Thalia's fertility journey

Sweet people

Thank you everyone. I'm doing ok. Our holiday hotel is not quite what we expected (rather more of a resort than a secluded upmarket beach place, but very nice with it), but we are having a lovely time in the wind and the sun. Pob has charmed everyone in the hotel with many shouts of "Dad DAD dad DAD DAD!" As well as lots of crawling after dangerous or forbidden items, and even more smiling and waving. She's developed a very cute habit of shrugging her shoulders up to her ears and grinning and giggling simultaneously. She does it when she sees her teddy, when she thinks something is funny (not much rhyme or reason to what she thinks is funny), or when we are laughing at her. It's a virtuous cycle.

I am doing ok. I was pretty sad on Monday, sadder than I thought I would be. The thing that really made me cry, however, was having to wait 35 minutes at the clinic for my bloody blood test. Which takes about 90 seconds once someone calls you. It's not as if there were lots of people waiting, just 5 or so in line in front of me when I arrived. And plenty of nurses, just none of them taking blood, for about 25 minutes. Somehow the utter injustice, as well as the stress of trying to get into work early so I could leave early and do Pob's packing before she went to bed, just got to me and I ended up in tears when the nurse who finally called me in then asked me if I had permission to have my blood test on day 13. What was I going to say at that point, no?

Anyway, I knew it would be negative, even while I sort of hoped otherwise. But really, Aurelia aside, my internal instinct, my sensing based on vague symptoms, and the pee sticks, have always been true before, so there's no particular reason to doubt them now. And they were spot on.

What's next? Of course, sod's law, I'm travelling over the days I will probably ovulate this month, so we're unlikely to have another miracle. We'll see Dr Candour on the 28th for a review. The question is whether it's worth doing another fresh cycle given how crappy my eggs turned out to be this time, even while there were a lot of them. H thinks we should give fresh one more try. I dunno, I've lost faith in my eggs somewhat. I've ordered some DHEA, will give that a try and at the very least, we will do a frozen cycle in October - September is just too busy with work for it to be realistic. We're down but we're not out.

Will write more when I get back from holiday. Thank you again for your lovely messages.

Just a trick of the light

Completely white this morning, not a shadow of a line. A brief chemical perhaps, or just a rubbish test. Less drama this way, I guess its better to be clear.

The answer is unclear

It's been both a lovely weekend and a tough weekend. I was pretty sad yesterday morning, although hanging out with Pob is enough to lift my mood almost entirely, so I was nowhere near where I would have been 2 years ago. We had visitors nearly all weekend, and multiple people in each slot, as this is the last 'free' weekend we have unti the end of September due to holiday, weddings, hen parties, and the birthday parties of all the babies from my antenatal class. We had friends from university and their children. We had my father. We had my mother (not at the same time). We had one of Pob's honorary Gdparents and her daughter. Pob did amazingly well with all these visitors, particularly with the three big girls (5, 5, and 3) who were here today, who all wanted her to do various things with them. She good naturedly let them marshall her around, enticing her into her paddling pool by holding out her teddy in front of her, etc. She was a bit of a star.

The toughness was mostly about the not-pregnancy. Because I was sad on Saturday, and the the friend who stayed on Saturday night tried hard to cheer me up by talking about how great it is to have an only child (she has a five year old and is unlikely to have any more for various reasons, not really by choice but by circumstance). I just am not ready for that conversation. I know if Pob is an only child she will be fine, better than fine, but at the moment I want her to have a sibling for all the reasons I've discussed before.

The odd thing about the weekend is that I kept feeling an ache in my pelvis, with occasional sharp pains around where I imagine my ovaries are. I decided it was just my incipient period, althogh surprised as the gestone usually keeps it well at bay. On my way to bed just now, I decided to pee on another stick, just for the hell of it. It was white.

Then I brushed my teeth, washed my face. Took about 5 minutes, say.

And then, as you do, I looked at the stick again, and saw maybe a shadow of a very faint line. So faint that I'm sure H couldn't see it, unused as he is to peering at these things. So faint that I'm not convinced it's there. So faint that I had to hold up a positive from when I was pregnant with Pob (yes I have the sticks stacked in a drawer in our bathroom, so what?), to make sure the line i thought I was seeing was where a positive line would be should there be one. Sadly the blank one from yesterday has long since been thrown in the dustbin, and I'm not desperate enough to go searching for it to do a comparison.

