14 Weeks and 3 Days: About the length of a small flip phone?

It's been a couple of weeks because I've just started a new job and I've been run off my feet. Pretty much everyone there knows about the baby, and there's a lovely feeling from them all, even though I'll be leaving in less than 6 months.

Other news:

- I have a lovely round belly. I'll try to post a picture of it today, because it looks really nice :) Strangely, it's not even - where my most recent scar is, my belly pokes in a little.

- We had a scan last week! Just for fun, as the fertility specialist said (since we didn't have the one to detect Downs Syndrome). Turtle's heart is still beating strong, but we got to see so much more - including baby feet and toes! Turtle was sitting with his or her knees folded up, either crossing his or her legs for a story or stretching for ballet (my story, anyway)

-The fertility doctor also said I have excellent blood pressure. Is it ok to be proud of that?

-And he changed my thyroid medicine up again.

-The nausea is completely gone, and now I'm starving all the time. I've been able to introduce more dairy into my diet which has to be a good thing. But my cravings are stranger. I still desperately want fruit, veggies (especially potato) and red meat, but I also want French Onion dip and sat and ate ice cream out of the tub because I desperately wanted it the other night (a month ago, I couldn't stand it)

-I bought a Belly Bean maternity pillow and I love it. It's like two round pillows joined by a wide strip of fabric. It supports my back and my front, and will only get more useful as I get bigger. I actually started sleeping through the night when I got it, so there's happiness :)

-I had anaphylaxis training yesterday through work and they actually gave us all training pens to use. I felt a real flashback to the injections, and the same flinching even though these pens had no needle in them. Of course, I was less squeamish about it then I might have been before IVF :)

- Oh! Edited to add that the paperwork from the hospital came in! Thanks to a kind neighbour it wasn't completely drenched in the rain, so today I'm going to be filling it all out and this will all start feeling real!

Eight week and six days: About the size of a martini olive . . .

-The biggest news of this week is that we've seen the baby! We went in on Wednesday morning to our fertility specialist and I had yet another internal ultrasound. M. came in (he declares that he could pick the baby straight away). The doctor quickly showed us the baby's (massive) head, and then pointed out a wonderful sight - a tiny, beating heart. We also got to see the arm, and the spine of the baby and we have our own print out picture that I like to stare at for hours.

-The doctor also told me to finish my pack of progesterone and that would be it for IVF medication. I had the last one on Friday! So happy to be done with all those unnatural hormones. He also said my ovaries were as normal as expected from an IVF conception.

-General consensus seems to be calling the baby 'junior' or 'turtle' because of the number of eggs we got during the egg pickup.

-The nausea has well and truly kicked in. Some days are worse than others, but the lists of smells I can no longer stand seems endless! Other than that, I think I might almost graze a b cup with my breasts, now; and I am incredibly, bone weary tired.

The Verdict

The phone call came at 1.14pm

My doctor was on the end of the line and he said the magic word . . . Congratulations.

I'm pregnant.

It's still really early days. I still need to take the crinone to make everything hospitable in there. And we won't get our scan for a few weeks due to a whole bunch of real life stuff going on. But for now, we're just enjoying it (well M. is. I'm really bloated and achy, so not so much)

A pregnancy and I didn't even pee on a stick once!

Another type of hormone: the wonders of crinone

So, soon after the egg pick up (still want to say harvest), the doctor put me on crinone, a vaginal gel that contains progesterone. (if that's tmi, you may not want to read anymore.) basically it prepares the uterus for pregnancy and then acts as a support.

The application of it is easy, but not necessarily pretty (unlike the shots and the nasal spray, I can't do this one in the car). The side effects, though, are the real killers. Someone described it to me early as having all the symptoms of pregnancy and all pre menstrual symptoms at the same time. The leaflet that comes with the pack, though, warns of:

"Very common side effects"

Including

"cramps, abdominal pain, head ache, breast enlargement (here's hoping) or pain, feelings of severe sadness and unworthiness, decreased sexual drive, sleepiness, feeling emotional, constipation, nausea"

That's just the very common side effects. The common side effects also include my old favourite, bloating, vomiting and painful joints.

