speaking the doctor's advice was more 'accurate' although with the average length of suppression being around 14 days my honest opinion is that it would not make a significant difference. Time issues with IVF only become critical around the time that hCG is given.
My advice would be to start as midway between ovulation and your 'expected period' as you can best estimate. Should we get this wrong and you begin on the cusp of a period then this is not problematic, about 30% of my patients have an 'early follicular or' day 2 start. The pregnancy rates are identical, a day 21 start is associated with a lower incidence of cyst formation, which is the reason we are currently favoring it.
I hope this answers your questions. I'm in XX at present giving a talk, but will be back on Sunday night.
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I think I'm quite lucky to have found Dr Candour.
I think I will start on day 19, just not to tempt the fates too much. That's Tuesday.
I have a question for you all. How long did you stim for? I'm trying to do some planning (yes, so the powers that be can laugh at me) for this and don't know if I should be estimating 10 days or 14 days or somewhere in between. My clinic says 14 days maximum, but I have no idea how much less than that is possible. Any help much appreciated as always.
Just spoke to the drug company. £436.78. Yaay for them! Now it may go up later as this assumes I only need 150mIU of Puregon a day for 14 days, but still, it's a much more manageable cost than I thought. I guess there are some advantages to doing this in the UK.
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Which don't include my fun doctors at my clinic. I called today to check on when I should start Buserelin, given that I ovulated on day 11, and usually have 10-11 day luteal phases. The doctor (same one who sensitively finally cancelled our IUI cycle) asked what my usual cycle length was. About 25 days I replied. "Then," she said, "you should start buserelin on day 19 rather than day 21." I asked why, given it seems this cycle will be even shorter, I should only start the drug 2 days early. Because apparently I am an ignorant native who doesn't have a clue. Or, in her words, a combination of temperature shift, cervical mucous and OPKs don't actually signal ovulation. Oh, great. All that time and now she tells me. According to her all that indicates is that you ovulate a couple of days after that. Umm, what about the temperature rising because of the progesterone, which comes after ovulation? No, not according to her highness. She's right and I (and the rest of you and Toni Wechsler and everyone who ever wrote anything about this) am (are) wrong.
I pointed out that this cycle didn't look ordinary, and I guessed it was due to stopping the B6. She pooh-poohed that idea too and stuck to her guns. She said it's better to take an average cycle since I really didn't know that this one wasn't average. I pointed out that I've been monitoring cycles for 18 months and have never ovulated on day 11 before, so I didn't see why my average cycle was a good guide. Eventually I had to give up.
I tried a different tack, and asked if it would be a problem if my period was about to start the day I started Buserelin. She never answered that question, but kept telling me to start on day 19. I'm going to start on day 18, since at least that's logical (my average cycle is 3 days shorter than the standard 28 day one). I think I'm also going to take Dr Candour up on his offer and check with him. I so don't want to screw this up.
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Faffing. Not sure it's in the dictionary but it means something like "farting around" - i.e. lots of activity for not much output. Somewhat, but not entirely, pointless activity. Extra energy expenditure than is needed to achieve level of output.
Feel free to incorporate into the American tongue as you see fit.
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And I have to finally own up to having exaggerated my classmates' profiles somewhat. Other than the first one, which was almost verbatim (ok I added the bit about the teapots). I took elements of the others and jazzed them up a bit. But you enjoyed it, right? And I made my point, admittedly in a hyperbolic fashion. So I feel ok about having had a bit of fun writing those.
Perhaps I could use these skills of exaggeration and write some sketches on clinic characters? Perhaps for television? Only you'd have to make them really absurd before they'd be funny, right? No. Wait. I think they already did that.
I finally bit the bullet and ordered the drugs for our cycle yesterday. It didn't feel too scary. No idea how much it will cost yet - that joy is still to come. What's the really expensive thing? Is it the stims or the buserilin? Because surely they can't charge me that much for antibiotics or progesterone suppositories?