So here's the story. It may be, possibly (because it could also be an evap line), that I am a little bit pregnant. A little bit. These FRERs measure something between 6.3 and 25mIU/ml of beta-hcg, depending on which site you read. If I'm pregnant to the tune of 6.3mIU on 9dp3dt, well, let's face it, chances are this will drag on for a few days and then crash and burn. In fact, it's eerily similar to the FET, where i had a positive on a peestick on about the same day, only I didn't even realise it until after the beta came back at 70mIU. And then it stayed at 70mIU. And then I'd had my first chemical pregnancy.

And it still may not be a real line.

Mindfuck.

Beta in the morning. Flights on Tuesday morning to Ireland. Who knows?

I'd like to think of a clever title

This morning H's bloody alarm went off at 6am. That was not helpful. I lay there for 10 minutes, trying to get back to sleep, while he drifted off again. At 610 Pob started her morning chat. If we leave her she often goes back down until about 7, so I lay there listening to her for a while, then gave up, grabbed the monitor, and came downstairs. I went to the loo, then started cleaning. I poured the water for Pob's bottle. I washed up the two bottles from yesterday afternoon and night. I washed up the pans and dishes left in the sink. I washed up her water cups. I emptied the dishwasher. I put the coffee on.

In between each task, in the space around the full stops so to write, I examined the peestick I'd laid out on its instructions. Not that I need the instructions you know, just so as to keep it off the kitchen counter. The last time I had a peestick on the kitchen counter it was already saying 'pregnant', but that was 19 months ago. This one stayed snowy white. It's still snowy white. As I suspected, not pregnant.

It's 8dp3dt so it's possible it's too early. But not convincingly. I've been pregnant three times. The first time I got a positive at 10dp2dt, a clear strong no-doubt-about-it positive, which means it would almost certainly have been positive the day before. My beta on 12dp2dt was 251 and doubled beautifully. At six weeks the embryo had no heartbeat, and at 8 weeks I had an ERPC.

The second time I was pregnant my test at 10dp2dfet was equivocally positive. I didn't notice the positive at the time, only when I re-examined it after my positive but low beta at 12dp2dfet of 70. That pregnancy never went anywhere.

The third time I tested on the evening of approximately 13dpo, and it was clearly, strongly, positive. A beta at 15dpo came back in the 250s. That was Pob.

So you see, a negative at this stage is either a clear negative, much more likely with my crappy embryos, or a weak positive which won't go anywhere. Sadly Kath and I don't get to do it again together. It hasn't worked.

The ridiculousness of planning

H and I are not very good at holidays. When we take them, they're usually great, but we are in the extremely lucky position of having plenty of choice, and this perplexes us. We discuss all the possibilities, feel overwhelmed, then decide to think about it, and meanwhile I'm getting booked up at work and tickets are getting more expensive. When we were in the middle of primary infertility, this confusion was compounded by not knowing when the next cycle would be, when the blood test would be, whether or not I'd be pregnant. We didn't take many holidays while we were trying to get pregnant with Pob, and one of them in particular was crap.

Things should be easier now, but we don't seem to have become any more decisive. Of course now we have a bunch of restrictions on what we (mostly I) think is a good holiday choice. Italy - superb choice. Fairly reliably good weather, people love babies, delicious food, fascinating things to see. What's not to like. H? Not so keen. We went there, you see, so now he wants to be off to one of the 1000 places to see before he dies. Like Victoria Falls (malaria), the Masai Mara (malaria), the Pyramids (bloody hot), Bali (20 hours on a plane with a baby, are you kidding me? Not to mention the 11 hour time difference), New Zealand (see above). Or he wants to go out into the wilderness and do some serious fishing and hiking and mountain climbing. While Pob and I stay at the hotel I think - not that he doesn't want to spend time with us, it's just that his hunting/shooting/fishing fantasy doesn't really have passengers - or shouty babies - in it.