So basically I'm going to be a bloated, depressive, big breasted walking ball of pain.

In reality, I seem to have relatively mild side effects, though the depression is one to watch. I have a history of anxiety and depression, but at least this time I know it's a possibility and can take measures to curtail it. Like looking a photos of grumpy baby meerkats (photo to come)

Cycle one: Egg Transfer

With the doctor's ok, we were able to go ahead with the egg transfer yesterday ( must have been all those crossed fingers you guys had). Because it was a weekend, we had to go to a different hospital (just a specialist one) in a suburb near the city. We were, of course, really early, so we went for a short walk around the block before heading in.

Once in, I signed the million pieces of paperwork, and then M. and I were taken to get changed. This time I got to keep my top half on, adding a beautiful gingham hospital gown and a nice fluffy robe to the mix, along with feet covers and hat. M. got hospital scrubs, plus feet covers and hat. We were then taken into the lounge to wait with a few other people. Luckily it was just a short wait before we were taken through.

The embryologist came and saw us first. He let us know that they'd frozen four embryos early, 2 had gone through to blastocyst (one of these was put back in) and another four looked like going to blastocyst yesterday or today. Which makes 10 altogether, which is a very good number.

Then I got to lay back and put my legs up on these bars. The doctor put the speculum in, which was the only painful part of the whole process. (I found relaxing made it a lot easier). Then the embryologist came out with a catheter with the embryo in it, the doctor placed it in, the embryologist checked it had left the catheter (Those tiny cells. Always playing hide and seek, you know). Then I was good to sit up and go.

M. And I got back into our regular gear, then made our way back to the patient lounge. The nurse made us both a cup of tea and we had some cheese and crackers. About 30 minutes later we were good to get on with our day (the nurse suggested no bungee jumping though).

So in less than two weeks we'll know something. I still need to take it relatively easy because of how close I was to serious illness. But one thing I am doing is taking a quiet walk every day, which is good on many levels.

Don't fret, I have plenty of posts planned to keep us all busy during the two week wait! Just hold on until I tell you about the wonders of Crinone . . .

One of those kinds of weeks

After the egg pick-up we weren't sure if we'd go ahead or wait a cycle for the transfer. Because of the huge number of eggs they got, I was in serious risk of hyper-stimulation, and I actually got very bloated and put on 2 kilos, which is not a good sign.

Luckily over yesterday and today, I've regained some equilibrium. The pain is gone, most of the bloating is gone and I've actually lost 3 kilos in two days, which is relatively remarkable. So the embryo transfer is on for tomorrow morning.

I've got 'lush' lining in there, and I'm on crinone (progesterone - more on that later) to make everything nice in there, so we've just got to wish and pray and hope that the embryo likes it all. So, in two weeks time we'll find out if we're pregnant or not.

Update from the Embryologist

30 eggs removed.

20 mature enough to fertilise. (the scientists ended up using ICSI)

13 embryos at the moment. This could obviously change if some of them fail.

Keeping everything crossed.

Egg-pickup: The Long Version

The pick up was set for 2.30pm which meant we had to get a few things sorted in the morning. I had to fast from 8.30, so I had to have my thyroid tablet and some breakfast in the morning, along with a tonne of water. Of course the minute I started fasting, I was immediately hungry and thirsty.

We had to be at the hospital by 12.30, but it's me, so we were there by 12. They pretty much took me straight through after I paid a huge amount that my shoddy health insurance doesn't cover. When they got the right file (take 2) we went through all the blood pressure, pulse, go through medical files stuff. Then I waited. And waited (I finished a book)

Fnally it was time to get changed. The joy of a private hospital is that they gave we the regular hospital robe (yuck) plus a fluffy hotel room robe to wear over the top. Since there was no way I could do up the straps, this was excellent.

I waited a little longer and then they took me to a cubicle on an extremely uncomfortable hospital bed. Unfortunately Question Time was on tv. Fortunately Tony Abbot didn't speak. There were some small mix ups with them asking me if I was someone else, which raised my anxiety levels, but when I mentioned the anxiety the nurses were wonderful, making sure to comfort and stay with me. They let M. in briefly to sit with me and to give me his 'sample' (the males get all the euphemisms) which I had to tuck between my legs to keep warm. I'm sure there's a joke in there, but I can't think of it right now.

