Post IVF#2: Miscarriage, grief and recovery

Sunday, 09 July 2006

Pointless, yet poignant, post just to get that last one off the top of the page because I can't bear it any more

I'll apologise to Dar now for having mangled her title, but oh boy was I lacking in inspiration this morning. It's been a week. A busy week but one in which one of my clients told me I'd transformed him. Which was nice. But also a week in which I spent the whole of Saturday night writing a memo, and then went to bed. Which pissed me off. A week in which we struggled through our Saturday morning appointments (which were a session with the trainer at 0745 and a hair, nails etc appointment at 9am for me, but well, when else am I going to fit it in?) in order to get to my parents-in-law's house on time for what we thought was an intimate family lunch consisting of our PsIL, H's brother and SIL and their two children, and H's cousin who is over from Oz and his wife and two children.

Only when we got there it turned out to be those people PLUS all of H's father's brothers (4) AND all their wives (4) and children (about 20) and grandchildren (umpty million). Yup, no one in that family has any trouble procreating. Except us of course. And the number of people who said: "Wow, we haven't seen you since the wedding and how have you BEEN?!" with a questioning look on their faces would need to be counted on the fingers of very much more than my two hands. The food consisted of the EU's entire backstock of new potatoes (my MIL miscalculated somewhat. Seriously, we all ate a lot and then when we'd finished we discovered the world's largest stock pot on the stove, still full of potatoes. It was like that fairy story of the magic cauldron), plus a huge variety of barbecued (incinerated) meat. On the one hand my FIL was very keen to cook the meat properly, hence the high carbon content. On the other hand when distracted he just started loading the cooked meat back onto the platters where the raw meat had been marinating. Hence kind of invalidating the whole "don't give your guests food poisoning" element of incinerating the meat in the first place. And then after about an hour my SIL and I realised that our MIL was really quite drunk. It was the picking lamb chops off the plate and tearing them into pieces her fingers, then wiping her fingers on the tablecloth while telling us a long involved story about the sports club they belong to that gave it away. It was actually quite funny in a hysterical sort of way.

Sorry. I do love my PsIL very much, but yesterday was all a bit much for me.

In a minute we are off to my mother's 70th birthday party. Yes, this is the birthday that keeps on giving. Sadly the weather has gone from nicely sunny yesterday to grey and showery today. Which is what British weather does, I guess. Mum seems to be holding it together quite well for someone who has 100 people coming to eat lunch in her garden in a few hours. The only thing she has nagged me about in the last 24 hours is finding her some Essie nail polish in Pomegranate, because apparently hers has chipped. But I'm insisting that there's none to be found despite not really having tried. Because I'm a terrible person like that.

After the party I fly off to Austria where I'll be leading a training course all week. It's going to be pretty busy so I might be a bit quiet. Have fun without me.

Wednesday, 05 July 2006

Dr Candour loses some brownie points

I just got the following email from the esteemed doctor.

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Re miscarriage, 30% chance of pregnancy, then a 15% chance of miscarriage. (I could have sworn he said sthg different in the meeting, but there you go).

Your karyotype results are back. Normal 46XY

Regards

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Yup, not the most tactful way to break the news.

I didn't realise how devastated I would be to know that it was a boy, not to mention a normal boy. I was very convinced it was a genetic problem which would be just bad luck and might or might not happen again. But if I miscarried a normal boy, then presumably I might do that again. What do we do now? I know the answer is nothing, we just try again, but somehow it is even more terrifying. And very very sad. It is so much more real to know that we had a boy, not just an embryo. A boy who would have become our son, if something hadn't stood in his way. Something that we don't understand and therefore can do nothing about.

Just when I thought things were on the mend.

Tuesday, 04 July 2006

A plan

It wasn't my most satisfying appointment with Dr Candour, but we came out of there with a plan. The contributors to it being less satisfactory is that I really wanted a conversation about what happened and our chances, but he was having one of his over-scheduled mornings, and the results from our cytogenetics weren't back yet so we were missing one vital piece of information. He ended up spending about 10 minutes on the phone trying to get hold of the cytogenetics information, but the lab weren't cooperating. So we don't know yet if there was a genetic problem - or even if we had enough genetic material to find anything out. We briefly discussed the Prague meeting and he said it was very good, although he was a bit stunned about how much publicity it got.

