Thalia's fertility journey

Endings and beginnings

Yesterday happened as expected. Dear Leggy, thank you for clinging onto hope, but really there was none. I did have flashes over the last week of thinking we'd go in and there would be our embryo, heart beating away, but they were just flashes and I was fundamentally unsurprised when the sonographer's wanding showed a gestational sac that had started to collapse. It was long and thin like one of the balloons that you use to make balloon animals with. Only not orange or purple or anything. There was no sign of anything in it, the yolk sac from last week had already reabsorbed. The pregnancy had definitely failed. I got her to tell us our hcg result from last week. It was 9,100. Not really what you're looking for at 7w1d. So really, I think we could all have declared this over last week. No matter, this is the life (or not) we got and I'm not going to get angry at anyone after the fact.

We went up to the private ward to get checked in etc for our ERPC. It stands for the Evacuation of the Retained Products of Conception (that link is patient info from another hospital in the UK  - best explanation I found through googling). It's supposed to be more gentle than a D&C. Then of course we waited and waited. Turned out Dr Candour was in a consultant's meeting that morning so he didn't show up until 9ish to do our pre-op discussion. That was after the nurse had checked us in. During which she asked me if I was pregnant. Which I thought was a bit of a dumb question. And which, for a change, I actually said to her. Well, what I said was: "That's kind of the point, isn't it?" She had the grace to blush, and said, "Sorry, we have to ask everyone."

We also had a little drama in that it had not occurred to me to contact my health insurance company. After the nurse had found this out, the insurance lady bustled up to my room and told me: "You know you must call them to get pre-authorisation before you come in, this really isn't the right way to do things." Luckily I remembered that in February when the insurance co had authorised the wrong date for my lap we had called them that day and they'd been good at sorting it out, so I pointed this out to her, told her she'd have a letter in the files from them from February with all the contact info on, and that my company has a dedicated line to them so presumably I could call them and we'd get it all sorted. She went off to get the letter and I burst into tears. She didn't come back at any point during the day so I assume she got it sorted. Insurance ladies aren't famous for letting you leave the hospital - or even have the procedure - until you've paid.

When Dr Candour turned up he was his usual calm, kind and reasonable self. Which of course made me cry. He hadn't seen the notes from the clinic so I told him that everything looked bad. He was, of course, not surprised, went through the procedure, the risks etc. The anaesthetist was also very kind. It was the same woman who'd done both of my laps, and she remembered (from the notes presumably) that I had problems with dehydration so she told me to keep drinking water until we had to go for the procedure. Which wasn't until around 11:30. So we waited. At around 11:10 a junior doctor came to tell me she was going to insert a drug which would start to soften the cervix. She was, to put it mildly, cack-handed. That made me cry a bit. After that I started to get mild cramping and at 11:30 they wheeled me down to theatre. In the prep room I started to cry again. Not sobbing, just tears running from my eyes. It just all felt so sad. Although I'd started to give up on this pregnancy two weeks ago, I guess it's not really over til it's over. Dr Candour came out to see me again, and after all the prep I was put under at about 11:40. At 12:15 I was waking up in recovery, and by 12:40 I was back upstairs in the room, and H was there waiting for me.

As always after a general my mouth felt horrible, and no matter how much water I drank it wasn't helping much. The nurses were very sweet to me, and H kept asking if he could get me anything. He was trying to work but gave up and watched the tennis instead after a while. I felt ok, just crampy. They kept giving me painkillers, but told me I had to eat before I could have the good stuff. That was encouragement enough so I ate a sandwich at about 13:30 and got some di-hydro-codeine shortly afterwards. That made me feel a bit better. At this point I wasn't really teary any more. I'm not sure why. Perhaps it was a relief that things were over.

Around 14:45 Dr Candour came to see us. He said that everything had gone well. The uterus wall looked good and smooth afterwards so he was confident I would not need a second ERPC (happens in about 8% of cases). He also said that everything looked very sterile and intact, so he did not think I had suffered from an infection that caused the embryo demise. He had sent samples off for histology and genetic testing. I asked if they really had enough for genetic testing given we couldn't see any embryonic tissue on the scan, and he said he didn't know but it was worth trying (This is where I get a little cross about the delay. Presumably we'd have had more chance of finding something if everything hadn't already deteriorated. Oh well). The histology scan will see if there was a problem with blood clotting etc. He asked us to make an appointment to see him in about 3 weeks, when he'll have all the results back and we can make a forward plan.

I had been freaking out over the last few days about whether I am kidding myself even trying this again. At 39, having been pregnant only once in my life, and then with an embryo that had no chance of developing, I wonder about whether my eggs are just never going to make it. I saw that the chance of genetic abnormalities of the embryo at my age is 1 in 70. That's pretty high. So I asked Dr Candour whether he thought that was our chance, that we've had our pregnancy, it's not worth us trying again. He answered that the fact we got pregnant was definitely a good thing. That what they worry about most is lots of cycles of negatives with no sign of implantation. That it's implantation that is the biggest barrier to successful pregnancy, and one that they can do the least about - and the one they understand the least. So the fact we got implantation this time gets us over a hurdle, and, as far as he is concerned, makes it worth trying again. I can't tell you how much of a relief that was. I know that it is entirely possible that we won't get pregnant again next time, or that if we do, that we may have another miscarriage. I know that. But I want to try again so it matters that the doctor I trust to help us make that decision thinks it's worth it.

We were released at around 1600 with a packet of augmentin - prophylactic antibiotics. Unlike last time, the nurse in charge sent a junior down to the pharmacy to wait for our prescription, and wrote URGENT all over it so we didn't have to wait two hours. That was a relief. H and I got home fast and decided on gazpacho for dinner as it was another horribly hot day, and I thought it might work ok with how horrible my mouth felt. H went off to get the ingredients, and we then chopped and blended together. He did a bit of work and I watched a soppy movie. We had dinner (delicious. First time I've made gazpacho but totally worth it) and watched an episode of ER (not sure that was our best choice, but our next Lost episode is the one where you get the back story of the Mr Eko group and it looked pretty terrifying so I thought probably not my best option).

All evening I was mostly doing ok. Each family member texted me which was nice. I wasn't teary. I felt sad but not bereft. I was bleeding a bit but not too much. Dr Candour told me that a little light bleeding might continue all the way to my next period. Around 10 I went to bed and read some more of my fantastic chick-saga type novel that I'd carefully selected last week. No pregnancies, just lots of family feuding and delicious jewels. Then I slept. With a fan blowing because it was so bloody hot, but I slept and I don't really remember the dreams. I slept a lot better than the previous night when I kept waking up with Imelda Staunton singing into my subconscious "maybe they're really magic, who knows" in my ear (yes, I've been overdosing on Into the Woods).

This morning I woke up sad again, but I do feel ok. I'm not going to work til Thursday, but yet I don't feel ill - not like recovering from a lap when I really needed the time off because I was in pain. I have a few cramps, but Dr Candour told me that was the uterus shrinking itself back and was a good thing. And they're really not bad - not even bad enough to take painkillers any more. I'm bleeding a bit, but nothing major. I'm sad, but it's a dull kind of ache, not the sharp, immediate panicky pain of seeing that ultrasound last week. The kind of ache I'll carry around for some time, I imagine. Dr Candour told me I'd really feel the hcg and progesterone coming down, but other than the sadness and feeling of fragility I'm not noticing anything. Luckily the heat has broken a little, so it won't be too miserable being at home today with no air conditioning. I've got gazpacho for lunch and plenty of work admin to keep me busy if I so desire. Or else that chick-saga to finish.

I'll be ok. I want to get on with further treatment so we can see if we can finally get that baby we're dreaming of. I know I'm going to be sad, and I feel a bit lonely, but I know that that's normal. I don't know how I'm going to manage to cope with work again, but I guess I'll manage that, as well. My first appointment on Thursday morning is to get my annual review feedback. Not sure that was my best option, but it's the only time my evaluator can see me. How much do you bet that at least some of the meeting involves me crying? My evaluator is a sweet, but conservative, Polish man so I'm not sure how well he's going to cope. Poor guy doesn't know what he's got coming.

Hairdressers: a most pressing issue

You may remember that my hairdresser conceived around the same time that we did, with the same due date. She called me on Wednesday to see how things were going. I told her, she fell apart. She was really very sweet. I asked how her 7w scan had gone, and of course it had gone fine, no problems. She told me that if I want to come in and see someone else I could, that I could come in on days when she won't be there, whatever I want she will organise. For now I have kept my next appointment with her, but I don't know when the time comes if I will be able to handle it. The last time I saw her we were both pregnant. The next time I see her, just one of us will be.

The dilemma is that I've just settled down with her after a couple of years of peripatetic searching for a hairdresser I was really happy with. For most of my life I'd been to the same guy (he was an apprentice at the salon where my mother went when she first got married, so he was the first person ever to cut my hair), and frankly, he still gives the best cuts ever. But in the six months before I got married I had two bad colour experiences with his salon and so after the wedding I decided to look around. I went first to the salon renowned for colour in London. I quite liked them, but it was extremely hard to get an appointment, and I was often asked to change to a different colourist at the last minute. After a couple of months of that, I tried the other colour salon. I sent in a web enquiry, and the next day my current hairdresser's assistant called to book my appointment. L and I bonded immediately. She does colour, and someone else in the salon does the cut and blow dry. He's fine, nothing special, but the colour is wonderful. It may be that someone else from the same salon will do just as good a job, so that I don't have to see L, but I'm always going to know that the reason I'm not seeing L is that she is just as pregnant as I should have been...I don't know, I guess I should leave this one for another day.

In another amusing hairdresser-related incident, my mother, who still goes to the first guy's salon, has obviously shared our news with him and his half-his-age second wife, who is the receptionist at the salon and is lovely, but who got pregnant with an oops baby on basically our wedding night as far as I can tell, so there is some pent-up jealousy from me there. The reason I know that Mum has told them about us is that I received in the mail quite a sweet note from the hairdresser's wife, with an info card about someone doing acupuncture and chinese herbs for infertility, who she knows socially. The note says things like: "My heart breaks for you," and "I hope that something will help you get what you deserve." It's all very well meant but somehow just didn't sit well with me.

Perhaps because it came the same day as a note from my mother attached to a recent news article about the Finnish study that showed that we might as well all go back to single embryo transfers. Is it just me or am I reasonable in being suspicious that the reason why this study has had so much publicity in the UK is that the HFEA really wants us all to go to single embryo transfers to minimise multiple pregnancy, despite other studies which show precisely opposite results? Forgive me if I'm not too keen on that bandwagon. The thought keeps occurring to me that perhaps if they'd put three back I might have another one still happily developing in my uterus right now. Unlikely, I know, but for goodness sake I've got to have something to hang on to.

I'm still a bit of a basket-case, and H had another breakdown yesterday. It's just so hard for both of us to give up on this pregnancy. H has made an appointment to see the counsellor at the clinic tomorrow. I can't quite bring myself to do the same. I'm not sure why, as I've found therapy very helpful before. Perhaps I'm just not at that stage yet.

By this time tomorrow I won't be pregnant any more. Not that I've been feeling pregnant for the last two weeks. But for some reason I still haven't let myself drink or eat sushi. After tomorrow I will have no such compunction. Thank you again, so much, for the amazing messages and emails. I have now read through a lot of material on miscarriage and loss that I wasn't previously aware of. Katie had previously recommended The Miscarriage Association, and their leaflets, while not telling me anything I didn't know from all of you, have been very helpful to read. Thank you to all of you for taking the time to provide what comfort you can. It's been wonderful. It's made me cry, but it's still wonderful.

The banality of suffering

I've always enjoyed the poem: "La Musee des Beaux Arts" by WH Auden. I generally like Auden's poetry, but there was something special about this one. Or perhaps it's because I had to do a lit crit on some poem sometime when I was about 14 and my father suggested this one so I learnt if off by heart and my father said lots of interesting things about it. Anyway, it's come to mind a lot over the last few days. Go and have a quick look before you go on. I think typepad will open a new page so you won't even navigate away from here.