Finally they took me through to the surgery area. They put the observation gear on, including a child blood pressure cuff (for my tiny arm). Then I waited a bit more. Finally the anesthetist came in and promised to try and avoid the reactions I've had in the past. Then the embryologist came in for a quick chat and to collect the 'sample'. Finally they took me through to the operating theatre. My doctor caught me on the way in and let me know that he'd catch up with me after.

The anesthetist knocked me out pretty quickly with talk about a tropical island, and before I knew it they were waking me up. The best part was that they let me keep my glasses right up until knocking me out and when I woke, I had them on again. This helped with the anxiety so much. The first question I asked, of course, was how many. When she said 30 she wasn't really sure, which is why I've asked M. to verify it over and over again :) They gave me some pain killers and a wonderful hot blanket.

There was a bit of a backlog, so even though I was quite alert I had to wait there a little before moving into the next area. There they gave me some water (yay)and my own clothes (more yay) before the doctor came in to confirm the 30. However, he's very worried about the hyperstimlation risk, so the transfer may have to be put off for a month, which sucks.

Then into the sit up recovery room where I discovered that M. hadn't left the book I wanted to read in my bag. So I was left with the wonderful magazine collection and the tv until they discharged me.

I'm on panadol forte at the moment, but there's still a little discomfort even with that. I'm drinking a tonne of liquid and resting. I need to check in with the doctor later today to let them know how I'm feeling and I should hear soon about the number of embryos we got. So keep the fingers crossed.

Egg pickup - quick post

I'm home, feeling relatively good after today's egg pickup. I'll post more tomorrow, but wanted to share the magic number.

30 eggs.

I've checked several times now, thinking I was in some sort of anesthetic dream. Still 30 eggs.

No wonder I was sore.

More tomorrow.

The Last Check up

My eggs do not look like this . . .

This morning I had my final check up, scan and blood test before the egg pick up on Monday.

On the way in, I was feeling very sore. Walking too far or too fast is becoming a problem at the moment, due to the pain in my lower abdomen. The scan showed at least six large follicles on one ovary and nine on the other. "So we could be looking at as many as 20 eggs" he said, relatively calmly.

Since this is significantly above the 'doctors are really happy with' number of 15, I'm at a high risk of Ovarian Hyperstimulation Syndrome. (Check out the link. There's a pretty good picture similar to what my ovaries look like at the moment). There are a couple of things that could happen here

1. Everything goes wrong over the weekend. Egg pick up is cancelled. I cry a lot because I'll have to go through all this again (everyone thinks this is very unlikely, but possible)
2. I don't recover well after the pick up and I get OHSS. The embryo transfer is cancelled and all embryos frozen for a later date. I only cry a little. (More possible. I'll know by next Wednesday)
3. Everything goes as planned, and I don't really cry at all. (Probably equally possible with option 2)

Then we were off to the nurse to pick up my next lot of drugs (the trigger injection for Sunday morning and crinone for afterwards), to get more warnings about OHSS and to go through all the hospital stuff for Monday. Then a blood test and we were done.

So, fingers crossed we're ready for Monday. I'm quite thrilled that we've made it this far after everything we've gone through. Now just to get through the next few days.

Image from flickr

And the award for most scanned ovaries go to . . .

Back to the doctors again this morning - I feel like I'm living there at the moment. Another scan showed no more follicles (phew) just the sixteen that were already there (16!). All a good size, all healthy.

Which is Good News. The egg pickup (or harvest as I like to refer to it) is booked for Monday at 2.30pm. The trigger injection, therefore, has to be given at 2.30am on Sunday. 2.30am. 2.30 in the morning . . .

Unfortunately, this good news means I'm experiencing quite a lot of ovary pain, and walking, sitting and standing are not so easy at the moment. Or wearing pants. I wore my last pair of loose pants yesterday, my only skirt with elastic today and I'm pretty much going to be wearing tracksuit pants by Friday. The doctor offered to bring me ugh boots to wear for the next scan (another one!) then.