We discussed the fall-out from the ERPC and my trip to the ER. He asked me if I was ready - emotionally - to try again. I said I wanted to try again as soon as possible. He wanted me to think about it whether I was prepared to be thrown into the hormonal maelstrom again. I said I was terrified about getting older and how long everything takes, and I wanted to get started. He was fine with that, he said that physically it was ok, it was just a lot of additional stress to pile onto a difficult emotionally stressful situation. We briefly discussed doing a frozen cycle. He pointed out that fresh cycles are more likely to work, although they bring with them all the extra invasive procedures and hormonal interventions. I said that we wanted to do exactly what we did last time, and he was fine with that. He told us that they've used the same or similar protocol on several women since I had it, and are becoming more comfortable with it.

So the story is, wait for my period. On the day of my period or 1-2 days after, have a scan to make sure I don't have any new endometriomas. If everything is ok, on the same day have the Zoladex shot. Four weeks-one month later, start Puregon. We'll start at 300 mIU this time. Then we'll see what happens. He gave us about a 30% chance of getting pregnant - increased odds because we got pregnant last time - and a 15-20% chance (per cycle, not per pregnancy) of having another miscarriage. That seems to mean that once we are pregnant there's a 50/50 chance we will miscarry (30% chance of a pregnancy per cycl, 15% chance of a miscarriage per cycle - am I messing up here?). After we see the heartbeat there is an ongoing 10% chance that we will still miscarry.

I asked him how many times he'd let us do this. He said five in total - three more. There is a cumulative improvement in the chances of getting pregnant through the first three cycles. And a slight improvement through the next two. After that it flatlines: "it's a bloody miracle," he said, "when people get pregnant on the 7th or 8th cycle." Because we got pregnant on the second cycle, that ups our chances of getting pregnant again, so if this one fails he'd be happy to try 3 more, assuming that we get a good follicular response on each preceding one. After that we talk about donor eggs. He assured me that we don't need to go there yet, which I'm relieved about since I'm very much not ready to go there yet. He assured me that there was nothing to worry about in that on our first cycle we had six of six eggs fertilise, while on the second only five of nine did. He was so distracted by me mentioning the six of six that he ended up writing ICSI on our prespcription form for the cycle as he was busy talking while he was writing and said while he wasn't concentrating his brain was telling him that that kind of fertilisation could not have been straight IVF!

This somewhat scuppers our holiday plans as we were planning on taking off two weeks mid/end August, but that might be just when we're stimming, depending on when my period comes. My hcg on Satuday 17th, the day we went to A&E, was just 141 which means that it should have been zero sometime the weekend before last. Which means that my period should come about two weeks or so from now. That would take us to mid August for the start of stimms. Maybe. Who knows what my body is doing. I should probably pee on a stick, as Kath suggested, and see what's going on. Not sure if it should be an OPK or a pregnancy test, I'll see what I've got in the cupboard at home. I went to do one this morning but was distracted by H being in a very grumpy mood due to the difficulty of sleeping when it's so hot. Tonight we'll talk about when else we can take a holiday. The alternative is to take the holiday while I'm on the Zoladex. That will mean that we need a slightly less strenuous holiday than we were planning since I get migraines on Zoladex if I get dehydrated or too tired. But since we don't know when I'll need to get the Zoladex shot, it might be a bit tricky to plan the holiday. Perhaps we'll have to be spontaneous for a change - and pay spontaneous prices!

I'm left feeling quite emotional, and quite sad. I'm so scared of going through another cycle and finding out it's negative. I can cope with the cycle itself. Injections are no big deal and I know now how to manage the minimal side effects that I get. It's the negative result I'm scared of. If we don't get pregnant again, the next time we'd be able to cycle is just before my 40th birthday. I never thought that's where we'd be, still not pregnant at 40. Oh how I envy those of you who started this journey at 30, or 26, or 34 (without POF) or anywhere other than 38/39/40 when you can feel that death knell of your aging eggs hanging over you. I'm more scared of us not getting pregnant than I am of getting pregnant and miscarrying again. Perhaps because getting pregnant is the first hurdle, perhaps becasuse it's the hurdle we've always fallen at before. As Dr Candour said, it's very hard in this endeavour to find the right balance between hope, which keeps us all going, and realistic expectations. Anyone would think he read infertility blogs.