Walking out of the clinic on Tuesday was a weird experience (I've realised after all that stuff about how I care about spelling and punctuation that there are some words I habitually spell wrong. Wierd/weird is one of them. I have to correct it every time). It's been a week of beautiful weather in the UK. So the front of the hospital was full of people having a nice day. Sunning themselves on benches, chatting with their friends, having a quiet sandwich break. As H and I clung together, he reluctant to get in the taxi that would carry him back to his training course, I reluctant to dive into the hospital to get my repeat prescription for progesterone and heparin, we both remarked that it felt all wrong. I suddenly understood why films do things the symbolic way. I always laugh when it happens, but it's so necessary, so right. That when the tragedy is occurring, that the external world recognises it and responds accordingly. An eclipse, thunder and lightening, pouring, torrential rain. That's what we felt and that's how the world should have responded to us. But instead, like the scene as Icarus crashes into the ocean, everyone gets on with their lives. They don't notice the pain, because it's not visible enough, we're trained to keep it in.

Monday night was even worse on that basis, the dinner with my entire family to celebrate my mother's 70th birthday. I had booked the restaurant, organised the cake, bought the present, made the card. Everyone knew about our situation. I knew that we would get bad news the following morning. I know you were still hoping for us at that point, and I know my family was, but I knew after that first ultrasound that things weren't going to go our way. So I barely held it together through dinner, as my brothers and SILs talked about their beautiful sons and the lovely things they've done recently. My father gave my mother a picture of her taken exactly 40 years ago at the Grand Canyon, when she would have been about 2 weeks pregnant with me. My mother talked about how much happier she was at this birthday than she was at her 60th. And I continued to barely hold it together - and smile - while my extraordinarily beautiful SIL got the waiter to take our picture around the table.

Once the meal was over I made sure that H and I paid first. As we got up to leave the others to finish their coffee, my SIL asked for another picture outside, as it would look better than one around the table. No, I said. No. I don't want there to be another picture taken of this evening. And then I lost it, and I left. I feel bad as my SIL is a lovely woman and she didn't mean to upset me. But I'm dreading anyone even showing us that first picture. And when I got home I broke down again and cried to H, shouldn't our pain infect the people around us? Shouldn't they feel it too? How can people who love us go on being so happy when our lives are falling apart? It doesn't feel right.

And then I feel horrible for wanting other people to feel miserable. I honestly don't want them to suffer, but I do want some acknowledgement that our lives suck right now. Just like I want the weather to reflect our pain. Our families all know, and told H when he called them how sorry they were. But no one has done anything other than send an email (my mother). No calls, no other emails, not even a text message. One of my college friends called Tuesday night, and another has texted me. One has emailed. Why doesn't my family get it? I don't really want to talk about it but I do want to know that they are thinking of us, however impotent they are to help.

But I guess the answer is that this doesn't really affect their lives. Of course they are sad for us, but then they have to get up to feed their baby in the middle of the night, or go to that important meeting, and that's their life and it takes over. And that's all fine and normal. But it's hard to take when it feels right now as if this sadness that I feel is never going to go away. Maybe that's right, maybe that's true. I know the sadness will get easier (much easier) to deal with and I know we will agitate for our next cycle and in time we will either have another baby or we will move on in other ways. But I think I know that there will always be a part of me that will mourn this loss. Our 22 January 2007 baby. The baby that never really existed. Certainly I will never look at a positive peestick with the same joy again.

This post hasn't really ended up where I thought it was going. It was going to be a musing on how suffering is so hard to understand, from an intellectual perspective. But I see that it's too raw, too present for me right now for me to be able to take that intellectual position.

I remain awed and cared for by all your comments over the last three days. Words can't thank you enough.

Bringing the end a bit closer

It pays to say (or type) what you think to your doctor. In writing to Dr Candour yesterday to let him know that I didn't want to take him up on his offer of a consultation, I explained that I wanted to go for the ERPC as soon as they could confirm that things were over. He has just written back to say that he can fit me in next Monday, so he suggests I book my scan for first thing that morning, then come straight over for surgery later that day. Sounds like a deal to me. I need to check with him if being on heparin changes anything, but other than that, consider me booked in.

Just FYI, he said that the reason for their conservatism is that about six years ago in Bristol, a woman was told she had had a miscarriage. A week later things were found to be ok. The same thing then happened again with the same woman two years later. Since then "all units scanning this early have diagnosed a miscarriage over two separate scans." Seems to me I've already had the two scans, but I think because the first one did show (perhaps) a fetal pole, that it doesn't count. At least I understand the protocol now. That poor woman.

Thanks for all your comments. I actually found it harder to wake up this morning than I did to get through yesterday. It's the waking up and realising that things are just going to go on being really bad that hurt the most. I don't have the words to type about it right now, no doubt I will in due course. This is why we blog, right? Anyway, thanks again. 

The beginning of the end

The sonographer looked for ages. I can't fault her for thoroughness. My bowel was in the way so she massaged my abdomen to try and move it. The picture still wasn't great. But it didn't look good. There was a gestational sac. There was a yolk sac. There was no clear evidence of a fetal pole, let alone a heart beat.

She went to get a doctor, who has to view the scan in all cases of a miscarriage. I asked for Dr Casual as opposed to Dr ICU. As the sonographer left the room, H started to sob. I have never seen him sob before. Tears have come to his eyes as I have wept over our misfortunes, but today he sobbed. We sat there, me awkwardly holding the paper sheet over my nether regions, and waited. And waited. And waited. After 10 minutes Dr ICU popped in, noticed there was no sonographer, then left again. I cried some more, thinking that Dr ICU (who I'm sure is a lovely person, but I just don't like him) would be the one to confirm my miscarriage.

Eventually Dr Casual appeared with the sonographer. He'd been doing the transfers upstairs. In the meantime Dr Candour had called down to speak to the sonographer to hear our results, she told us, and had asked them to get a blood test as well. So Dr Casual did a further scan. Lots more pushing and prodding to try and get a good picture, with the same outcome. There was a gestational sac. There was a yolk sac. But there was nothing that could be described as a fetal pole.

The sonographer and Dr Casual agreed that this was not good. Then they told us we needed to come back in a week for another scan. "You're joking!" was my reaction. No, apparently they are not. Because they couldn't get a good picture, they don't want to initiate a surgical 'completion' of the pregnancy, nor do they want to stop the progesterone support and see what happens (I don't want that one either, thank you). So we have to continue with progesterone, and heparin, etc etc etc, for another week.

It's a different week than last week though. There is no hope. They agreed that although there was some minuscule, microscopic, vanishingly unlikely chance that this would work out, none of us really believe in that chance. 7w1d with no fetal pole doesn't really bode well. "If you start to bleed," said Dr Casual, "you must come straight into the hospital." But I'm not actually likely to bleed because the progesterone is keeping everything going. So next week we will return, they will confirm that everything looks shit, and then, hopefully, they will let us have a surgical procedure, which they didn't call a D&C but I didn't catch what they did call it, to 'complete' this pregnancy. Dr Candour has sent me an email saying that he is available this afternoon if I want to see him. Other than showing up and weeping, thus making him feel awkward, I'm not quite sure what this would accomplish, so I think I'm going to say no.

On the way to the hospital the one thing I was hoping for was no more ambiguity. It's not really ambiguity, but the doctors are treating it as if it is. What, precisely, did I do to deserve this?

Limbo defined

In November, many papers reported that a year-long commission on limbo was about to recommend to the Pope that he abolish limbo. I cannot find a news article that says whether this happened or not, so I guess this decision is still in limbo (I know, cheap shot). For those of you who aren't Catholic, the concept of limbo is that it is neither hell, where wicked people get to know the wrath of Gd forever, nor heaven, where they get to be close to Gd forever. Limbo is therefore populated with the souls of babies who never got to be baptised, and those who lived before Jesus could redeem them, but who were otherwise good. They get neither one nor the other. Dante saw limbo as the first circle of hell, but before the gate of judgement. A beautiful but dull castle where righteous pagans resided. Catholic official doctrine never formally recognised limbo, but apparently most people believe in it, making it hard to abolish. Maybe why that's why they don't seem to have made a decision.

Limbo in colloquial terms, of course, simply means being held up without being able to move forward. The Amstrad computer, apparently, used the term 'in limbo'  to refer to files which had been deleted but which could still be restored.  Neither in one state or the other. Sounds pretty apt to me. I'm still here, in our own current limbo. I'm having good days and bad days, or probably more accurately, good moments and bad moments. Yesterday afternoon was a bad moment. I got overwhelmed by the immense need of my mother to talk to me, despite me telling her I didn't feel like talking about it, and the immense need of my family to get me to organise my mother's 70th birthday present, and the immense need of my mother for H and I to show up at her house for tea this afternoon despite the fact we're having a posh dinner with her and the whole family tomorrow, on her actual birthday. I'm fed up with people needing stuff from me, it's hard enough to get through the day with a smidgeon of politeness and niceness for my colleagues, without needing to do the same for my family all weekend. I know they care and they're just trying to show it, but frankly I just wish they'd go off and care somewhere else.

H is also majorly stressed about work, as well as very sad about what is happening to us, and I'm finding it hard to know what to do to help him, he's just so bloody miserable and he doesn't want to talk about it. Instead he just Fs and blinds whenever anything tiny goes wrong (burning the toast this morning, the coffee spilling, his computer going to sleep, the neighbours playing the radio), and finds it very hard to calm himself down.

Yesterday was also not a good day as I had to go shopping for something to wear to a black tie event next weekend. One which I really, really don't want to go to. I am a bit fat right now and looking at myself in a changing-room mirror is all I need to make me feel like a big blimp. I remember when, only 18 months ago, I was on the small side of a size smaller than I am now. So bloody depressing. H and I have agreed that if this doesn't work out, our summer holiday will be at a spa in Thailand where I've been before, where they serve you such totally delicious food that you don't realise you're only eating 1000 calories a day, and there are exercise classes at all hours of the day so you can get fit and relax. And everyone is really really nice to you. The two times I went there before I lost about 8 pounds in 2 weeks which was a great confidence booster. I need that right now.

I mostly feel that we are going to get bad news on Tuesday. It just seems that that is the way our life works right now. Also, I just don't feel pregnant - see below table for the scientific examination of signs that I am or am not still having a pregnancy. The boob thing upset me. They shrunk back sometime last weekend, and my nipples are no longer that bit darker. That was my one compelling symptom! Yes, I know, symptom, schmimptom, but still, don't tell me that those of you with pregnancies under your belt didn't spend a chunk of time looking for those illusive symptoms?

Reasons why this pregnancy might still be continuing	Reasons why this pregnancy might not be continuing
Boobs ache a lot towards the end of the day, bra doesn’t fit well	Boobs are back to a ‘normal’ size, as are nipples back to a 'normal' colour
Round ligament pain, often excruciating
No bleeding; stretching type aches in the uterus-type area	Period-type aches and pains
	No constipation
	No nausea, not even a smidge
Still very tired	Have been working very hard and not sleeping well

I've decided that I want a D&C if there is nothing in that sac this time. I don't want to spend weeks waiting for a miscarriage, and I'm scared of the pain and the blood if we let it happen on our own. And presumably the heparin treatment has some implication here? We'll have to see what the doctor says.

The general lack of feeling pregnant has an upside in that I can sometimes forget that this is happening. And then I get excruciating round ligament pain when I roll over in bed, and I remember. Last Tuesday seems in a way like a bad dream, one in which we are still living. I wonder how this Tuesday will feel. I'm scared. I have to give a speech first thing Tuesday morning (which I should be writing right now), then I head off to the hospital to get the news. I've booked the rest of the day off. I don't know what I'm going to be like. Despite my negativity I still have hope. Just a little. There is still a chance, but the likelihood that we will get given this chance seems so very small.

You were all right, it's been a long week. Two sleeps until we find out either way.

Last night I dreamt...

...that somebody loved me. No, sorry, that was just for Pru and Pamplemousse's benefit.

Last night I dreamt that we went back to the clinic. Actually just I went back to the clinic. One of the embryologists was there with my mother, looking at my ultrasound pictures (not sure how they did them without me but somehow this didn't matter in the dream). They handed me a newspaper article - it looked like the Daily Telegraph - which had a detailed "artist's impression" picture showing my embryos and where they had implanted. That's right, embryos. One had implanted high in the left wall of the uterus - which is where we saw our gestational sac on Tuesday. The other was hard to see but it was right down near the cervix. "That means placenta previa," I noted to the embryologist. He nodded sagely. The embryos were drawn in a vaguely humanoid shape, surrounded by vasculature, and the wall of the uterus showed similar detail.