Overachieving Ovaries

So, I had my scan this morning at the doctor. (I must say, there's nothing quite like beginning your week by dropping your pants in the doctor's office.) My uterus now has a 'lush' lining (his words), and my ovaries have been nice and busy since starting the Gonal-f stimulation injections.

A little too busy.

Seems my ovaries are as overachieving as the rest of me. The doctors usually like to see 12-15 follicles total at the end stage. At a week out, they like to see a little less.

I have (at minimum since these are only the ones they can see) 8 follicles in each ovary. Quite a nice size too.

Which is, of course, mostly good news (much better news than no follicles or only one or two). The only problem is that I'm much more open to hyper stimulation, and the whole thing might happen earlier than we like which means only one day off work, not three :p Also, the cramping sucks big time (think ovulation cramping and times it by 16)

So, dear ovaries, I promise you can have an A+ if you just behave until next Monday. No need to go overboard, okay . . . :)

A Bit of Good News . . .

We made our way back to the fertility specialist this morning (btw, peak hour traffic sucks!). This time the scan was a lot better - left ovary clear, tiny follicle in the left, but on its way out. The doctor was happy and the injections could begin. Phew!

The nurse ran us through the basics of the injections - how to dial up the dose, how to attach the needle - then asked if I wanted to do it, or get her to. I decided I should do it - after all, I'll have to do it on my own starting tomorrow. Then I saw the needle.

The big, long, pointy needle that has to go into my stomach.

I froze completely. I just couldn't bring myself to hurt myself in that way. Luckily the nurse was on the ball and helped me guide my hand in. Turns out it doesn't hurt very much, and is quite easy to do. I was going to do them on my own before I left for work in the morning, but M. has suggested we move it earlier and he'll be around to help me. (He was also a bit shocked by the size of the needle and said he didn't think he could manage to poke himself with it.)

Hopefully the main side effect of this will be counteracting the Synarel - I want my mind back again! I just need to get lots of liquids and protein to avoid organ failure if I over-react to it.

I have a blood test on Thursday and a scan next Monday. All going well, the tentative egg retrieval is set for 31st October. And . . . Cue the Halloween jokes :)

Squeezing in an update

So, I said I saw an end to the Synarel, didn't I. What a fool am I.

We went to the doctor early on Tuesday morning for a scan and to set up the injections. Unfortunately there was a big follicle (28 mm) still lurking in my left ovary, which would completely confuse the matter if we started injections. Doctor's advice? Just stay on the Synarel for another week and we'll look again.

Since then, the side effects seem to have become worse - strong hot flashes (I was sweating last night, but M said it was pleasantly cool), desperate thirst, headaches - hopefully all launching me into faux menopause and getting rid of the follicle.

Next appointment is Monday. Cross everything for me that we have a good result then

Learning all their is to know about IVF (and wishing I knew more)

Yesterday, M. and I had our compulsory session with the fertility nurse. The objective of the session was to make sure we were comfortable with the elements of the procedure, go through different aspects and supports and through the money stuff as well.

The nurse is really supportive and her information was comprehensive, though there were times when I wished her office was set up a little better so that M. could be better included. I realise I'm the one doing the spray/injections/day surgery, but he's the one supporting me and the one who'll but up with my frantic questions if I forget something. She's given me a tonne of information to go through as well.

What I'm doing is known as the Down-regulation cycle, or the Long Down Regulation cycle. Basically it means I start treatment a week before my cycle actually starts (in fact, I started treatment today). Treatment consists of a nasal spray for up to 24 days, injections starting around day 5 or 6 of my cycle and going for around 10-12 days, then an injection to trigger the eggs into fertility. Then there's the 'egg pickup' which involves a general anesthetic, then an internal ultrasound with a needle attached (pretty cool when you think about it). Then the scientists do their magic (funnily enough, they do this in a suburb where I lived for 6 years). Finally there's the embryo transfer, followed by the horrid two week wait. During that time I also take progesterone to keep conditions all nice.