Is anyone else sick of taking prenatal vitamins? I'm really starting to resent that neat foil sheet with the 12 carefully placed big red shiny pills. And to resent in particular the nice rotund pregnant woman on the front of the packet. Don't they know they're missing a big marketing opportunity by selling only to those who can imagine themselves with that kind of stomach? We could establish a new brand, characterised by a hot chick in a cocktail dress and pointy-toed-shoes, washing down her dose with what is clearly her 5th martini of the evening - the aspirational infertile (because we all know that we sit around in yoga pants with unwashed hair and unshaven legs and eat cake and drink the nearest bottle of wine).
I stopped taking the mega doses of B6 that I started over a year ago to regulate my luteal phase. Didn't seem to be any point this cycle given the whole suppression thing that's going to start in 9 days time. But then I ovulated on day 10, which seems a little early. And my nails have started to split a bit, which they haven't done for ages, since, oh, probably around the time I started dosing myself up. And I had (sorry for sharing) gobs and gobs of the good CM for three days running. Now, this cycle, I get nice and (potentially) fertile. Anyway, I wouldn't have taken advantage of it even if I could, given the fact that presumably we'd kill off any little spawn through the buserilin, but H was away walking this weekend so no chance. Please feel free to laugh at me for even idly musing that that might have been a possibility this cycle.
As I mentioned, H went away walking this weekend. We had tremendous faffing the night before he left. One of the friends he was going with came over and they had all their equipment laid out all over the floor of our sitting room. I went downstairs to watch television, and just caught mumbled phrases like: "Damn, I forgot to wrap the sleeping bag in plastic, now I'll have to start again," and "this shovel will really come in handy," and "So if we eat the stuff in this pile on Saturday, that leaves us with the dried mince for Sunday," and "I hope the meths got delivered ok to the pub in D-----y". It was fun. They faffed for hours, I fed them curry, they faffed some more, I went to bed, they faffed even more. They left the house at 4am on Friday, and got back last night. They were very smelly and very bearded, and looked all pleased with themselves for having done something so manly. I didn't point out to them that the whole faffing thing was really pretty girly.
THE RULES: 1. Go into your archive. 2. Find your 23rd post. 3. Find the fifth sentence. 4. Post the text of the sentence in your blog along with these instructions. 5. Tag five people to do the same.
I said I wanted to schedule an IUI for the next cycle if it doesn't work this cycle, and started to figure out when the baby would be due if the IUI worked (I know, I know).
I do that every time. Don't you? I know the expected due dates of each month that we've had any chance of success. The one just passed would have been due on 23 May. What a strange numerical coincidence. I always wanted a May birthday when I was little. The ability to have a party in the garden, as my September-birthday-ed brother did, seemed exciting, almost exotic. Instead of the snow that usually marked my birthday. And it's nice and far away from any family birthdays. And it's far enough before June that it's unlikely the child would have to suffer exams on their birthday, or even if they did, they could have a great post-exam party and get lots of presents at the same time.
My fantasies really are running amok, aren't they? I know that, yet every month I do the calculation, and every month I mourn that lost birthday.
If the IVF works, the baby would be born sometime towards the end of July I think. I haven't calculated it yet (and I refuse to do so now), but it must be there or thereabouts. Kind of sucks, as everyone will be on holiday and so all their friends will forget their birthday, and it will be hard to have a party because no one will be around. Although the weather will probably be pretty good.
I said this to H a few days ago. "Whenever our baby is born," he said, "will be the perfect birthday."
I went to a speech last night by an academic who studies organisational energy. We were discussing whether it was easier for an organisation to regain energy it had lost, or to build energy from scratch. Ah, she said. It's about belief in success. If you've never been successful, it's hard to believe that you ever will be. Sound familiar?
But I think it's worse than that for us. We are mostly women who are used to being successful, and to being able to influence that success. Here we are, powerless to make ourselves successful in this miserable endeavour at which we all keep failing, and we also don't have the coping tools to deal with the fact that we keep failing. Low energy from the fact we've never been successful, and negative energy from the frustration at not being able to control our fate. A bad combination.