I then had a conversation with my mother who was very angry about something. She had donated her eggs, but I hadn't used them, and something had gone wrong with the egg collection procedure and one of her ovaries had been messed up. She was in a bed in the middle of the clinic. I tried to resolve things but we didn't quite manage to.

Then I left the clinic and went to meet one of my teams. They were having an outing at a castle. I was clutching the Daily Telegraph article, and kept looking for other copies of the Daily Telegraph to buy. It was a hot day. I realised that I'd left the clinic without knowing if the embryos had a heartbeat. I thought it would have been pretty cruel to give me that newspaper article if they didn't have a heartbeat, but still I really wanted to check. So I was alternately calling my mother and the clinic to try and find out, but no one was answering.

At some point my team wanted to climb up to a burial mound on the top of a very steep hill so I decided I wouldn't join them. I wandered off through the town and came across my sister-in-law to be (not either of my current SILs) who was looking for a place to get married outside. One of our family friends had a great house in this town we were in, with access to a communal garden, and this SIL was scoping it out. She decided it was not for her, but not before we'd spent time in this friend's house, who turned out to also be some kind of cousin with lots of family photos arranged on her piano. The SIL decided to get married somewhere in the US. I'm still trying to call the clinic.

I was very much involved in the dream. It had seemed totally real despite the wierdness. I believed it. Both embryos. Twins. Sometime after that I woke up. And it wasn't true.

7 days, 7 years, what's the difference?

Thanks for everything yesterday, everyone. You are the best. I'm worried that what I'm about to write is going to be self-pitying and ungrateful, so please either cut me some slack or skip this post, probably you should just skip through to next week in fact.

The chances of a successful pregnancy if you don't see anything in a gestational sac at 6w1d are low. They are not zero, but they are low. Yesterday we saw a big, oval gestational sac. That's all we saw for about 5 minutes. After lots of looking around for another sac, looking at the ovaries, focusing up and down, zooming in and out etc., we saw a smudge. A smudge that the sonographer measured and said: that might be the start of your embryo. It's not like there was something clear in there that was just too small. There was maybe something that was like a needle in a haystack to find, and could have been the wall of the sac just in a different plane. Frankly, I don't think the sonographer was sure that it was anything. It's not like she pointed at it and said - there's your fetal pole! She found it just before she was going to give up and measured it for the hell of it. We did not see a yolk sac.

Although the sonographer and the doctor I spoke to in the afternoon (bloody Dr Candour is on holiday AGAIN) both said not to give up, just as you have, it is hard not to despair. I tried to push the doctor to be realistic with me but she kept saying that it was common, although she would not say how common. What I know is IT IS NOT A GOOD THING. It may not mean it's definitely over, but it isn't in any way a hopeful sign. If something does show up next week with a heartbeat, it will be a slow growing embryo, much behind where it should be. That's not good. Don't get me wrong, an embryo measuring not too far off for dates with a heartbeat next week will have me jumping for joy. For at least five minutes until I start freaking out again.

Although after much googling I have not found any statistics (just a lot of articles about Wayne Rooney's foot (try googling: "six week scan" and see what comes up) and a lot of articles by people who can't spell on message boards saying things like: "we had no hrtbt at 6w or 7w and then at 8wks we saw an embryo although the doctor says its too small. The doctor says I'm going to miscarry but I'm trying not to be passamistic (sic) I'm trusting in Gd for a miracle. Don't give up") that say what the chances are, I'm betting it's below 10%. Thank you to everyone who has had this happen to them, Jenn, Nikole and Wendy (on a message board about my hospital). And Catherine, thank you for posting all that information. It does make a difference to know that there is some chance. But even that information said that we should have seen a yolk sac. We didn't.

The fact that there is a chance, however small, makes more of a difference to H than to me. Perhaps because it's a small chance and my life with infertility so far hasn't revolved around being lucky with statistics. He is just that bit more optimistic than I am. I guess it's not hard. And my experience of this cycle so far is that you all have been right to keep on hoping at each stage, when I seem to be floored by disaster as soon as it appears, however vaguely, on the horizon. Either way, it seems much more likely to me that the universe is fucking with me and H again - like Leggy's experiences with blighted ova. Does one blighted ovum a path to donor eggs make? I'm not ready for donor eggs. The whole experience yesterday was so cruel because actually, although I was terrified, I had decided that there was no reason to expect bad news. That the statistics were on our side. That I could hope. Last time I do that.

I did, of course, torture myself yesterday, and it seems that almost every other blog than those mentioned above had a heartbeat at the equivalent stage. Julie's pregnancy with Charlie, Pru's pregnancy, FisherQueen and Lori's recent pregnancies. I'm not posting any more because it's making me cry. If you look through each blog (and I had a good go at this yesterday) you don't end up with much succour.

I'm already calculating when I could cycle again. Probably September given my conservative clinic. I'm figuring out how we could do the Zoladex treatment again and if I'll need another lap. I am sending off my pack of info to Big Guns clinic this week. I'm very not ready to give up, even though part of me feels that I should. I have always always wanted to be a mother. I don't understand why the universe is making it so hard for me, but I am going to keep going until something makes it abundantly clear to me that I just have to find a different path.

*UPDATED TO ADD*

Finally had a no-holds barred converstation with a doctor, in this instance Dr Gorgeous. She agreed that the lack of a yolk sac was a problem. She thought that the fetal pole was a fetal pole, and that 3mm was 'ok'. The size of the gestational sac was good. She said that it was too early to tell, but that next week's scan would be definitive. She put our chances at 40:60 (after much pushing), where 40% is the chance of things going ok next week. At least now we know.

I guess I don't need another category after all

I hate it when my pessimism is well founded. There was a single gestational sac. There was something, after much searching at different resolutions, that might have been a fetal pole. If it was a fetal pole it was not measuring right for 6w1d, it was about 3mm and it should have been 4. There was a sonographer who came out with the immortal line:

"Even in IVF pregnancies the pregnancy timing can be wrong, you might only be 5 weeks."

I thought I'd be kind and not ask her to explain to me precisely how that would work. Our embryos just hung around for a week not developing? That sounds healthy. They implanted a week late? How does that correspond with betas of 251 at 14dpo and 642 at 16dpo? Pretty good betas for an embryo which had only implanted on day 13.

We have another scan next week. My bloody connection is so slow today that I can't google effectively but my guess is that no clear fetal pole at 6w1d means it's blighted ovum and it's all over.

A few weeks ago I said I felt I was being made to go through every infertility hoop, one at a time. I guess this is the blighted ovum/miscarriage or D&C one. I expect the next pregnancy will be the 'see a heartbeat at 6w, embryo croaks subsequently' one.

I saw a chart that said that 85% of women of my age with my beta numbers go on to have a successful full term pregnancy. I guess this was my chance to fall on the wrong side of the statistics.

DBTs and windy days

We're up in the North of England, at our cottage here, for the long weekend. It's a wonderful, peaceful place, and we've been making the most of the sunny, windy weather by taking long walks and exploring our favourite places. I've got work to do but have avoided it so far.

I'm keeping myself busy with the DBTs. My boobs have returned to normal size, and I've still got no other symptoms other than copious amounts of CM. No nausea, no veins showing up, no special tastes or food aversions. I'm just as I always am, with extra lumps in my bum and weight around my middle. Of course I'm having periods of being absolutely convinced that it's all over. I know there's nothing in this list to make that true, but I am panicking nonetheless.

I really upset H this morning by telling him I was convinced that it was all over. He trusts my instincts, after I knew the day before IVF#1 was officially over that it was all for naught. He has regained a bit of optimism after a very blowy walk around the harbour this morning, and has gone out to buy some (hard, pasteurised) cheese for our lunch. Me, I'm not entirely pessimistic but really not convinced either. I keep panicking about how I get through tomorrow if it's bad news. I guess I'll cope, just as I always do. I was about to write that I was hoping that it would be good news but I seem to be beyond hope right now. I just wish I'd develop some bloody symptoms so I wouldn't have to second guess this every time! I didn't bring any peesticks with me so I don't even have that crutch.

Well, this time tomorrow we'll know.

When oh when will I add a new category?

I went to the hairdresser this week. In a bizarre turn of events, she is pregnant. Since her last menstrual period was 17 April, which is exactly 2 weeks before we did egg collection, she is officially precisely as far gone as I am. Although it was an accident, she is thrilled and wanted to talk all about 'going through the pregnancy together' while I was there. When she asked me things like where I wanted to deliver I had to tell her that I was a long way off being ready to even think about that! It made me realise all over again how different things are if you haven't experienced this loss, this difficulty in getting to what seems like just a starting point for every fertile.

Several people have asked questions about protocol etc., so here is a quick recap:

• I am taking 20mg of enoxaparin, which I think is equivalent to heparin, and have been since the day after egg collection. This is to respond to my MTHFR mutation. I've found that mostly I don't get bruises, although I do have a couple of impressive ones where I've misjudged the position of the needle. I've also found that these injections hurt more than I expected.
• I am taking 5mg of folic acid a day, also to respond to the mutation. It's a generic 5mg folic acid pill that the doctors at the clinic prescribed for me. Before that I was just chucking down 12 or 13 of the 400microgram standard pills
• We are doing progesterone in oil, due to my early bleed last time. My husband is doing the injections for me, although the week after next I'm due to go away on business so may have to bite the bullet and do them myself. I now have hard lumps on both buttocks. They're quite sore.
• Our six week scan is on 30 May, next Tuesday, which will be 6w1d in official pregnancy-speak. The Monday is a bank holiday so we couldn't do it at exactly six weeks. Believe me, we would have done if we'd had the chance.

I am very much looking forward to, but am also dreading, that scan. I've been planning how I can drop out of my meetings for the rest of the day if it's bad news. I know that chances are that things are fine. But I don't FEEL pregnant. Yes, my boobs are bigger and they ache, but I'm on megadoses of progesterone. Yes, I get odd abdominal aches and pains, but see above with the progesterone. Two nights ago I suddenly decided that my nipples were darker, and H agreed, but now I think maybe I was imagining things. I'm not feeling sick (nauseous to you Americans). I keep thinking that I maybe I'm about to start, particularly when I look at my breakfast, but then I realise that it's really nothing. On the other hand I don't have any symptoms of NOT being pregnant. I'm not bleeding, not spotting at all any more and haven't done since last Thursday (of course, having written that, I'm waiting for the sky to fall).

I think I'm getting a little better, though. Although I check my underwear every time I go to the loo, which is quite frequently, I'm now not terrified of seeing something. There's quite a lot of dampness there, which I hear is normal, and that's what has sent me running to the loo several times to see if it's blood. But so far so good. At our lovely anniversary dinner on Tuesday night I carefully avoided the cheese course. We even touched on, very lightly, the need to buy a new car if this continues as I won't be able to continue to get in and out of H's sports car. Then we both touched wood and got on with our dinner.

Oh the obsession. It is exciting, but mostly I'm not letting myself get too excited. I wish I could but every time I remember someone else's horrible experience, and I feel chastened. So for now I'll just keep going, trying to let myself be joyful when I can, but also allowing that this is also terrifying, and sometimes it's ok to be terrified.

Knowing your place

Four days after her positive beta, in the pregnancy that resulted in Charlie, Julie wrote a post that says oh so much better than I can how I feel to be where I am. She wrote about the challenge of not knowing her place in the new order of things. Was she still an infertile, welcome in the infertile world? Would what she had to say hurt the very people who had made her journey to this place manageable, bearable? Not to mention the ambivalence that results from the 'wearing nature' of being constantly worried about what might happen. She wrote about feeling guilty about not being happy, that it was almost disrespectful to those who might be envying her, that she'd got this far.

I'll stop paraphrasing Julie now. But the sentiments are there, and I'm sure if I looked there would be a post from each one of us who has passed this particular stage gate on the way to a potential take-home baby. We remember how we felt, writing that 'congratulations!' comment on a fellow IF's blog, then making a mental note that we didn't need to visit quite as often, particularly not when we were feeling fragile. For some of us that means immediately moving someone to a new part of the blogroll. I did that, the first time one of my reads got pregnant. It was Megan. Then a few weeks later she had a miscarriage and I moved her back. I felt awful. Now I don't move anyone til 12 weeks, unless they seem so confident early on that the confidence affects me and I therefore feel safe moving them early. Some people, like pixi and mm, who have had miscarriages before, I moved even later than 12 weeks. I basically move people when I think they are starting to see the pregnancy as something that might work out for them.