I suggested a range of options. Mountain walking in Austria. Friends in Vermont or Cape Cod. Northern England, Italy (see above), Portugal, Madeira, a bigger holiday later in the year. None of them seemed to bite. Eventually we were down to a week when we could be away given work commitments I'd stupidly agreed to (covering for colleagues who are better than we are at carving out holiday). So we decided to pull our fingers out and book something. We settled on a week at a nice hotel near Cork, with good facilities, overlooking a beautiful beach, etc.

The only challenge? It would involve flying off on 12 August, the day of my scheduled beta. Now you know I will POAS before that, so I'll know what the story is, but I need to have that blood test for my own sanity and for the clinic to prescribe me any follow-up meds I might be lucky enough to need. So I suggested to Dr Not My Favourite on Friday that I could come in the day before. He initially told me this wasn't possible, but eventually said it was ok to have the test that day he supposed (let's face it, whether I'm pregnant or not, a beta on day 13 is going to be perfectly clear). However, he told me he would not advise flying in early pregnancy (should we be so lucky).

This seemed odd given the fact I've flown plenty in pregnancy before, and Dr Candour has never seemed concerned, although he did gently dissuade me from going to California when I was 5 weeks pregnant with Pob. But Ireland and California are not really comparable journeys. So I followed my usual strategy and emailed Dr Candour, who just replied to say he thought a day 13 blood test was fine, and Ireland was fine, although if we got a low positive we might have to change plans so that I stayed near a hospital in case it was an ectopic.

So that's ok then.

What I hadn't really considered is my addiction to betas. Although my clinic, like most in the UK, doesn't usually do repeat betas, Dr Candour has always pandered to me and allowed me to come in whenever I want for a follow-up. If we go away for a week, that's not going to be so feasible.

But this is all ridiculous, because the chances are that I won't be pregnant so all of this will be moot, and I"ll feel really silly about this post. And that's the ridiculousness of planning. We have to plan for these eventualities, no matter how silly they turn out to be. But this time we won't let that need to plan defeat us. We're booking the hotel and the flights tomorrow. We'll see if there's a problem when that problem shows up.

Optimistic? Sort of

I have three embryos on board. Yes, that's three. Which is pretty much impossible in the UK if you are under 40, which I'm not, and hard even if you're over 40, which I am. But we were confronted with the scenario this morning of three good embryos, two six cell and one five cell, and two average embryos, both 6 cell, and two embryos which gave up the ghost at 2 cells, although one was still hanging in there. This made me ask the question about whether it was worth transferring all three good embryos to give us the best chance at a (singleton) pregnancy.

H was against transferring three. I came to the idea after hearing about how this crop of embryos had done overnight. It is the poorest crop of embryos we've ever had. Trransfer previously has been of 'excellent' embryos - 8 cells at day 3 or 4 cells at day 2, and I've been pregnant twice, both times unsuccessfully, with those better embryos. So I felt we had the best chance of getting pregnant with three. Pregnant with a singleton, at best. So I asked about three, the embryologist checked with Dr Candour, who ok-ed it. And I figure if he ok-ed it, he's pretty sure our chances of triplets or even twins are close to zero.

All this took a long time and I was glad I'd paced myself with the water drinking. Last time I was about ready to explode before transfer. This time bladder was full, but bearable. The same doc did the transfer as did our last transfer. I think they got him up specially to do me as I had a long wait on the table, so I think I should be flattered. But I'd rather have someone else. He's very kind, but has hurt me more than any other doctor at transfer. So it was uncomfortable, even a bit painful, but ok - better than the last time, anyway.

I had to get myself home in a taxi as H rushed off after transfer to take Pob to Gymboree. I went to M&S and bought yummy strawberries and cherries*, came home and sat on the sofa all afternoon watching episodes of ER and reading blogs. It wasn't a bad afternoon, as they go. And when Pob got home she was delighted to see me and told me all about her day. At least that's what I think she was saying.

Thank you so much for all the good wishes. I read many of them while in various positions in the clinic today, it meant a lot to me to have all of your support again.

* I know many of you are put on bedrest by your clincs after transfer, but honestly I've looked at the evidence and it's nonsense. The only sensible study I could find found that women who took a normal level of activity after transfer had higher clinical pregnancy rates than those who went on bedrest. So though I did take it easy and did feel a bit crampy on and off, I feel fine about having had a wander this afternoon.