Sunday, 02 July 2006

Getting started again

It's been a long time without a personal post - nearly 2 weeks. Partly because that ESHRE post took me AGES to do, so it took up quite a bit of the available blogging time. Partly because I've been busy at work. Partly because I've been uninspired. It's not very exciting to plan a post which you know will at least partly consist of talking about sadness and difficulty. I feel as if I've had my share of posts where the only comment anyone can leave is "I'm sorry." I'd like to get back to more engaging thoughts, posts, writing in general. I guess the ESHRE post was a good start, I'm so pleased you appreciated it. There were many more pieces of research I could have written about, but I had to draw the line somewhere. Most of what I read isn't going to mean anything for most of us, but it's always good to know what's going on. I'm glad my doctor was there.

So how am I, many of you have asked. I'm ok. I'm a lot better than I was. My meltdowns have gone down to one or two a week, rather than several a day. I'm cooking again, which is therapeutic. Last Sunday we had friends over with their three children for brunch. I made three different kinds of muffins, and they were all absolutely delicious. And then I also made scrambled eggs and smoked salmon, and finally orange and ricotta pancakes - a Nigel Slater recipe from his latest book that I've been dying to try. I worship Nigel Slater. Such an unapologetically greedy cook. It was too much food, but it was fun. And it meant we safely had leftovers when my father, brother and nephew arrived mid-afternoon to watch the football.

This weekend I cooked again, for no good reason other than I seem to be addicted to baking. I made two more sets of muffins (the orangette recipe is for a loaf cake but I made it into muffins). Sadly the pear and goat cheese ones didn't really work. I expect a muffin recipe to make 12 unless it says otherwise. So I gaily half filled 11 muffin cases, then realised that I was supposed to still have half the batter left. I didn't. I stole some out of a couple of the cases that looked 2/3rds rather than half full, and persevered with the goat's cheese and the rest of the batter. As a consequence they don't really have enough support for the filling. And the taste is only ok. The first ever muffin I've ever made that I probably won't make again. Luckily the banana/chocolate/ginger/pecan ones were delicious, so H had enough good stuff to take round to his friend's yesterday to watch the football with. I joined them to watch the second half, and extra time, and penalties, and to comfort my poor sad man when they inevitably crashed out. England, oh England, you're always just a bit disappointing as a team.

You may be surprised that I was round at a friend's house with H, watching the football. Let me explain. H went to see one of the counsellors at the clinic this week. He found it was very helpful, and quite practical. She pointed out that when we're in the middle of all this shit, we tend to not have the energy to nurture ourselves in other ways - things that we enjoy doing fall by the wayside. It's definitely true in our case. H is very social, I am less so, but we've barely seen anyone socially other than our families in the last six months. H sees one friend once a week to play squash, but that's about it. H made his list of 'sustainability' activities (his homework from the counsellor), which included seeing friends more often. So that's why I agreed yesterday to go round to the squash friend's house to watch the football and stay for a barbecue. It was actually really nice, very relaxed. The husband is one of H's friends from school, and his wife is a very down-to-earth Northerner. They have one daughter who is now five. The wife had such bad post-natal depression that she never wanted to be pregnant again. We just had a fun, relaxed time, and talked about nothing much. I never want to go to these things in anticipation, but it's never that bad once I'm there!

It's bloody hot here again. And today my brother is moving out of his home. He and my SIL (they're not married but they've been together for 8 years and have a child together so I've considered her my SIL for a while now. They did get engaged, but then they got pregnant and the wedding seemed to decrease in importance). We don't really know why they're separating. My brother just told us that it's been a bad year and they're going to spend time apart while they try and work things through. When we've seen them together they've been fine with each other - no sniping - but we do often only see my brother and nephew - at the last minute my SIL will have a hangover or a yoga class she needs to go to and drops out of whatever arrangements we've made. I know my brother has been keen to have another baby, and my SIL has not, and I wonder if that's part of the cause of the split, or just a symptom of other issues.

They were doing quite well, keeping it amicable then apparently on Friday, my SIL's birthday, it all deteriorated into a big screaming match, unfortunately in front of my nephew, who is 3 and a half. Today my brother came round with a friend and a van to take away the bed, futon/sofa, bookcase, bedside table, lamps and other sundries we're loaning him while he and my SIL decide whether this is for good or just for now. H has been a bit of a hero, carting our furniture down four flights of stairs and driving round to my brother's new (rented) flat to help him cart it up two flights of stairs again. They all left here looking distinctly dishevelled and sweaty. I supplied what I could in terms of frozen fruit lollies, water, and beer, but they didn't seem to want any girls involved in moving stuff, so I've stayed a bit out of the way.