Today I saw that someone has moved me to the 'en route' section of their weblog. It freaked me out. Of course everyone has the right to keep their blogroll anyhow they want. I remember Susan saying one time that she moves people immediately - it's just too hard otherwise to hit on those links accidentally and get hurt. So the moving is ok, it's just the idea that others now see me in a different category. One I really wasn't sure I would ever see. And as far as I'm concerned, I'm not there yet. My brain isn't there yet. Although I do absolutely have those moments of joy, I also have moments of fear. And, in particular, moments of worry about hurting those who mean so much to me by what I chose to write here, now.

This is dumb because I know I'm a grown up, just as you are. I have carefully chosen how to read blogs of people who got pregnant in the last 2 years. I chose when to visit, and when not, and I have been genuinely delighted for their good outcomes. Almost never has anything anyone wrote upset me other than in a generic, I'm so fucking jealous of them, kind of way. So I have to assume that that is true for the rest of you, too. We're mostly a pretty empathetic, sensitive group. But somehow getting this positive news makes me fear that I might drop off some abyss into insensitivity and inadvertently upset people. I'm acutely conscious that four of us had egg collection within 24 hours of each other (Nina B's was probably also within a few days of us). And it was bad news for all of the other three. That seems so unfair. The fact that all three of those who got negatives have been here, cheering me on, overwhelms me. I know how I felt last cycle when Lindy and Caroline got their good news while S and I were left with the miserable negative. The graciousness of those three, along with so many others in our community, is part of what makes this community blow me away every time. Thank you again.

In terms of the mundane detail, and although I am petrified to type this, I haven't seen any spotting since Friday. I'm still a bit crampy on and off, but much less than early last week. Also getting slight aches down in each side of my groin which I think is just ligament loosening, although shouldn't that happen later? I'm taking it easy this weekend, and feeling resentful when anyone tries to disturb me. I want to be quiet, to think about what's happening, and to partake of my regular drug of choice, bad television. That's where I'm off to now.

Par for the course

I've spoken before about how superstitious this whole process of infertility has made me (sorry, it's late on a Friday evening and I can't face looking up links right now!). How I look for signs, how I panic about saying or doing the 'wrong' thing - usually something that might be perceived as hubristic. Well, now I'm convinced that the universe WANTS me to be this perverse. The spotting has decreased every day since Sunday, and I've not seen red again since Monday morning. I've been telling myself each day, it's normal, don't worry. But then yesterday, after a very vague smear, hardly worth being called a spot, appeared first thing, there was nothing all day, even after a little digging. I started to feel good. Yes, I thought, there might actually be a baby at the end of this.

Guess what happened when I got home? Yes, I went to the loo, and there was a big browny piece of gunk on the loo paper. It's those damn Fates, they are out to get me. I immediately freaked out again, and had to be calmed down by H, who is actually starting to find this quite amusing. Every spotting incident makes me less optimistic. I know that's nonsense, but it's just the way it is. Today, I probably speak too soon, there has been nothing. I keep thinking I'm bleeding, and I run to the bathroom, and then there's nothing there.

I don't see how anyone who has been part of this community DOES feel confident at this point. I just relax briefly and think how cool it will be to be about to give birth when I celebrate my 40th birthday, and then I freak out, thinking about the great beta numbers and good 6 week ultrasound that akeeyu had. How can one retain any faith in a just universe after that? Not to mention all the other horror stories I've read - Manuela's miscarriage at 13 weeks, LEB's at a similar point, all of Lola's, Pixi's...it's very hard to forget it now that I know it!

Don't get me wrong, part of me is very, very happy. Then I remember in how many messed-up ways it can go wrong and I feel scared. Then I think about being pregnant for the FIRST TIME IN MY LIFE and I feel happy again. Not optimistic, but happy. Then I let my dreams run away with me and I start to feel crampy and I freak out, then I remember what Liana said about how she wished she'd enjoyed being pregnant with zappy when she had the chance, and I resolve to do better...you get the picture. I'm sure this is nothing new to you old hands. And I'm coping ok. I'm tired, and I wish I could bleep right through to 30 weeks or something so I could stop the worrying, but I'm ok. When I need to, those are the times I let myself pee on a stick again, so I can see the line and wonder at the novelty of that being true for me and H, for now. And then H laughs at me for being ridiculous, but I don't mind.

Thank you, thank you. You are all part of this, for me.

642

642.

Amazing.

Spotting be damned (don't get me wrong, I wish it would stop), this is wonderful news! And I am going to be happy!!

I know it's normal to be absolutely terrified

Wow. What a lovely response over the last few days. You are all amazing, thank you so much, particularly to those of you who are in your own personal hell right now. You are all very gracious to be so kind to me.

I'm doing ok. Last night it looked as if the bleeding had stopped, so I rejoiced just a little. Then I had an unbelievably restless night - one of my worst since I was a teenage insomniac. I think it was a combination of stress, excitement, and physical discomfort. I had a good two hours sleep until about 12:30, then woke up and tossed and turned til about 01:10, then moved to our guest bedroom, read for a little then tossed and turned some more til 02:30, then I got up and went to watch television, which is usually a soporific for me if I am tired. After about 5 minutes of television I realised I really didn't want to watch anything, turned it off, closed my eyes, and woke up again at 06:30. So I didn't do too badly on total sleep, it's just that it was all a bit fragmented. I tried counting sheep, I tried my other counting technique which I used to use as a teenager to try and send myself to sleep, I tried meditating, nothing worked. I'd start imagining names for a baby, then I'd freak out at the hubris of it all, then I'd get tense because I had sharpish pain in my left side and I was worrying about an ectopic, then I'd feel damp between my legs and freak out that I was bleeding again...you get the picture.

This morning there was a little more blood first thing when I wiped, but it was brown and there wasn't much. Since then, nothing. I'm terrified to write that in case it's tempting the gremlins, but I've been truthful before on here so I might as well continue. The gremlins can't get all of us, all of the time. I'm having lots of abdominal aches and pains, but nothing so bad I'd want to take painkillers, yet. I've sort of decided to go for the next beta tomorrow, even though part of me doesn't want to know if it's bad, and because I know if we were losing one the numbers might not double. I've done the maths and either it/they implanted REALLY early (like day 5 or something) or the hcg was more than doubling every 48 hours (one of the many sets of sums I did in my head last night when I wasn't sleeping). So that seems good.

I feel very incoherent, I'm sorry. I am both excited and terrified. Aware of everything that can go wrong and excited about what the world might look like if it goes right. All those comments about early bleeding yesterday really helped me, as did a conversation with a real life friend-of-a-friend yesterday who told me she had bleeding throughout her IVF pregnancy, and of course it freaked her out every time, but that everything was great in the end. I do remember the article that mm mentioned in the comments yesterday. I thought it was from "A beautiful day" but I can't find it now. Anyway, I know that a bit of bleeding is relatively normal, but I also know that any bleeding is not a good sign. As Julie said once, it might not be a bad sign, but it's not a good sign either. So I remain, cautious but quite happy in between my freakouts. Thank you again.

My own personal soap opera

Beta is 251. My memory is that that is pretty high for day 14. So hopefully it's too high to be on the way down already?

Doctor says there are 2 possibilities: we're losing 1 of 2, or it's just a 'normal' early IVF pregnancy bleed. Of course presumably there is also the chance we are losing both, but the bleeding has slowed so I am a tiny bit hopeful. Nowhere near how I felt early yesterday morning (was it really only yesterday?), but not despairing, either. I can only imagine how overwhelmed with happiness I'd be with a number like that if I hadn't had any bleeding.

I have to call this afternoon to make an appointment for 2 weeks time for a scan. I'm allowed to go in for another beta “whenever I want”, although they don't usually do them. I think I might want.

12dp2dt: who knows what is going on

I did what you all said and retired to the sofa yesterday afternoon and evening, drank lots of water. Bleeding continued but never got as far as the pad, just there when I wiped. Overnight it seems to have stopped, what is there is, is brown. Unfortunately, however, the FRER this morning was only just positive. Not the kind of positive you have to squint to see, but definitely one you have to look at a few times to see if it's there. Probably about half the thickness of yesterday. Which means, that, sadly, option 3 from 2 posts ago was probably right. The beta today will be positive, but I am losing it. I feel like I'm being made to jump through all the hoops of infertility, one by one.

And it's ok, I'm not going to work today.

11dp2dt updated: That was a short dream

Since my earlier post I have watched some bad television, slept for two hours, had a lovely breakfast cooked by H, gone for walk to buy a wider range of peesticks, saved up the pee for a few hours, peed on two new sticks, seen a positive on both...and started bleeding. And I'm not spotting, I'm really bleeding. Not enough for a tampon, but enough that there is blood, red blood, every time I wipe. It must have started about 20 minutes before I went upstairs to pee on the new sticks. Life just sucks sometimes, doesn't it?

11dp2dt: In the blink of an eye

It seems that our local supermarket doesn't stock pregnancy tests. Or if they do they are behind the counter of the pharmaceutical area. But I couldn't see them there, and decided to be good and not ask the pharmacist. I did walk up and down the 'toiletries' aisle several times just to see if I could spot them, including once after I'd already paid for the rest of the shopping. I decided to take this as a sign, and went home carrying my minimal supper-related shopping. It will be good, I thought, to have another day of not knowing that things are negative.

H sent me to bed early last night as I was knackered after a restless night the night before. On the way to bed I remembered that over a year ago I bought a pack of 'clear blue easy' digital pregnancy tests. I also remember someone else saying that these aren't very sensitive, and, indeed, when I read the instruction leaflet it says that it works from the day that the period is expected. Unhelpful, I think, I'd better not use that as it won't be conclusive and I'll just have another day of wondering. And of course I don't really want to test, do I? I want that extra day of hoping.

I don't remember my dreams, but I do remember tossing and turning for a great deal of the night. At about 0350 I woke up pretty completely as I was feeling cramping again. Not the kind of period cramp that wakes me up with its stomach-churning pain, but cramping nonetheless. I had a little root around but of course it was dark so I couldn't tell what was on my finger, although it didn't feel sticky. In addition the birds were having a party in the trees outside our window, which was somewhat distracting. I lay there, willing myself to go back to sleep, but realising that I had to pee. So I had a debate in my head.

"You won't be able to go back to sleep anyway, you might as well get up and at least make sure you're not bleeding"

"But if I get up I'll definitely have to pee, and that will waste the FMU. So if I am going to test I must test as soon as I get up"

"But you don't really want to test! How will you feel if it's negative?"

"Let me think about that. Hmm. Ok, I'm looking at a positive test, how do I feel? Overjoyed, elated! I'm looking at a negative test, how do I feel? Disappointed, frustrated that the test isn't sensitive enough."

"Not despairing?"

"Let me check. No, not despairing. Not happy or anything, but resigned to wait til tomorrow for the real answer"

"You realise that it's 0415 in the morning don't you?

"Yes, what of it, I'm not sleeping anyway"

"But if you get up that means you have only had 4.5 hours sleep, you'll be a basket case"

"But it's Sunday tomorrow, I can sleep all day if I want to, and anyway, I've tried to go back to sleep and it's not happening."

At that point, I rolled out of bed, collected my water bottle and my book from the side of the bed and crept to the bathroom. Slowly opened the cupboard under the sink so it wouldn't creak too much, and picked up the box. I brought it downstairs. Went to our downstairs bathroom, and turned on the light. Wiped to check on the bleeding. No sign of any blood. I lent on the shelf above the boiler and stared at the pregnancy test box. And stared some more. It stared back, no answers from that particular piece of cardboard.

I decided to seize the moment. Ripped open the box, and the plastic cover to one stick, inserted the stick into the holder and peed away. Trembling, I put the holder down while I went to flush and to wash my hands. When I went to pick up the towel to dry my hands, there it was, looking at me. A sign that says: Pregnant.

Pregnant.