In other news, it's been a hard week to not be pregnant in my little corner of planet earth. First, and I readily admit I did this to myself, was the documentary on the Discovery channel about Jackie Clune. I'm not going to post a link to the discovery home and health site as all it gets you is a large picture of a naked pregnant woman, nothing to do with the documentary, that I imagine at least some of you aren't really in the mood for.
Anyway, Jackie Clune, for you ignorant non-brits, is a comedian. A reasonably famous one in the UK. One reason she's famous is that she spent 12 years being an out and proud lesbian. Then, as she puts it, she decided to give men another go, fell violently in love with a very handsome man, got accidentally pregnant at the age of 37, and had a daughter. Then, just 8 months after her daughter was born, she got accidentally pregnant again. At the 12 week scan they found out it was triplets.
Triplets. Accidentally. At 39. Now I'm not hoping for triplets but couldn't I have just a little tiny bit of her fertility? A smidge? She does seem like a nice woman - unassuming and terrified - but it was still hard to watch due to the usual blast of overwhelming jealousy at someone else's good fortune that I now seem to be unable to quench.
Second event was my high school reunion. Which I avoided, but I did get to read the newsletter. Let me offer you a sample of what my erstwhile schoolmates have been up to.
Juliette Fertile (nee Party Animal): Well, after getting my MA in Chinese at Oxford, and my PhD in international relations at Yale, I've spent 10 years travelling around the world to various trouble spots, working first with the Red Cross and now with the UN, helping set up crisis centres and saving people from certain death in areas like Biafra, the Sudan, Croatia, and Afghanistan. My latest posting in Iraq has forced me to finally become fluent in Arabic and in my spare time I'm helping a small women's cooperative develop their business in making and selling teapots. I'm also incredibly lucky to be married to the most gorgeous man in the world, Ollie (yes, Fiona, it's true, I promised you I'd marry him and I did!) and we have two lovely children: Joe and Amelia who are 7 and 4 respectively. Looking forward to hearing all your news!
Selena Really-Really-Fertile (nee Artypants): Having won an Oscar for my documentary: Up the Amazon in 2001, I've spent the last three years focusing on writing while being a mother to my adorable twins, Sophie and Madeleine. I hope at least some of you saw my first novel, I still can't believe - which made it onto the Waterstones top 10 list last October -it was very well received.Meanwhile my husband, Jurgen, has continued to wow the Art world with his creative video installations. Thank goodness Charles Saatchi is such a fan! I'm now expecting a little brother for the twins, who will be born around the time my second novel, Having it all, is published in the Spring. So excited to see you all!
Francesca I'm-so-bloody-fertile-I-get-pregnant-just-walking-down-the-street (nee Maths-Wizz): My First in maths at Cambridge soon turned into a PhD on option theory from MIT, at which point I went into banking. After becoming a senior vice president at Goldman Sachs five years ago, I left to set up my own company, which manufactures and markets the product I invented - the QuTiClean - that (we hope!) will change housework forever. Turnover finally hit the millions last year so now I can relax a little and enjoy life with my husband, Jamie, and our children Hamish (10), Freddy (7), Barty and Eloise (5) and little Jessamy (2). It's been an amazing few years and I can't wait to share more news with all of you!
Bitter? Moi? And honestly, I'm not exaggerating. These are truly superwomen.
Another old friend called in conjunction with the reunion. She and I have been out of touch for a while but she wanted to call and say thank you for the sympathy letter I sent her when her father died earlier this year. She's also been very successful - she's married to an actor, has two children and is a child psychologist with a weekly column in a national newspaper and two regular television programmes on mainstream channels. In the course of her work she met Sir RW, the uber-doc of UK fertility. She mentioned this after I told her about where we are on the fertility front. And good news, she passed on the maestro's advice! Now we'll all be pregnant soon! Are you ready for this advice? Because given the source, it's clearly going to be fab, right?