On Tuesday we see Dr Candour. I'm hoping very hard we can get going as soon as possible. I stopped bleeding about 10 days ago, but am showing no signs of ovulating so I'm wondering how long this cycle will go on before I bleed again. I haven't peed on a stick, but I assume that I'm no longer hcg-positive. We haven't re-convened marital relations yet, so there's no chance of one of those miracle pregnancies (haha, as if), and the lack of nooky is becoming a bit of an issue. We both kind of want to, but are a bit nervous about H's problem resurfacing, and I think it holds such tension for both of us that we talk about it and then avoid it. Perhaps the right answer is to plan to just go to bed next weekend after we've had a nice meal and a bottle of wine and just see what happens. No pressure. But that's not very realistic. For H there's always pressure.

I have reconvened going to my trainer, although sadly I've only got 6 weeks left before she moves back to Australia. Anyone know a good personal trainer in London who does fun stuff (preferably kick boxing) and lots of stretching and flexibility work? I felt really good after I saw her yesterday. My back has been really bad since I stopped being pregnant, making me think that perhaps the pregnancy hormones were masking the problem in some way. She really got my back going - stretching and various twisting and stretching exercises, and it was great to feel physically tired again. I've been sleeping ok through the night, but then waking at about 5am and not really falling asleep again - just dozing for 10 minutes or so at a time. It means that I get up already tired, which isn't a good start to the day.

I have more to say, but want to craft a few posts rather than just continuing to burble. Thank you all so much for all the support. As a community, we rock.

Tuesday, 20 June 2006

Surviving

I feel like I owe everyone an update, although I'm singularly un-inspired. A few days of travelling will do that to you.

We ended up at A&E on Saturday. By the time Dr Casual had spoken to my GP on-call, who had then spoken to the gynaecologist on call at the hospital, they decided I needed to be seen. So at about 1915 we headed off to the hospital. H took a book and an ipod, I just took a book. It was a long, boring evening so I'll spare you the details. Needless to say, we never saw the gynae on call, despite her having promised my GP she'd see us. We did see a very sweet junior doctor who did all the right things including swabbing for infection, taking blood, and doing an internal exam. He then made us wait while he waited for the gynae on call to come and see us. At about 2310 H decided this was ridiculous so he went to find Mr Junior, who told us that it was ok to go home and he'd send our results through to my GP. He gave us some paracetomol with codeine, which also didn't touch the pain, sadly. So that was a waste of an evening.

The one thing that H had been holding on to throughout this experience was that our local good pizza co delivers til 12 on a Saturday night. So as we walked out of the hospital at 2325 I called them. "We're closed." They said, in no uncertain terms. I tried arguing, then hung up, and burst into tears. I was inconsolable. I guess I was crying about more than the pizza (you think?). It lasted through driving home, making a cup of tea and a bowl of cereal, H going out to pick up a chicken kebab, him coming home and holding me while he watched the football highlights, and me eventually falling asleep.

Sunday morning I felt a bit better - better enough to have made muffins and done all the dishes by the time H got out of bed. They were very good muffins. The advent of wireless internet in our house has totally changed my internet habits, and probably not for the better. I spent quite a bit of Sunday going through food blogs looking for good recipes, and let's face it people, I have no self control when it comes to good food. I am now definitely overweight again and I've got to find some motivation from somewhere. Where I don't know, but it's got to come.

Since Sunday I've been doing ok, and I'm now barely bleeding. I still cry, quite a bit, but I'm not in physical pain. I'm impatient for 4 July when we see Dr Candour. I know which conference he's been at and I've been reading the abstracts. I'll do you guys a summary of the interesting nuggets when I get the chance.

Off to catch a plane.

Saturday, 17 June 2006

What they don't tell you about an ERPC

One of the reasons I wanted the ERPC is that I wanted this over with. I didn't want to walk around, waiting for the miscarriage to happen. By my melt-down day on Wednesday, I wasn't bleeding enough any more to need a pad. Part of me felt lucky to have escaped the ickiness of bleeding through a miscarriage in all the ways I've read about.