I checked carefully to make sure that I wasn't missing a 'not' somewhere. But no, it definitely says 'pregnant'. It's now 0430 and I decide that even so, I am going to wake H. I run back upstairs and gradually wake him. He wants to know why. I tell him. He asks me not to turn the light on, then he says, no do turn the light on, I want to see. We turn on the light and H grabs the test and stares at it, laughing. I'm shaking and nearly crying and holding his hand very tightly. We discuss everything it might mean. H believes the clinic when they say that these things aren't accurate so early. But I point out that it's false negatives rather than false positives that are the problem. False positives are rare. We agree that there are three possibilities:

1. I am pregnant
2. I am not pregnant and this is the 1 in 100 clear blue easy digitals which is giving a false positive reading
3. I am pregnant but the numbers aren't doubling or are fallling and the test tomorrow will be ambiguously low (say, below 50) and they won't be able to give us a definitive positive, and the pregnancy will fail

We agree that later today we will go out and buy another brand of tests just to check on option 2. And we agree that variations of option 3 won't leave us for several weeks, even if the numbers tomorrow are good, I will be anxious til the first scan, and then til the 12 week scan again. But we agree to be cautiously happy for the time being.

After more hugging and nearly-crying and laughing and shaking (mostly me) and smiling and hugging(him) I turn off the light and leave H to go back to sleep and come downstairs again to write this. I'm still bemused. I didn't expect anything so unequivocal. A positive within 30 seconds of finishing peeing. It's a good sign. I don't quite believe it yet, but I am happy. Scared, tired, anxious, elated, petrified, happy.

It's 0513. It's getting light and the birds have chilled out a bit. I'm going to find some old film on the television and see if it will send me to sleep. Not sure that it will work, but it's worth a try. I'm amazed that I am here, at this moment, at our kitchen table with a test that still says: "Pregnant" sitting next to me.

10dp2dt: A dream

I'm still not bleeding. I don't think I will now until things are decided (or hopefully, not bleed at all), I think that the PIO is doing its job. I do have a constant, well, I think you'd have to call it a feeling more than anything else, in my lower abdomen. It's not exactly cramping, it's more a fullness, a constant reminder that something is going on there. We'll see.

I'm less of a basket case than I was earlier in the week. I've realised that the prospect of starting to bleed early again was really, genuinely terrifying me. Once that barrier was over I got a bit slap-happy. I realised that I was in danger of believing that it must have worked. That the removal of my biggest fear for this cycle meant that I was back in that state of hopeless optimism that many of us were in during our first cycles. Why should anything bad happen now, haven't we solved a bunch of issues that came up in the last cycle?

Then I felt crampy again on Friday afternoon and remembered what it was like to be freaked out. But to be honest, I think I am scarily hopeful right now. I had an incredibly vivid dream last night. I dreamt I was bleeding, that it was all over. I had to go to the hospital to get checked out. It was one of those dreams where nothing works quite right - cars kept taking me to the wrong place, I couldn't find H anywhere. After some happenings that I can't remember, Dr Condescending handed me a colour magazine opened to a double page spread which outlined a long, very detailed, very small font explanation of what was going on - with lots of feedback loops etc. - it was all to do with progesterone metabolism and natural killer cells. The font looked like handwriting, but wasn't. (why I can remember so much about fonts in my dream, I have no idea). One embryo had implanted, setting off a reaction, which caused the bleeding but somehow enabled the other embryo to secretly implant. Although then the first one had implanted, too, as my beta (carefully written into the middle of this complex tract) was 240. I was to be admitted to hospital in order to manage the immune response I was having, and my bed had to be turned to the wall, which I thought was funny. Then they told me that if I went home and stayed home that would probably be better than staying in the hospital.

A bunch of other stuff happened, too, which is just a vague memory, but the dream was very real. I don't believe in dreams as 'signs' in any way - after all, last time I spent the night before I started bleeding dreaming that I was pregnant - but it was nice to have such a positive outcome to a dream that started badly.

My current positivity is the reason that I think I'm wanting to pee on a stick. I still have the fantasy of showing it to H, of that being how I tell him that we are pregnant. Of course, I still might not be, but somehow that doesn't seem as real right now. But I do have a realist part of me that is telling me not to pee, that it's better to have two more days of hope before I get the bad news. I keep thinking about how I get through next week if I am pregnant, alternating with knowing how hard it will be if I am not. I have a big conference to go to on Wednesday and Thursday in Germany, and either it will be a case of trying to give myself the PIO shot while I'm there, or it will be coping with the post-IVF bleed. I'd rather it was the first, funnily enough.

In the meantime, Vanessa has had some bad news from her cycle, please go and give her some love - although her site sometimes doesn't load, do keep trying.

H needs me to go to the supermarket to get some stuff for dinner. The question is, will I manage to avoid the peesticks?

9dp2dt: 1 day's reprieve

I'm not bleeding. I don't think I'm anywhere close to bleeding. Consequently I feel wonderful, which is probably just as stupid as how awful I was feeling the last two days. But I've decided to take my mood swings at face value and let them happen. Of course now I'm going to be even more devastated on Monday if we get bad news, but that's life (if we get that far, of course. Must keep saying that). I think I'd be pretty devastated if it's bad news on Monday anyway, so being in a good mood now won't make that much difference. It's amazing how pessimistic you can feel and still have Hope sitting in a corner of your brain, saying, "It might have worked, you know. Those pains, they were different than anything you've had before!"

Linda asked about why I bled last time at 8dp3dt. Good question. We should start by reminding ourselves of why we have to be given supplemental progesterone. At the beginning of IVF treatment, no one had any idea that this was required. Eventually they figured out that the disruption of the follicles during aspiration means that they do not go on to start their progesterone synthesis a day or so after ovulation in the way that they should. Although many women did get pregnant in those early days without progesterone supplementation, too many did not. Progesterone supplementation became the way to go. There is still much debate about how long it needs to be continued. Most studies show that you can stop after the luteal phase and get the same live birth rate as if the progesterone is continued throughout the first trimester because by then the follicles have recovered, are forming the corpus lutea that they should have become in the first place. Continuing progesterone support through the first trimester results in an increased rate of late miscarriage - i.e., the progesterone support is 'allowing' pregnancies that would otherwise have ended to continue.

Last time I used the progesterone suppositories rather than the PIO. At my clinic the suppositories are the standard treatment as much clinical evidence shows that there is no difference in clinical outcomes between PIO and intravaginal support, and most people prefer the suppositories to sticking themselves in the ass. Although, I have to say, I've read a lot of the papers on this and they are not exactly conclusive - plenty say that IM progesterone is better so I imagine that Dr Candour and team are partly going on published studies and partly on their own experience. They use anal suppositories here, and you do them at night, so you don't get any leakage. No side effects of smooth thighs and messed-up underwear. In addition, it is not true to say that you will not bleed while the progesterone continues. In one study, 67% of women bled before IM progesterone was discontinued (admittedly, at an average of 16.2 days after retrieval, so I am a bit wierd). Actually, recent work says that hcg might be better than progesterone support, but I guess it's too early for them to be switching.

However, since I bled at 8dp3dt on the suppositories, clearly something was wrong. I have a short luteal phase on my regular cycles - anywhere from 10-12 days, but averaging just under 11. That might indicate a progesterone problem, but my progesterone a week after ovulation was a "text book excellent" value of 59 when it was tested 15 months ago. So it's not the absolute level which is the problem. Apparently, though, everyone's body uses progesterone in different ways, probably due to genetic variability in the chemicals which metabolise progesterone, so testing the absolute level doesn't actually give you the answer. Dr Candour decided that PIO was the way to go, just to see if I was the one case in a million where it made a difference. So far he seems to be right.

That's enough science before breakfast. Onwards and upwards.

8dp2dt: 1 day from disaster?

You know, I'd forgotten how fucking dificult the two week wait is. I wonder if it's like childbirth. Not that I'm that well informed about childbirth, you understand, but I've been told that after you give birth you forget how awful the pain was. That this is 'nature's way' of ensuring that you are prepared to go through it again. Do you think the 2ww is the same? Of course, I remembered that it was shit, and I've posted on enough people's blogs to get regular reminders that it sucks, but I had honestly forgotten just how unbelievably stressful and anxiety-making it was.

As you can tell, I'm a basket case. I am managing to hold down my job because it's a good distraction mechanism from all the pain, but it's not distracting enough that every time I feel a cramp, I don't freak out. Even though I have never started bleeding on day 10 of the luteal phase before, I am still rushing to the bathroom every 2 hours to check that there is no blood. So far there is no blood. This morning there were no cramps, but this afternoon they are back again (I document this, you understand, for my future sanity should I have to do this again. Last time I was scarily slapdash about recording every symptom). Luckily, so far, they are not dull, achey period-y pains, but more sharp cramps, often around the ovaries. So I am not despairing yet, although I was earlier this afternoon when I thought I felt the onset of achiness. So I don't know what's happening, I just don't know.

So my first battle is to wake up tomorrow and not find blood on the toilet paper. That would be a little mini-victory. And then I guess the second mini-victory would be to do the same on Saturday. And then Sunday, and Monday. I have never had a luteal phase of longer than 12 days before, so being blood-free until Monday will be a major win if we get that far.

If we get that far, I am tempted to pee on a stick over the weekend. By Sunday it will be 11dp2dt and we should be able to see something if there is anything. However, H has asked me not to test. He wants to go with what the doctors say, which is that urine tests are unreliable this early, and blood tests are the only way to go. I know that Suz, for one, might agree with him. He knows that if it's negative I'll freak out, and he wants me to stay positive as long as possible. I don't know. I don't know if I can last that long. I don't currently have any peesticks at home, except for maybe an old clearblue digital, but I know that that one is not accurate enough to use this early, so I'll have to go shopping before I can indulge myself. Part of me doesn't want to find out, however - the part that wants a pregnancy to stay a possibility for as long as possible. That might mean just until tomorrow morning, or it might mean until Monday. Or, if I'm really, really lucky, it might go on longer than that.

It goes without saying, but I will say it anyway, that you are all wonderful and I honestly can't imagine doing this without you. Thank you so much for all the support.

7dp2dt: 9 days

I'm grumpy. I woke up grumpy. I'm grumpy because my dreams are filled with anxiety. Anxiety is manifesting itself in my dreams in a way that I can't remember once I wake, but it leaves me with residual grumpiness that isn't much fun. In reality, I'm terrified.

Last time, I bled on the 11th day after retrieval. The equivalent day this time would be Friday of this week. I've been having vague cramping since Monday. I know that this can be the progesterone, and I know that it can be the uterus stretching, or the ovaries shrinking back to normal size, or just my peritoneal cavity having a party, but it makes me think of last time. Of how I felt on that Monday evening, feeling cramps and just knowing that the cycle was over. This has been compounded this morning by relief from my post-transfer constipation. Yes I've been eating lots of fibre and drinking lots of water, but the same thing happened around the same time last time. So suffice it to say, I am not feeling optimistic. I'm trying to send warm loving thoughts to those embryos, but then I think, well, they're probably dead by now anyway, so what's the point. I suck at all that visualisation stuff, anyway, my brain always moves onto something else quickly, it's hard for me to keep it still.

I did something stupid this week which didn't help the grumpiness. Ages ago I said yes when asked to sit on a panel of senior women for an internal conference. This Monday was the conference. As each woman introduced herself, she said: I'm X, I have three children, who are 9, 7, and 4, I work in blank, I've been on a part time programme since Y, and am delighted to be here. I was the only one on the panel with no children. Having children and working was not the official topic of the panel, but it certainly felt that way. It didn't end with the introductions, either. People talked about their maternity leave, and how progression through the company felt different when you've got a child, and blah and blah and blahdiblah. It was awful. At the end the audience said thank you so much for coming, and we all got a bottle of champagne, and then I went back to my office and cried.

It's just so hard not being able to do anything to help this to work. It's up to my body and those embryos to figure out if they are a good fit. And there's nothing I can do about it. There isn't a single minute of the day (or night, apparently) when I don't think about it. But it isn't up to me. I wasn't going to type that I just want to get through to the blood test without bleeding, because I did that last time and it didn't work. But I do. I want to get through to that blood test and out the other side. But what I want has nothing to do with it.

3dp2dt, 6 weird things

Apologies to those of you who tagged me for this, I was saving it for this difficult period, where there is no cycle drama to post about and "a week on Monday" feels like a life sentence.