Ready?
Are you sure?
Ok because you know I'm going to tell you.
So, Sir RW says that what we need to do is...
JUST RELAX! Can you believe it? How can no one have told us this before! Seriously, he told my friend that you need to do two things. 1. Go on holiday, relax and have lots of sex. 2. Have an orgasm after the deposit has been made.
I can hardly speak I feel so enlightened.*edited to add that I am well aware that SirRW's comments were being relayed to me by an unreliable witness - I'm sure anything he had to say was more nuanced than this.
To add insult to injury, last night over dinner a colleague was discussing having found, on the JP Morgan women's initiative page, a policy saying that they supported adoption with various benefits. She was joking that of course JP Morgan had to offer those benefits since all the women who worked there would "have to adopt" since they'd be too old to have children by the time they got round to it. I thought about a suitable retort, and then just stayed silent. Coward.
And another colleague just started showing. Her third. Oh well.
The FSH is exactly what it was last cycle, although the LH is lower. Should I worry about that? According to Dr ICU (for it was he), I am good to take Buserelin starting on day 21, i.e., 17 days from now, then come in for a scan 14 days later. [Ignore the next bit about E2. It is only interesting as an artefact of how focused on worrying I am. It took Nico to point out that I had read the page wrong. I saw the upper limit as 50, when it clearly says 75. I guess I'm looking for problems!!].The E2 seems to me to be on the high side, although it's just below what would constitute a problem. Although note the voice of gloom on that page: "Levels on the low end tend to be better for stimulating". Sheesh. I'm hoping that since that site measures day 3 levels, and mine are day 2, that partially explains why they are a little high. That's reasonable, right?
Because otherwise this would be a really boring post, and in a desparate attempt to stop myself from obsessing about those numbers, I decided to respond to Larisa's tag (by the way, I was ridiculously flattered by this. I nearly didn't notice as I always assume no one would be interested in what I have to say on any meme, but my name just popped out at me as I scanned the blog. Thank you!). I have to admit to pinching one or two verbatim from Larisa. Seems we have quite a bit in common!
7 things I plan to do before I die... 1) Be a mother 2) Weigh 140 pounds, at least for a few months, just to see what it feels like to be really slim 3) Make a difference at an important charity 4) See Australia and New Zealand 5) Work for love, rather than money (see number 3) 6) Get my husband to watch all seven seasons of Buffy with me 7) See every Shakespeare play live on stage
7 things I CAN do... 1) Get people to tell me things they didn't originally want to tell me 2) Understand what other people are feeling 3) Remember every single thing that was said during a conversation or an argument, even years later, and play it back, much to the annoyance of the other person 4) Cook - healthy and unhealthy, I always make plenty and it's usually delicious 5) Recite Jabberwocky. Word perfect, with lots of sound and action. I once seduced a guy this way 6) Recall phone numbers, or indeed any numbers, eerily well 7) Read at the speed of light, and retain what I read
7 things I CANNOT do... 1) Play sports that require hand-eye coordination 2) Stay patient 3) Do a swan dive (in yoga - I don't bend at the waist easily) 4) Paint or draw 5) Complete things *before* a deadline (I meet deadlines, but just) 6) Go a day without eating some kind of chocolate 7) Stop buying books
7 things that attract me to the opposite sex... 1) Height 2) Wit 3) Kindness 4) Thoughtfulness 5) Sense of humour 6) Intelligence 7) Twinkly eyes when he smiles
7 things I say most often... 1) Do you like me? (irritating schtick I do with H) 2) I'm so pissed off I got fat again 3) I can't believe we don't have a baby already 4) I love you 5) Tell me more about that... 6) It would be fabulous if... (usually to one of my teams) 7) Does that make sense to you?