Hmm, perhaps am just normal old lady

Looking ok but not great today, three 3-cells, three 2-cells, all labelled 'good'. The other one has disintegrated overnight. I asked the embryologist shouldn't they be 4-cells by now, he, rather non-committally, replied "all embryos have their own timing."

Hmm. Not bad but not stellar. Let's hope we have some decent-looking ones tomorrow.

Am old lady IVF superstar

Seven out of ten fertilised normally. Not bad, eh? Have also come to work for the first time on a day after retrieval, and so far am feeling ok. Will try to go home early. Transfer on Friday unless they all look crap tomorrow.

Not too shabby

10 eggs. We'll see what's left in terms of embryos, but not too bad a start. Transfer scheduled for Friday unless something goes wrong and they want to do a day 2 transfer instead (which is standard at my clinic). I asked for a day 3 transfer due to work stuff, but we'll see.

Going to sleep now.

Tonight we sleep the sleep of the just

A veritable bevy of follicles. 21, 19, 19, 17, 15, 13 plus some little ones on the right, 17, 16, 16, 16, 13, 12 on the left. We are to trigger at 2330 tomorrow night and go in for collection on Tuesday.

Yet another new-to-me doctor (nice, blonde, good sense of humour) told me we should be there at 7 on Tuesday morning, but given I've previously triggered at 2230 and still waited hours for retrieval, I negotiated an 8am arrival so that we can be at home with Pob until the nanny arrives.

We put Pob down for her afternoon nap at Granny's house, and are now heading out of the big smoke towards druid country. I am quite nervous about leaving Pob but I know she'll be fine. She'll miss us, but she'll be fine. We'll miss her, but we'll be fine.

What's that story about tortoises and hares again?

I had over an hour at the clinic this morning. First the scan, which showed

• Left: 14, 14, 13, 13, 4<10
• Right: 19, 18, 16, 13, 13, 4<10
• Lining: 10.

So not bad. Heading in the right direction, roughly a mm a day. Which is a bit slow but at least they are doing something.

***

Contrast in doctors' personal styles was observed. The nice doc from last weekend saw me in passing, and said 'Hello Mrs [realname], how are you?' Five minutes later, the doc I saw on Wednesday was the one who called my name for the scan. He called me then went and fiddled with paperwork for a while. Then called me again, while looking straight at me. Then when I pointed out I was standing and waiting he ushered me into the scan room and introduced himself. Which is ok, I guess, better than not doing so if he's not sure he's met me before. But let's just call him Dr Memory for the sake of it, yes?

The whole memory thing was borne out when he ushered me out of the clinic straight after the scan, without remembering to ask I needed more meds. Which I do. Luckily I remembered before I got to the bus stop, so I came back, had to wait around to get someone to give me a prescription, then wait around to get it filled. Luckily in that process I thought to ask if I could do a blood test that Dr Candour has ordered to try and get underneath my blood panel results at the clinic rather than going into town to a specialist lab. They agreed to do it and that saved me a trip, although it did cost me yet another nasty bruise on my arm. Which doesn't look good in short sleeves.

***

Dr Memory left it til 1635 to call me with my instructions for the weekend, which was leaving it a bit late given they close at 1700. The call came 5 minutes after I left a polite but slightly stroppy message, so I do wonder if my paperwork had fallen on the floor somewhere. Anyway, they want me to come in for a scan on Sunday morning. This is not good, as H and I are going away this weekend, without Pob for the first time. A friend is having a rather swanky 40th birthday party at a hotel in the deepest darkest countryside, and we thought we'd have a little jaunt and leave Pob with my mum. Which will be somewhat less fun if we have to get up at 6am on Sunday morning to drive back into town for a scan. I asked if I could come tomorrow, Saturday, instead, just in case that way we can avoid the Sunday scan, and Dr Memory acquiesced. So let's hope they're all clearly growing tomorrow morning - let's say 21, 20, 18 and a bunch of 17s, and then we'll be able to trigger Sunday night and get on with this.

Although to be honest, retrieval on Tuesday and transfer on Thursday will totally bugger up my work week. But that was always going to happen, yes?