Speaking of life sentences, I've been watching, with fascinated horror, the occasional episode of "Test Tube Babies" on Discovery home and health. It's a UK programme, enjoyably amateurish with an incredibly irritating voice over. Each episode follows one couple going through an IVF cycle and one couple who are about to give birth after IVF. The cycle stories mostly seem to end badly, with couples getting a negative result. All the birth stories are positive, I just can't relate to them so I mostly channel hop while that bit is on. Anyway, the point was that the culmination of the cycle bit is that all the couples are filmed at the moment of calling the clinic or being called with the results. I cannot imagine getting that news with a camera in my face. And of course they all break down, with tears of joy one way, or tears of despair the other. They all seem to get the news as a couple. Maybe that's in their contract. I'm still fretting over how I'm going to figure out how to get the news on Monday 15th, with continuing to act like a professional and pay attention to the all-day review meeting I'm supposed to be in. So far my best idea is to get the clinic to call H, and he will figure out how to get the news to me. I don't want the news while I'm at work, but will I be able to wait? And then I kick myself for even believing we could get as far as Monday 15th and still have hope. And then I kick myself for not being more optimistic. Gosh this is fun, isn't it!

Anyway, I promised six wierd things. This was really hard.

1. I am obsessive about accurate writing and, in particular, punctuation. You don't see it on here because I type these posts so fast that sometimes errors get through, but in real life I am a terror. So much so that at a recent team kick-off, when asked about my most annoying habit, a colleague volunteered my continual proof-reading as something that drives him bananas. I dislike errors so much that I can't read some blogs because their owners don't spell or punctuate well. I know it's bad, but it just upsets me so much it's not worth it. And don't even get me started about the boards...

2. Punctuality. I am not punctual, but being late really makes me tense and upset. I cannot figure out how I manage to combine these two traits and not drive both myself and my husband insane. Well, I do drive my husband pretty much insane, but I somehow potter around getting ready for some event with no sense of impending doom as the time of said event starting gets ever closer. This is despite, or, I guess, because of, having spent my childhood being tense because my parents were ALWAYS late for any school event. I do,  however, have a good sense of just how late I can cut it and still make that train/plane. I've never yet missed a plane (touch wood).

3. I drink a lot of water. Really a lot. To the extent that I got myself tested for diabetes, as constant thirst is one of the symptoms of pre-diabetes. But I don't have diabetes, I'm just thirsty. As are my father, my aunt, and my brother. We must have a thirstiness gene. This has the advantage that I have a well-trained bladder. Don't get me wrong, I pee a lot, but I can also drink a lot in between peeing. So lying on a gurney after embryo transfer holds no terrors for me.

4. I am overly sensitive to being made a fool of. Some might describe it as having no sense of humour. This is combined with a strong ability to mock others. Which isn't fair really. As an example, a team played an april fool on me last year where they tried to persuade me that an absent team member had been drinking too much for ages. I didn't believe them, and kept telling them to raise it with him. Then he walked in and they all cried: "April Fool!" I burst into tears. Yeah. Made them all feel shitty. I was relieved that April Fool's day this year fell on a Saturday.

5. As a child, I lied a lot. I lied mostly because I wanted to fit in. So, for example, if a friend told me that her brother played trombone, I'd say: "Mine too!" You can see how that got me into trouble. But somehow I always continued to insist I wasn't lying. This had the unfortunate effect that my mother didn't believe me when I was telling the truth, like the time the ink got on the ceiling of our dining room. I honestly didn't do it!

6. I have an incredibly low boredom threshold. I have to have noise around me. When I walk into the house I turn on the television. When working I have my itunes playing. When I start to work I compulsively check my email or blogs before I can get started, and then I get distracted while working and do something else. This means that I always work right up to a deadline. I get stuff done, but with much more last minute angst than is strictly necessary. My shrink thought it was to do with me being frightened of how powerful I'd be if I let myself concentrate. Hmm.

Hope those are wierd enough. Everyone else seems to be on to the next meme now, so I won't tag anyone. Thanks for the moments of pause you gave me.

Three of five makes six

Can't get over my borg-like naming structure for these posts. It will persist for this post, then I'll have to retire it. Herewith the wrap up post with the bits I couldn't bring myself to type.

Heleen asks: why are we doing PIO?
Because last time I bled at 8dp3dt which of course is much too early for anything to be successful. Although the clinical evidence suggests that there is, in the general IVF population, no difference between the suppositories and PIO, Dr Candour felt that I might be the one patient in a million to whom it makes a difference. This despite my post-ovulation progesterone rating of 59 ("textbook excellent according to Dr C) when it was tested on a natural cycle over a year ago. Apparently everyone's system responds differently to progesterone and so the numbers don't always tell the whole story. Anyway, if I post here next Friday saying I'm bleeding, we'll all know that that particular experiment didn't pay off.

Lots of people ask: what happened to the other three embryos?
All three were frozen yesterday. There was one other good four cell, a good three cell, and a dark and miserable looking "average (arrow down)" three cell. They froze all three even though that last one clearly isn't making babies any time soon. That means we now have six frozen, four of which there is some hope for. Which is ok.

I mentioned "if it's twin boys" a while ago...
I mentioned this as something that would freak me out, not my dream scenario. My dream scenario, despite all I know about how difficult twin pregnancies are, not to mention looking after twins, is boy/girl twins. Because then I wouldn't have to worry about getting pregnant again. I know, first of all, that I am tempting fate, and I know that wishing for twins is stupid because of how badly things can go wrong, and how difficult it is to cope when they are born. But it's all so unreal that right now, hoping for it doesn't seem too scary.

If it's twin boys, we'll just have to wait and see what we'd do. H would be fine with it, but like many of you, I have always dreamed of my daughter. In this generation of cousins, both my brothers have boys, and H's brother has two boys, so the whole family could do with a bit of balance. Twin girls? I'll have to negotiate with H. A singleton of either gender? We'll at least attempt to use the embicicles. But you know, it's all very hypothetical at this point.

How much time am I taking off work?
Despite one of my colleagues telling me that she took off the whole IVF month both times she did successfully did IVF, I am off this week, then going back on Monday. I know there is no evidence that working/not working affects chances, but my job is pretty full-on. Although of course there are others in this community with similar kinds of stressful jobs, who've got pregnant so I know I am not alone. My main concerns right now, are,
(i) the guilt at not being at work today and tomorrow. I feel fine, with just a bit of twinging. I am doing mild bits of work from home, but that's a far cry from what I'd be doing if I was showing up. My people are all ok without me, but it's hard to hear what they're handling and not feel like I should be there to support them.
(ii) how I cope the day we get our beta. It's scheduled for 15 May, which is a Monday. I'm supposed to be all day in a review committee, I can't just duck out as I did last time I got a negative result. We can't get it done on Sunday as they don't get blood results on Sundays from their lab. I think I'll have to POAS on Sunday at the latest, assuming, of course, that I dont' just start bleeding again. That would really suck. Ha.

I'm not feeling optimistic, but I'm not feeling pessimistic either. Everyone at the clinic yesterday kept telling me that things looked good, that I should feel happy. And that it would make a difference if I did feel happy. I think they were sneakily 'just relax'ing me. Isn't that immoral of a clinic to spin that line? If you don't get pregnant, it's nothing to do with us, it's that you weren't happy enough. Bastards.

Speaking of which, I'm going to write to Dr Candour to ask if I should prepare to go back on zoladex if we get a negative. Don't want the endo to grow, after all. Nothing wrong with being prepared.

Two times four

We transferred two good four cells at 1130 this morning. Dr casual did the transfer. He wasn't as good as Dr Condescending. Decidedly cack-handed with the speculum, but at least he was nice about it. The nurses stood in between me and the screen, so I saw nothing until it was over, but H had a good view. At the end they showed us the bright light of the liquid that carried our embryos, high up in my uterus. Let's hope they know what to do now they're there.

We were not allowed to transfer three. Dr Candour had ruled overnight that we did not have the “extenuating circumstances” that would be required by the HFEA to allow us to transfer three.

The two that we did get to transfer were both graded “good”. One was close to perfect. No fragmentation, cells in the right orientation to each other, generally quite impressive. I'm calling it Buffy. The other was a little less good, although the embryologist insisted it had every chance of making good. Around 5% fragmentation, calls looking a bit clumpy. I've named it Faith. When I finally get back on a computer I will put in some links so that those of you not well-schooled in the buffyverse can have some sense of what I'm going on about. H wanted to name them Bill and Ben (after the flowerpot men, of whom I'm 90% certain you've never heard), but I've unilaterally decided that that is a failure of the imagination and I don't want twin boys, after all.

Of course all that is out of my hands now. We have what we have. Let's hope they find their new environmant nice and cushy.

PS H did my PIO shot this morning and it didn't hurt at all! Any advice on how to do them myself much appreciated. I can't figure out how you get the angle right.

Five of nine

Just got the fertilisation report. To say I am disappointed would be an understatement. Although I knew that every cycle is different, I had not expected us to go from 100% fertilisation last time, to 55% this time. My hopes of having enough in the freezer to try again without a fresh cycle are now dashed. I know I should be grateful, but I'm sad.

The embryologist was really sweet. We had a long discussion about day 2 versus day 3 transfer. He told me that their stats are equivalent, and that they think they can grade the embryos pretty well on day 4 given the orientation of the cells, fragmentation, etc. He says freezing works better earlier, too. So he's persuaded us to go for day 2. He's also (at my request) going to talk to the docs about whether they will let us transfer 3 - which legally in the UK they can't do with a woman under 40 unless there are extenuating circumstances.

He could sense that I was really disappointed, and kept saying: “you should be feeling great, this is within the normal range for an IVF cycle, please don't be discouraged.” It was very kind but hasn't lifted me out of my discouragement.

I've been sleeping a lot since we got home yesterday, apart from going to the clinic early this morning so the nurse could do our PIO shot. They are legally not allowed to teach H how to do it in case something goes wrong, but the nurse this morning said she'd just talk through what she was doing very, very slowly and if H wanted to listen that was ok with her. Funny that a UK clinic should be so sensitive about this when US clinics send you guys home with instructions.

H is working from home and is hogging the broadband, hence my need to post from the blackberry. Thanks for all the good wishes. Transfer tomorrow.

Nine

They got nine. I have to confess to being a bit disappointed, but H keeps telling me that we should be thrilled with getting 50% more than last time. I'm also feeling much less pain than last time, I guess they didn't have to poke me around so much internally. We're just waiting now to see an embryologist to discuss whether we'll do a day 2 or day 3 transfer. I feel strangely deflated - emotionally rather than physically. Perhaps I wanted more drama?

Fear factory

I'm scared. As always, I'm worrying about the myriad things that could go wrong from here.

1. I'm worried that I will have already ovulated before retrieval tomorrow
2. I'm worried all those follicles will be empty tomorrow for some other reason
3. I'm worried that they'll have eggs, but the eggs won't fertilise
4. I'm worried that the eggs will fertilise, but then conk out before transfer
5. I'm worried that we'll have embryos to put back at day 2, but that I won't get pregnant because day 2 is too early to tell if those are the right embryos
6. I'm worried that I'll get mildly pregnant, with an unhopeful beta, and then miscarry
7. I'm worried that I'll get pregnant, but that there will be nothing on the scan
8. I'm worried that I'll get pregnant, and we'll see something at the scan, but that I'll miscarry after that
9. After that, I'm just worried that something else awful will happen - horrible genetic problems, stillbirth, cot death
10. Cheery type, aren't I?

Actually, anything after #6 seems quite unreal to me. I've been alternating between imagining myself pregnant, with being terrified about being pregnant, and with being terrified at how I will cope if we don't get pregnant. If I start bleeding at 8dp3dt again - or 9dp2dt it will be this time - it will be a Friday, and I'm pretty booked up on that day. Last time I was able to cry off from work and do phone calls from home, it will be harder to do that this time. The beta will be on a Monday, if we get that far. I wonder if I can get them to do it on a Sunday, instead? They keep telling me they don't get blood results at the weekend, but that seems impossible. Perhaps they just don't get non-urgent stuff? I'll have to ask tomorrow.

I also have to ask tomorrow how to do the PIO injections. H is very nervous about doing them, but is prepared to suck it up if he has to, but he's going to need a nurse to hold his hand - metaphorically of course - for the first one.

I did do a Puregon injection yesterday morning. The doctor hadn't given me a clear downside reason, so I did 250 instead of 300, as a compromise. That nearly-finished 900mIU cartridge was just sitting there in the fridge, taunting me. Afterwards I freaked out and wished I hadn't done it, but it was all too late. Please, universe, let this not be my undoing. This is the direct cause of #1 above. It was so very hubristic of me, that I'm now waiting for my Nemesis to arrive. That's the way it always works, right? Only perhaps with all the hubris in the world, I could be let off the hook this time? Let's hope so.

I'll post the news from my blackberry tomorrow.