Celebrity crushes... 1) Sam Shepherd 2) Simon Schama (ugly but oh so smart) 3) Patrick Stewart (alt.fan.sexybaldmen veteran!) 4) Rupert Everett (yes, I know he doesn't want to sleep with me but he's so gorgeous, and this is a fantasy list anyway, let's face it) 5) Cary Grant (it doesn't matter that he's dead, right?) 6) Dar Williams 7) Liam Neeson
A couple of weeks ago I noticed that, at my usual posting rate, my 100th post would be just in time to announce that I was pregnant. Or not, I kept reminding myself. Still, I kept thinking about how cool that would be. Every time, I'm so damned optimistic! Since I realised on Thursday that this was not the case, I've still been thinking hard about what to post to mark such an anniversary. But I got nothing, so I'm just posting.
Posting to say thank you for all your comments on the last post. Mellie was right, we do have plan A, and Plan A is still good. I went in yesterday for the day 2 bloods, and will get the results tomorrow. Right now I'm not obsessing about them, because so far they've always been fine so there's no reason to believe my FSH will have risen dramatically in just 2 months since the last test. Of course, typing that last sentence has now made me start panicking, but there you go, that's just me obsessing again. I went straight from the blood test to my kickboxing session, which probably wasn't the best idea. The bandage flew off a few minutes in, but luckily I didn't start bleeding again. I just managed to gross out my trainer.
She's used to the IVF shenanigans, though. Yesterday she shared with me what another couple she is working with are going through with their IVF. Their first ended in miscarriage. The reason they are doing IVF is that the husband has no vas deferens, so the sperm aren't going anywhere. Unfortunately the drugs are making the wife really really angry, so she left home on Friday after haranguing her husband about how she was going through all of this for him, and how he had made her do this and now she was ill and miserable and it was all his fault. That he wasn't a real man and that he was broken. She then got very drunk in a local bar and called my trainer to try to get help to calm down. It made me feel so very lucky to have H. Now I know I've never taken the suppressors before, so I don't know how loopy I will get, but I do know that H will never say anything like that to me. Not because he thinks it but doesn't say it, but because he doesn't even think it. And I have no sense that this is his fault. Through a combination of my endometriosis and age, we just can't get pregnant together, or at least not without help (please! please let this work!).
Amusing best friend incident number 476: On the phone on Friday. I called to tell her that I wasn't going to go to our 20th anniversary high school reunion today, Sunday. I just couldn't cope with all the: "And how many children do you have?" conversations. She asked why I was so down. I tried to explain. The next few sentences are verbatim (although as with everything else, subject to the vagueries of memory):
Thalia: Well, I just have no faith that IVF will work. Nothing else has worked, why should this? BF: You must have some faith it will work, or you wouldn't be doing it Thalia: Yeah, I guess you're right BF: Because, if you really don't think it's going to work, for goodness sake, just go have a holiday or something Thalia: Stunned silence
Unusually for me, I did call her back later in the day and call her on it, and she apologised. She means well, but she doesn't get it. Her other friends who've done IVF seem to have done it with every faith that it will work, and it has worked first time for all of them. She herself has had three girls, the last one an 'accident', conceived when she was 38, earlier this year. She does care about me, but she doesn't know how to help me right now.
The truth is, of course she is right, I must believe it might work or why put myself through this. And no doubt, with the usual cyclicality of my emotions, no doubt at some point I will start to believe that this might work. Right now, I am doing ok. I wasn't doing ok on Thursday and Friday but having H home (he was gone all week), and doing very little over the last two days other than working out, getting myself maintained (manicure, pedicure, leg and underarm wax, facial), and reading the paper, has led to a bit of an easier mood.
Later I'm going to cook the embaras de pommes that have arrived in our house, the fruit of an English autumn that is just getting going, go to the gym again, and tell my husband I love him a lot. Oh, and do that piece of work that's hanging over my head. But just for now, I'm going to keep forgetting about work and try and stay with my equanimity and sense that in H, I have something that makes me lucky, no matter what.
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