Hmm, old lady go slow

Well, the appointment on Monday went well. E2 at 1068 (291 American), follicles at 14, 12, 12, 10, and 5<10 on the right, and 10 and 4<10 on the left - growth of 2-3mm on average since the previous day. This put me about 3 days ahead of where I was on the cycle we did in August/Sept 06 - the last fresh cycle we did. They told me to start the antagonist and come back today, day 8 of stimms, for another scan.

Today's still looks ok, but everything has slowed down somewhat

• Right: 16, 15, 14, 10, 5<10
• Left: 12, 12, 11, 11, 3<10
• Lining: 9.9mm

So it's ok, but not as encouraging. These results would make me just 1 day(ish) ahead of where we were on cycle #3. The doc (another new one) said he thought we might only get three eggs - the three large ones on the right. If we keep on stimming at this new rate, I think we might get more - it's a similar number, and similar size follicles to IVF#3, where we eventually got 14 eggs, although retrieval was on day 16 and we didn't get pregnant, so it's not exactly the cycle I want to emulate in every detail. In any case, I have to return on Friday and we'll see what's happening then. At the earliest, retrieval will be Monday. I kind of hope it is Monday as that will make next week a lot easier with work, but we'll cope with whatever we get.

Oh, and I'm on 300mIU of Puregon, I forgot to mention that previously I think. I'm thinking about self-medicating and upping the dose, maybe to 375 - given this slow-down - what do you all think?

Not bad for an old lady

A lovely day for a day five scan. It's sunny and breezy after days of on-again off-again rain and grey skies which yesterday put rather a dampener on Pob's playdate with some other 10 month old babies in the park. I left Pob having breakfast with H and zipped off to the clinic, which is less than 10 minutes away in the early Sunday morning non-traffic.

I only had to wait five minutes or so before a doctor I'd never met before came up to introduce herself and usher me into one of the scan rooms. She was about the most efficient scanner I've come across, and so nice that I had to forgive her for being one of those docs who can't let you look at the screen at the same time. And the good news was that I've got six likely looking follicles on the right, and four slightly smaller on the left. They're all still quite small - around 10mm or so - but worth counting nonetheless. Since the largest one is still only 12mm, I have to go back tomorrow for more scans and bloods to see if I'm ready to start the antagonist.

What a difference lack of suppression makes. Every other time I've had a day 5 scan, they've got all worried and upped my meds. This time things seem to be progressing nicely. Of course half those follicles (or more) could stop growing, or some of them could be egg-less, and of course at least half the eggs are going to be crappy, but this is a decent batch to start off with.

It's Pob's 10 month birthday, and when she wakes up from her nap we are off to the zoo to celebrate and to make the most of the weather. She seems to really love animals so we're hoping she'll enjoy it. And we'll of course get to enjoy her.

Ah well, here we go again

It is ironic, or just sucky, that my period started while I was changing Pob's nappy this morning? Probably just a bit sucky - or rather, not as sucky since here I was, being reminded of the extraordinary blessing that is Pob, at the same time as being reminded that giving Pob a sibling isn't going to be as easy as I had hoped. Thoughts on secondary infertility will be forthcoming when I've got the time to think them through.

I really really really don't want to do this IVF cycle. I'm not convinced that at 41 there's much chance of it being successful - which is silly as I am as hopeful as all get-out every month that we try on our own. My brain is obviously unconvinced by the stats.  Because the stats for previous IVF tries aren't bad - I got pregnant on one out of our three fresh cycles, albeit only for 8 weeks, and on the one and only frozen cycle, albeit for about 5 minutes. This will be the first IVF cycle where I haven't been over-suppressed first, so I'm hoping I might get to stim for less than 15 days - my previous average. I think at my age we should be delighted if we get four or so eggs. But no doubt I'll feel like an under-achiever if it's anything less than 6 - our previous lowest number. And I'm trying not to obsess now about the possibility that we won't get any at all - which has to be a real possibility again given the presumed decrepitness of my ovaries at this point.

The clinic has been called, the drugs are ready to go tomorrow morning, we're back on that particular train. I need to find time to go in and update my hepatitis and HIV status, and should probably book a smear, too, since I haven't had one for three years (three years is the usual timing in the UK). Oh joy!