The final push

I'm feeling grumpy because I just got my upward feedback report from work, and it's only just above average for my peers. It's not bad, but I feel very frustrated. I've tried so hard in the last 6 months not to let any of what I'm going through affect people at work, after my feedback in the autumn showed that it was having an impact and people could tell my heart wasn't in my job. So although this one is better, it's depressing that it's still not great. Although I have figured out that this one includes the whole year, not just the last six months, so the last six months must have been considerably better to have lifted me back over the average. It has still made me cry. I just want there to be something in my life that I am indubitably great at, and I thought it was my mentoring of my staff, but apparently not. That's very disappointing.

Which is annoying because today brought good news again on the cycle. We have 13 follicles, people, count them, 13! Two are so small they won't do us any good, but still, to even be able to measure 13 is pretty miraculous to me.

• On the right, still over-achieving: 20, 18, 17, 16, 16, 15, 15, 13
• On the left, still sulking: 19, 16, 16, 12, 11
• E2: 4992 (1360 US)
• Lining: 11.6mm

It was a bizarre experience to lie there and see all those follicles in the right ovary. Each one overlapping with the other as she moved the wand around. I don't know how the ovaries of those of you who produce 27 follicles have room, this one looked pretty full up!

I got my prescription for enoxaparin, to be started the day after egg collection. H is going to the chemist's this afternoon to get some extra folic acid to take on top of my ironic prenatal. On the one hand on this cycle I have done much less to try and control how things turn out - no acupuncture, no wheat-free-ness, no fertility yoga; on the other hand we are doing much more medical intervention. Let's see if it makes any difference.

The instructions are to do the orgalutron injection tomorrow morning but no puregon, then do the ovitrelle injection at 10pm on Saturday night, collection on Monday. I am suspicious about the no puregon because I'm keen that those 15mm babies catch up. I discussed with Dr Gorgeous what the downside to taking it was, and she said they're concerned that my E2 will go too high, and that I'll be overstimulated. With this many follicles that seems unlikely, and I am tempted to go ahead and do a final puregon injection tomorrow. Sacrilege, I know, ignoring the doctor's instructions, but I think this is another incidence of them being over-cautious and the downside doesn't seem very bad to me. We'll see how I feel at 7am tomorrow. I'll keep you all in suspense til then.

Twitching

I have a sense, just a little teeny weeny one (as much as someone who has never seen the two pink lines except that one time when we didn't do an IUI when I peed on the stick after the hcg shot just to see what it would look like) of what it might be like to be pregnant and to be worried about symptoms coming and going. Over the last two or three days my ovaries have been getting increasingly uncomfortable. On Sunday at my parents-in-laws, I was getting these stabbing pains that caused me to wince, and everyone kept giving me these concerned, but slightly freaked-out looks, until my four-year-old nephew just looked straight at me, and announced: "Aunty Thalia's making funny faces Mummy!" That got everyone laughing which was probably a good thing.

Between my back pain and my ovary pain I'm quite the cripple. I have to bend over slightly when I walk and I can't walk very fast, which is completely unlike me as I am the woman who disappears in crowds by zipping through the gaps. In addition I'm now limping because my right calf muscle has seized up. I don't remember these kinds of stabbing pains in my ovaries last time, and I can't find any record of them in my posts, so I've been seeing them as a good thing. Although of course what it could be is lots of lovely endo growing on them in response to all that great oestrogen floating around. I can also feel my ovaries as hard, tender balls on either side of my abdomen. Good thing? Bad thing? It's a thing, anyway.

Yet today, the stabbing pains are not happening nearly so much. So I'm immediately freaking out, thinking maybe the follicles are shrinking as I type. Of course I do know that's nonsense, but it still is my little internal freak-out in that space where logic doesn't reach. I guess we will know more tomorrow.

Magpies and ladders

IVF, or perhaps infertility in general, has made my vague whisper of a superstition gene turn into a raging harpy. On the last cycle I regularly saw a single magpie out of the window of one of my clients' offices. It freaked me out every time, and I'd desparately peer out of the window, searching for that elusive second bird. Earlier this week I saw a single one again and,for an instant, lost all hope that this cycle would work. I've mentioned before my inner voice of tension which tells me regularly that we're not meant to have biological children, that because H speaks Chinese we clearly are supposed to adopt from there. I've given up all caffeine this time, not even my regular morning green tea has survived. I've been worrying because I'm not doing accupuncture and hoping that that is not a horrible mistake. Any ladders or black cats in my path are going to leave me a gibbering wreck.

A week ago I decided that perhaps I was being punished for a particular dark secret of mine that I had never told H. Perhaps the fact that I was withholding this information from him meant that I wasn't a fit parent and so the universe was withholding my fertility. So I confessed. He took it very well (no, I'm not going to tell you what it is). He was a little shocked, but he dealt with it well. It was such a relief, and such a vindication, yet again, that I married a marvellous man. Unfortunately the telling of this secret didn't magically relieve my tension, I'm still looking out for those damn birds. But it was the right thing to do, nonetheless.

What with all this insane stuff going on in my head, turning up at the clinic this morning was a regular laugh-a-minute. Again, I was so nervous I was shaking. We left home in a hurry, tense because I couldn't find the scan sheet I was sure they'd sent me home with last time. And after doing my Puregon injection in a frenzy of tear, wipe, click, turn, stick, push, withdraw, press. I was done in under a minute. Not bad going and such a change from the first injection last year. Luckily the clinic didn't seem to be too busy this morning, so they weren't that upset that we were five minutes late.

We saw a lovely new wand monkey. Dr Gorgeous should probably be her title, she was about 27, great hair, all the accessories in place, and generally quite charming. She was a bit awkward with the wand - how do some people manage to do the scan and you don't wince once, while others just seem to naturally hit the wrong angle? - but overall a good experience. Three follicles on the left, six on the right, all at about 7-8mm. While this hardly qualifies me for IVF superstardom, it's not too awful for day 5. It's sadly about the same as we got last time at this point, and some of them just didn't develop**. Of course we had no idea if the ovaries would respond at all given the Zoladex treatment, so perhaps I should count my blessings. I guess if we get six again, that will be ok. I was hoping for more, but we know that hoping doesn't get you anywhere in this game...

Dr Gorgeous did say that it looked quiet enough that they would probably not want me to start the antagonist today. I've got it with me just in case, it might be my first chance to do an injection at work, and why miss that opportunity for stress and stories.

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* Updated with the news that my E2 is 253, which is about 68 US, LH is 0.3. The doctor said that they want E2 to be at 300 on day 5, and mine is only 15% off that, so they want to up the dose to 300mIU a day. Which is their maximum. This scares me. No where else to go after that dose. It also annoys me as I wanted to start on 300 and Dr Candour told me it was too high as that was their maximum dose and he didn't think I was ready for that. Oh well. They want me to start the orgalutran today so I've taken the first shot in the loo at work. Not my best effort, a big bubble of it came back out! I'm not too worried since I'll do another shot of it tomorrow morning.

No more interventions til Tuesday morning. I wanted to go in sooner, but on Monday I need to get to one of those 8am meetings so actually it works better if I don't have a clinic appointment to deal with as well. I should take this as a sign. A good sign. Tell me to relax, someone, please, and I promise not to shoot you!

Sooner than you think

I had several reflective posts planned, one about superstition, one about luck, and one about sorrow, among others, but instead I am back in the immediacy of a cycle starting. This morning we rose early, despite the lovely luck of a bank holiday here in the UK, and headed off to the clinic. We were there for an hour, which is unusual for them, but at least part of it was our choice, and I'm glad we took the time. Dr Candour had sent me an email over the weekend, before he headed off on holiday (Again! What is it with this man? Why can't we all have the same holiday allowance, and the ability to take it, as our gynaecologists?), saying that I should try to see a particular doctor, and this doctor was hard to come by. At one point the doctor of choice called someone else, even though I'd already missed one slot with another doctor to wait for him. Although I went over to him and pointed out the mistake (I thought I might have to wait for ever), I decided to let the woman he'd already called go in front of me so as not to keep her waiting. I'm all for accumulating karma points if I can - heaven knows I need them - so I've been trying hard recently, offering my seat on the tube and all that good stuff. Do you think you get karma if you know you're trying to get it? Does it matter what the intent is if the outcome is good for the other person concerned?

Anyway, where was I? Oh yes, having a scan with the lovely Dr NoName. I saw him on the last cycle but didn't see fit to name him. Now I'm struggling for the appropriate moniker. He's quite ok in person but has a crappy phone manner, doesn't like me asking questions on the phone but is happy to chat in person. He's Israeli/South African, and told me to call him by his first name. Dr Casual? That will have to do for now, I'm not feeling very inspired. He got brownie points for remembering us, which was impressive given we haven't seen him in 5 months, and he didn't have our file out.

The scan took a while, and I was so nervous I was shaking throughout. I was also bloody uncomfortable. They've got a new set-up on the chair and the knee-holders are very very far apart. I'm just not that stretchy, people. Dr Casual did his best to adjust them for me, but we had to give up and just go with it. Eventually Dr Casual was done with the wanding (how I haven't missed that experience) and showed us the answer. My lining is very very very thin, so I won't have a bleed, hooray, and both ovaries are quiet, with no cysts but a respectable set of what are probabley antral follicles (I counted at least 5-6 on each ovary). My clinic doesn't seem to care about these, he certainly didn't count them, so I decided that was one less thing to worry about.

I then had to repeat most of my history, since despite Dr Candour's promises, he clearly hadn't discussed my case with Dr Casual, and Dr Casual was understandably confused about what happened next, since they've never done this protocol on anyone before. I talked him through it, including answering his question about why I was on Zoladex in the first place, and reassuring him that I knew I had fibroids in the abdominal cavity. He promised to check with the consultant on duty, and get back to me later.

And he got back to me a couple of hours ago. E2 29, LH 4.something, FSH 2.7. I guess that Zoladex did its job well. Was it supposed to reduce the FSH too? All we know is, I'm definitely suppressed, and the endo doesn't seem to have made a reappearance, although there was evidence of a little scarring on one ovary. He wanted me to start the injections today. I had been planning to start tomorrow, but there you go. It's my own fault, they want me to come in for bloodwork and a scan on day 5, as I insisted, and it's easier for them to do that on a Friday rather than a Saturday, so just after lunch I injected 250mIU of Puregon with my new pen, disposing of the needle into my tres chic new sharps bin, which is sporting a very streamlined and curved sillhouette compared to the one from my last cycle. How these things move on.

So we've started. I can hardly believe it. I'm excited. Although I've been planning for the last few weeks how I will cope with the day when I find out I'm not pregnant, and hoping that it won't be because I start bleeding, I also have some hope that this might work and of course have already succumbed to some great fantasies about what that might look like. H has told me he's hoping for twins so we don't have to go through this again, although he's also worried that my  back won't be able to take it. Also, if it's twin boys..Hell, I can't keep writing stuff like this, it's too scary. For now, I just need to stay calm and get through the next two weeks. We're on our way.

Side effects and silver linings

Along with the powerful, brain-constricting headaches, often accompanied by nausea, Zoladex seems to be doing me a favour. It's drying out my hair somewhat. I usually have to wash my hair every other day to keep it looking half-way decent, but for the last week or so I've got up to wash my hair on the second morning, and found that it still looks fine. The last time I had such an encouraging side effect was when I was 29 and I took Accutane to finally clear up my skin. I had all the side effects expected - horribly dry lips and nose, etc. - but I also woke up one morning to discover that my hair was going curly. It got really curly, to the extent that people who'd known me for a while thought I must have had it permed. I realised that the curliness was linked with dryness- I could get away without washing it for days and days and so long as I didn't brush it it stayed looking good. It stayed curly and dry long after I stopped taking the Accutane, but gradually wore off about 3 years later, leaving my hair in an annoying in-between state where it's got just enough random curl that it looks like shit if I leave it to dry on its own without a blow-dry. Let's see how long the Zoladex dryness lasts for - and it's not making my hair curly again, in case you were wondering. Which is a bit of a shame, but given that Accutane is a teratogen, I'd be a bit worried if the Zoladex side effects were exactly the same...

In the meantime, it's nice to get that extra 15 minuntes to go back to bed. Although this morning that resulted in me dreaming that I'd quit my job, even though I didn't really want to, and was working for a small company round the corner from my current office, who couldn't afford to give me a decent desk chair so my back was getting worse, and then it turned out that Melvyn Bragg worked there so he and I had a good chat. About what I don't remember.