What else did she tell us? Well she reminded us that there are counselors available, and that they can help me if I'm having trouble dealing with any part. She walked me through the delightful side effects of many of the drugs. She had no problem with me continuing my ballet class, though I'm not sure she understood how strenuous some of the jumps can be. She recommended 3 litres of fluids when I'm on the injections which is going to be delightful back at work. She also gave us the great news that with my health and age, I'm in the 'golden' zone for IVF, and my chance of getting pregnant could be as high as 50% (which is huge).

So with that down, we were all ready to begin the treatments . . .

Picture from Flickr

Making the choice of reproductive treatment

Well, we've made our choice. At this stage we will be beginning IVF in my next cycle, with preliminary treatment starting next Tuesday.

In the end, it wasn't a real hard choice to make. IUI sounds a lot less invasive (we just put washed sperm into you), but it does involve taking hormones every month, with some pretty harsh side effects. There's an increased chance of multiples (not at the moment, thank you) but a relatively low chance of actually falling pregnant. The insertion of the sperm doesn't sound like a picnic either - and with a lower chance, we'd probably have to go through it a few times at least.

IVF isn't great the first time. There's a nasal spray, injections and then the egg retrieval under general anesthetic. It will mean some significant time off work. But, the chances of falling pregnant (and carrying the baby through to birth) are significantly higher, and we're only going to choose to have one embryo implanted (common practice in Australia these days) so less chance of multiple birth :) . If it isn't successful the first cycle, we'll have had the embryos frozen, and latter cycles would be a lot simpler for both of us.

Considering all things, including our collective mental state, our comfortable financial position and how long we've been trying, IVF seemed the obvious choice. It won't be pleasant, I'm sure, but thankfully we're in a country where this is possible, and the science is good, and we have the means to be able to make this choice first. Most importantly, it's a decision we've made together, and one we're comfortable with.

Oh, you silly thyroid!

On Monday, the doctor decided to test my thyroid again since Stupid Doctor had said it was all ok.

Good thing we did, since the levels indicating an underactive thyroid were ridiculously high. The Fertility Doctor rang back yesterday and is sending out a new script. Until then, I'm on two tablets one day, one the next.

This is a change in the last month, though, and doesn't change the fact that we've had 19 cycles of trying prior to that. So we're still going ahead with treatment.

But it's nice to know there was a reason I was feeling bad!

Facing a new set of facts (Or the sucky post of suckitude)

This is going to be a very difficult blog post to write.

Before yesterday's meeting, we had a fair amount of hope that we knew what was wrong and it was quite easily fixable. Seems it was a case of counting the chickens before we'd seen the eggs.

My thyroid count wasn't as high as we thought it might be. The tablets are working as they have been, and my levels are only just above the preferred level. Because the Stupid Doctor had said all was well, the Fertility Doctor wanted to do another blood test to see if the result would be the same. However, he's pretty certain that the thyroid problem is not what's preventing us getting pregnant.

The only other issue was slightly lowered morphology in M.'s sperm test. This could be due to slightly too much caffeine or alcohol about three months before the test, and is so slight, that again, with all the time we've been trying, it can't be counted as what is preventing us getting pregnant.

So, our official diagnosis is unexplained fertility.

I believe that there are a couple of further tests available - increasingly invasive and/or embarrassing tests. I believe they probably won't tell us what we don't already know - my reproductive system is essentially healthy, M. is essentially healthy - but they will take a financial, and more importantly at the moment, an emotional toll that I don't think we can really deal with at the moment.

Which leads us to, what next. Essentially we're looking at IUI or IVF.

And that's a whole new world to get my head around. The doctor was great yesterday, gave us all the information and answered all my many, many questions, but I must admit there was an overwhelming feeling of having lost something yesterday. A feeling that persisted through the afternoon and resulted in quite a lot of tears last night.

We've talked about it, a little. We've read up on it a little. We think we've made our decision. But we're not going to make anything final until tomorrow. Then we'll get the ball rolling on a whole new approach to getting pregnant.

Photo from flickr

Surviving the HSG

Yesterday was the dreaded date for the hysterosalpingogram (HSG). I really wanted to avoid this test if at all possible, but unfortunately events conspired and there I was yesterday.