Sadly, my uterus didn't seem to have read the rule book. On Thursday evening I started feeling cramps, and noticed I was bleeding a bit. I put on a pad, took ibuprofen as instructed by the doctor, and went to bed. When I woke up in the morning the cramping seemed to have died down and I got up and went to the loo as usual. When I wiped I found a big clot. I was a little surprised given how I thought I'd escaped all of that, but at least it explained the cramping. I got throught the day at work on Friday with just a little bleeding and no more cramping. The cramping started again Friday night, particularly after a shitty journey home on the tube in the rush hour and a seemingly endless walk in the heat from the station - yes I know I was stupid. I took more pain killers and went to bed. And got woken up at about 5am by concerted pain on my left side, about where my ovary is. I took more ibuprofen but after 30 minutes it wasn't having any effect and I was still awake so I got up and came downstairs to make a nest on the sofa. I've had a day today of bleeding - not a lot, but consistently - and a few more small clots.

The pain has been consistent enough, unaffected by ibuprofen enough, and on my left side enough that I decided to call the clinic to see if they thought I should come in and see if something was wrong. I spoke to Dr Casual who told me that everything was probably ok, that this was just my uterus getting with the programme, expelling what was left and shrinking back in size, but to add paracetomol to the ibuprofen, and to go to A&E if things got worse. That was a couple of hours ago. The pain is still there, although it comes and goes. It's not just on the left side, so I'm trying not to panic that it's an un-diagnosed ectopic. I'm very whiny because it's just debilitating to have been in pain consistently for nearly 24 hours. We were going to go and get delicious sushi tonight, but it seems a shame to waste on a time when I'm feeling so shitty. I'm going to give it til tomorrow morning and if I still feel like this then we will go to A&E and see what they say.

In the middle of this, our dear friend sube has found out that her embryo has no heartbeat. Words can't express how sorry I am. Please go and let her know you are thinking of her.

Wednesday, 14 June 2006

Coping/Not coping

Yesterday, I thought I was doing ok. I still think I'm doing ok, in that I know it's completely normal to be up and down, but I'm not doing ok in that I can cope with everything - or anything, in fact. I sent out a couple of notes to people this morning. I had to tell a client that I wasn't going to be able to make a dinner with him this evening. That made me cry. I decided to tell my evaluator what was going on so that I had some cover for tomorrow. That made me cry. I just watched the Buffy episode where Oz comes back to Sunnydale having discovered how to stop himself becoming a werewolf, and discovering that Willow is with Tara makes him lose that ability so he leaves again. That made me cry. I got a note from a colleague saying how sorry she was, that made me cry.

I'm panicking about going to work tomorrow. I don't know how to get myself back into work mode. I'm supposed to be in a workshop all day Friday and the person who is organising it is doing a crappy job and I don't know how to intervene. H thinks I should take more time off but I don't really see how it's going to help. I can't stay off work forever. I've somehow got to find the wherewithal to cope with a normal life again. I managed to go to work after that first bad ultrasound, and yes, I cried at some points during the day but I coped with all the relevant meetings. So I know I can get through work even when bad things are happening. But I don't want to. I just want to sit at home and watch Buffy and be alone. Or with H, preferably.

I've realised something about telling people about this. No one can ever say the right thing. There is no way that anyone else can ever express adequately how awful this is, so the poor things are all doomed to failure. That note from my colleague that I mentioned above made me cry because it was so inadequate. But that's not her fault. It's impossible for anyone else to help. That's what I think I've been looking for - the knowledge that someone else really understands, I want to hear the right thing from people, to know that they appreciate what I am going through. But actually it's only some of you that can do that, those who have been through this and know what worked for you and what didn't. And even then, because we are all different, sometimes we don't get it right for each other, either.

Having said that, my brothers and one SIL have both done really well this week. I sent them three links on Sunday night and asked them to read them. One was Tertia's "How to be good friends to an infertile" classic. One was the empty arms video, and one was a leaflet from the miscarriage association for friends and family of those having a miscarriage. Both my brothers and one SIL have written back having read them with their thoughts and thanking me for sending them through. The SIL who wrote back's mother died of cancer a few weeks before my brother and SIL were due to get married 7 years ago, so my SIL wrote about that loss and how what we are going through takes her back to some of that. She also wrote to apologise about the photo incident. I wrote back and told her not to worry, and to thank her. It was a good correspondance, I'm very glad I sent the links. They are all trying really hard.

I'm off to eat some breakfast, 3 hours after I woke up, in desparate attempt to hope that it's low blood sugar that is causing these crying jags this morning. We'll see.

Tuesday, 13 June 2006

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.

You are not alone


Journeying for the second time


On their way


Been there, done that


Didn't need to go there


July 2008

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