Work is really insane, and it's making me tense, so the dream wasn't hard to interpret. In particular what's making me tense is that one of my clients is expecting me to show up at a series of meetings in the week commencing 24 April, all at about 8am. These meetings are about an hour and 15 mins drive from my clinic - in good traffic. My clinic opens at 7am. Do you see the problem? I'm not sure what to do. Of course if I get called in for a scan I will go, that's more important, but these meetings are with the big boss, and it's not ok to just walk in 30 minutes late - he's already very tense about the situation he's in. One option is to substitute for me, so I don't go at all. One of my colleagues would be happy to step in, but the client really wants me to be there as they think I know more about this area - which is mostly true. Well, I guess they will just have to deal with what they are given. But it makes me tense. At the best of times my job is so busy that I feel I am never able to be all the places I should be in one day. During a cycle, and a time when I'm very busy with work, this is exacerbated beyond my tolerance level - or at least beyond the tolerance level of my subconscious, which just wants me to quit. At least it has its priorities straight.

Falling is like this

Dr Candour did get back to me, and confirmed what Millie and others told us in the comments on my last post: In an Antagon cycle, you are messing directly with the level of oestrodiol, so there is little point in measuring E2 levels. He did say that they would want to know if there was an LH surge, so I wrote back to ask how they were going to know that if they didn't take any blood, but he hasn't responded yet. As I said in the last post, I know that if I just show up and put a tick in the 'blood' column, they'll take blood so I'm not that worried. And again, what I find frustrating is that it takes so little effort to give me the rationale behind their decisions, yet it is only Dr Candour who ever bothers to explain it - everyone else just fobs me off. Am I so wierd, wanting to understand what is  happening to me?

Don't answer that one, please.

I'm alternating between terrified of what happens if this doesn't work, excited at DOING something, and bored with waiting to get started. Not to mention consumed with anger and jealousy at those who are pregnant. I've made it to one day of our corporate boondoggle this week, and of course loads of the women are pregnant, and those who aren't are busy talking about their children. And there's no reason why they shouldn't, but it makes me want to slit my wrists. And then I feel guilty for being a horrible cow.

I'm also very, pathetically, fragile. While I am always someone who cries at the proverbial Kodak commercial, it's worse than usual. We had a presentation today from someone who works for a not-for-profit that aims to improve the lot of pre-school children across the globe. The short video they showed of the work they were doing in countries as diverse as South Africa, Northern Ireland, Bangladesh, Israel, Palestine, the US, and the Netherlands, reduced me to tears. In a crowd of 600 of my most senior colleagues. Not of course that anyone noticed, but I did feel like a basket case. Just to be clear, it's wasn't - at least consciously - a feeling of "there goes what I will never have" but instead just a signal of the emotional knife-edge on which I continually teeter. It's like it takes all my energy just to stay on that edge, so the slightest knock puts me right over the edge. And it's hard work crawling back up.

It's been a long time coming, this cycle. Four of us had transfers within a day of each other back in November. Lindy and Caroline are now 24 weeks pregnant. 24 weeks!! That's more than half way through and close to viability. S and I are still waiting to even cycle again. There's something wrong in that equation. Not wrong for Lindy and Caroline but oh how hard it is for me to read their blogs. I want to be happy for them, for all those women around me who are getting pregnant, but it's hard to stay focused on other people's happiness when I am so obsessed with what we don't have. And I don't know how we will ever get it.

Blood? I'll give you blood

A week has passed since my last post, and much has happened. But I've been too exhausted to blog - work has been tense and busy. I've discovered that dehydration is not the cause of my migraines - or rather, it's not dehydration alone. Last weekend in Istanbul (yes, it was Istanbul, congratulations to the one person who spotted it) I didn't drink much water at all on Saturday, and felt fine. All week at work I've been chugging water, but on Friday afternoon I got so ill I had to return home at about 1430 and go to sleep for an hour before I could continue with calls - I had a headache that felt as if a metal band was being tightened around my head, and horrible nausea. So I reckon the real cause is lack of sleep, since I was working til 11pm several nights last week.

My challenge for this week is how to keep that under control, since in the end my productivity is lower if I have to conk out early one day due to a migraine after a few days of working late, than if I just don't do the late nights and get home each night in time for dinner. I've already decided to drop out of our company's management boondoggle this week - or most of it - so that I can help control the situation at my client. The one part of the boondoggle I will turn up for is the part where what I've been doing is on show - apropos the political stuff last week, I decided I would be well advised to ensure I was seen to be clearly in the lead there.

I had an interesting discussion with my new mentor early in the week about the political shenanigans. He and I have been allocated to each other in a scheme that aims to improve women's position in business in the UK. He told me that he thinks that nice guys in business do finish first - that sharp elbows and people who mess around behind the scenes do get their dues. It's what I want to believe, so I'm going to keep believing it. Instead of getting too worked up about what is going on, I just made sure that I was incredibly well prepared for the meeting with the big guns on Thursday, and demonstrated with no shadow of a doubt that I was in the lead. I also had a conversation with the head honcho to tell him what I thought should happen and he mostly agreed with my take on things. I think it went pretty well. I know this is probably overly cryptic for anyone else to understand, but it helps me work through this if I write about it, although I don't want to be too explicit. So that's all you're getting.

In other news, this week we had our consultation for the IVF cycle. I can now go ahead and order my meds. Including the dreaded PIO. The nurse who did it was a real flake - I much prefer Nurse Earnest, who we got last time, and who was the nurse who answered the phone to me the morning I started bleeding after the IVF. She is a sweetie. Nurse Flakey forgot to show us how to do IM injections, so I'll have to get someone else to demonstrate. She also told us that with an antagonist protocol, they don't do blood draws. She announced it as if we should be delighted:

"No poking, won't that be nice," she exclaimed. I heroically refrained from pointing out that plenty of other kinds of poking are involved, but instead tried to understand why they, seemingly alone in all other infertility clinics that I've ever heard about, decide they can live without blood work during IVF. She, of course, didn't really answer me.

"Well, we got this protocol from another clinic about 8 months ago," she told us, in a tone of voice that indicated that she thought she'd answered my question.

"Don't you need the information on E2 levels to decide when to trigger?" I asked, getting increasingly desperate.

"No, we just go on the scan information." she assured me. After two and a half rounds of this I decided to give up. H and I hightailed it out of there, pausing briefly to hand over £2,400, and I immediately wrote to Dr Candour to understand what the hell his clinic is playing at. I know that on the last cycle my low E2 on day 5 led to an increase in my Puregon dose, so what would have happened if they hadn't done that test? Dr Candour is on holiday til Monday (he seems to take a lot of holidays, no?) so I'll wait to see what he says. He's already told them that I can be scanned as often as I like (ha! take that you scan-rationers) - Nurse Flakey wrote it on my scan sheet while I was looking - so I hope that he might force them to draw my blood too. It may make no difference to what they decide to do with me during the cycle, but I'm a qualified infertile with a degree from Dr Google University, for goodness sake, you can't deny me my E2 numbers and massive obsession during stimms, can you?

Speaking of forcing people to draw my blood, I went yesterday to get the whole miscarriage panel done. Dr Candour sighed as he wrote out the prescription last time we saw him, but he knows enough to humour me now. It's taken me til now to organise going to get the blood drawn. It took 8 vials of blood - he's karyotyping me too - so we'll see if anything happens. I'm not thinking that there is anything wrong, it's just that I don't want to have to miscarry before they figure out that there's a problem. £540 well spent, if you ask me.

Finally, I found this a few days ago. Very cool. It would be even cooler if it was based on a real analysis of in what way writers are similar. Instead it goes on what people read, but it still whiles away an enjoyable 5 minutes or so. Have fun.

And here my troubles began

Well those headaches are real doozies. I've discovered since the first one hit on Tuesday that the secret, as with the buserelin induced one I had in October, is to chug water like I'm someone who has been lost in the desert for weeks. Everytime I slow down on the drinking, I start to feel the edges of my skull start to constrict my brain and the vague nausea kicks in. If I drink enough in the next 30 minutes, I can usually fend it off. Tuesday I obviously just wasn't ambitious enough with my water intake, and by 7pm when I got the document I was working on out the door, I was in real, eye-bursting pain, with nausea just to cap it off. At that point no matter how much water I drank, it wouldn't go away. The cure was 14 hours of sleep, and since then I've been a bit smarter about the drinking, even if it does mean going to the loo every 2 hours minimum. An intake of 3-4 litres a day seems to keep it away. Fun.

The bleeding has slowed to a few spots here and there, and Dr Candour did get back to me, unsurprised and unphased. He pointed out that this may mean that I don't get a bleed at the end of this month, but that even so we go straight into stimms on 17 April, assuming that everything looks nice and suppressed by then. I don't see how it's possible for it not to be nice and suppressed given how I'm feeling, but I guess our bodies can always find some way to mess things up, right?

Thanks for your comments on the last post. I do suffer from moments of doubt, but at the same time I'm not ready to give up the interventions. Let's face it, after 15 months of medical intervention we've still only done one full round of ART. That's not really enough for me to say stop. We've barely tried. I remember reading Tertia's blog early on and being terrified at all she went through - something like 6IUIs and 6 IVFs before eventually Adam and Kate were born. I read that and knew that if that was what it took, I wouldn't be able to do it. Not because I'd give up before then, because frankly I want a child so much that I think I would keep going through treatment for ever if it looked like it had an earthly chance of working, but because I simply didn't have time to go through all those cycles. I was too old when we started this little boondoggle.

So I feel like I'm unfairly asking for a "get out of jail free" card. That because I started when I only has a few years left, I need to ask the universe not to put me through that kind of marathon. Although it's unfair, it's just true. If it doesn't work for us on this cycle or the next, I'll be 40 and really have to think about whether I'm doing the right thing in continuing to pursue treatment. Of course none of us should have to go through so many traumatic experiences with infertility, but Tertia did, and a friend of a friend did 10 IVFs before her baby was born, and T did I think five or six IVFs before her new daughter was conceived - people do. But I can't. I hope the universe is feeling merciful.

Bodies: can't live with them, can't live without them

My body is very confused. I took my last pill on Thursday night, prior to the Zoladex shot on Friday morning. Why should I need to be on the pill as well as uber suppressed? I didn't check with Dr Candour but was pretty convinced that I was right. Today, however, I have mild period cramps and am bleeding a bit, presumably withdrawal bleeding from the pill. So I am anxious that I shouldn't have stopped the pill (can't figure out why not though - does the zoladex take time to kick in?), and/or that the Zoladex isn't actually having the right effect. I've emailed Dr Candour so will wait to see what he says. Let's hope I'm not buggered before I've even started.

Having said that I'm worried about the Zoladex not working, I woke up in a distinctly damp bed this morning - is that a night sweat or would it have literally been a pool of liquid?

I'm also being completely laid low with back pain. I may have mentioned it before, but I am susceptible to this given an inherited malformation of my L5 vertebra which means that over the years my muscles have tried to balance me out, with the result that I put 70% of my weight on the right side of my body, my left  hip is nearly an inch higher than my right, my neck is too straight, my mid back is too curved, and I have a painful knot of muscle around L5. Since I reduced my exercise drastically back in October when we did the first IVF, the pain has gradually increased. I've been doing yoga stretches every day, often twice a day, to loosen up the hips and hamstrings as well as stretch my back, but it feels as if it's getting worse rather than better, and today it's awful - every step hurts. Probably exacerbated by a too-soft hotel bed last night, but it is still nonetheless deblititating and incredibly frustrating. I have to confess that secretly I worry that this will stop me from getting pregnant, that my body just isn't ready to take on a baby given how poorly it is currently functioning. I read how people like Deborah had terrible sciatica in the first part of their pregnancy and am wondering how I will be able to cope if, by some miracle I do get pregnant, and the back pain gets worse. Seems I can worry about most things at the moment.

Oh so I'll mention my most persistent fear right now. That somehow because H speaks Chinese, combined with all our reproductive woes, we are destined to adopt from China and I should just stop pursuing any other approach, that it's a waste of our time. That somehow I should have received the message loud and clear by now that I'm not supposed to bear children, but that we will take another route to our family. Yes I know it's illogical and silly, but it just keeps coming back. And I'm not someone who really believes in the "meant to bes".

Onwards and upwards.