We timed our arrival pretty well, leaving enough time to park and find where we were going (the diagnostic rooms are part of the nearby private hospital) and to fill in a few forms. Unfortunately, things were running late, and we were left in the quiet waiting room for around three quarters of an hour, which was enough time to really get my anxiety up. (Not to mention my disgust at the magazines which seemed to be filled with pregnancy and baby stories)

When we were finally called, they organised me to get changed. Thankfully, it was not a full change - just the lower half of my clothing (you do feel better with some of your own clothes on) were exchanged for a hospital type gown. Then down the hall to the room. They wouldn't let M. in the room, but he was able to wait outside (I would have preferred him in there, honestly).

The nurse explained the procedure to me, and then the doctor repeated the instructions. They were nice, but they insisted on carrying on their own conversation from earlier, which did nothing to distract me from my anxiety. Then I needed to get myself into position for the test, which involved a fair amount of contortionism, particularly when I had to hold my feet in a teeny little shelf. In the end, my muscles and ability to stretch did not work for me, and they had to hold my feet in place for me.

Medically, the procedure involves putting a speculum in, inserting a catheter through the opening of the cervix, inflating a small balloon to keep it in place, then injecting a liquid dye through and taking x-rays. From my perspective, it involved trying desperately to relax while the speculum was put in, increasing cramping and discomfort through that and the catheter, sharp lower cramping while the balloon was inflated and ongoing cramping through the whole procedure.

Afterwards, I had to lay there for a bit. The radiographer (I think) tried to make conversation, mostly around my birthday (just after Christmas), but she went on to say how her daughter shared my birthday, that she never wanted a Christmas baby, went back on the pill to avoid it, but got pregnant just after going off it. Just the right conversation for a woman obviously there for infertility, right? (No, I didn't tell her off. It's hard to tell people off when you're only wearing half your clothes)

I was mildly uncomfortable afterwards (M. did a lovely job rubbing my back which relieved it heaps), had mild nausea going home, and took myself straight to bed as the anxiety/stress caught up with me. About three hours after the procedure I had horrible stabbing cramps which were slightly relieved by panadol. This morning I woke up with almost no discomfort.

The good news was that there were no blockages, and the whole area looked fine. I just wish there was another way to find that out, and hope I never have to go through that again.


Photo from flickr

Making the First Visit

Today was our first visit to the fertility specialist, and, in my mind at least, our first steps into getting help in getting pregnant. Since the appointment was relatively early, I had initially planned to only take the morning off work. But with much deliberation (a couple of minutes) I changed this to a full day in case we got held up, or something went wrong. Nothing untowards happened, but as it turned out, I'm glad I took the extra time.

Walking into the doctors rooms together was like having a giant flashing light over our heads 'We're having trouble over here'. Luckily, the whole set up of the waiting room - from the obviously busy reception, to the awesome play area in the shape of a boat - was relaxing. We filled in the forms (with me wracking my brain to remember when I had all my surgery) before settling in to wait for our turn.

The doctor immediately put me at ease (phew) going through my reproductive history (very dull) and general medical history (much more interesting, especially when they ask about parents' health) and then asking similar questions of M. Then it was time for the exams . . .

Which meant internal exams. We started with a basic pap smear, a simple internal exam and then an internal ultrasound. Luckily, since I tend to freak out with new examinations, all these were familiar to me, and were done so simply and calmly that I didn't have any anxiety at all. The best news is that physically all looks well and normal there, and there are follicles developing in both ovaries, with a big one developing in the right ovary (great for this time in my cycle).

We followed this up with a billion and one blood tests (so much blood!) taken by one of the best nurses ever (barely a mark on either M's or my arm) and plans for a couple more tests to come (one for M and a rather uncomfortable one for me). They'll let us know in the next week if anything untoward pops up in the blood tests, but otherwise we're just on the wait until next time.

Possible treatments? Well the nurse only mentioned Clomid and intrauterine insemination, which seems to me that they're pretty comfortable with the less intrusive options first. Of course we won't really have an answer about treatments until our next appointment in four weeks time.

Am I glad we went? Well I do have really mixed feelings about everything at the moment, but I am glad that we chose this particular doctor and he was able to fit us in. As for the other feelings, they'll have to be for another post . . .

Photo from Flickr