Nine weeks and five days: nearly the size of a Brazil nut

All in all, it's been a pretty uneventful week. I've got rolling nausea, and it has become worse, but I haven't been sick at all. My lower back hurts at times, and I'm having some trouble finding a comfortable way to sleep - which doesn't stop me from falling asleep all the time!

We've announced the news to my larger family - it's the first great-grandchild on this side, so everyone's excited. A couple of my aunts had fertility difficulties of their own, so they've been particularly understanding of my anxieties. Also, my grandmother and aunt (mum's sister) both said they had relatively mild morning sickness, which really seems to be my case as well.

However, my sensitivity to smell remains. I went into the city to do Christmas shopping and could smell every horrible smell around. Then when the across road neighbours decided no party was complete without burnouts, the smell of burning rubber was absolutely horrendous.

Monday makes ten weeks, which is the week where the embryo becomes a foetus. It's also the week I turn 30, so maybe we should have a joint party. It's amazing reading about the development and seeing how much building is going on in there.

I've started reading about what do do with infants. Some of the books have been great, but very hetero-normative, which irks me. Others have some good information, but go over the top on the ultra-natural thing.

I've begun crocheting for the baby now (well once I finished booties with monster claws for a friend). So far I've finished a monkey hat and I'm 3/4 way through a baby blanket. We're not finding out the sex of the baby, but I'm refusing to use just 'neutral' colours. I do take great delight in using pink and blue together, since I love both colours.

Well, I think that's all for this very disjointed update. Hope everyone has a great Christmas/holiday :)

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.

7 weeks and 6 days. Around the size of the diamond on Nicole Richie's engagement ring . . .

Long time, no post. Mostly because I've been finishing up at one job, plus going away on a retreat for another. The retreat was interesting because no one knows I'm pregnant there yet (waiting for the second trimester), so I couldn't explain things away when I felt off. Also, making sure I could eat the food was kind of special. Luckily the nausea was kind to me, as long as I kept away from the cooked mushrooms.

Most of my nausea is smell related. Mushrooms, coffee, chocolate and cheese toast from Sizzlers (darn) are out. Mashed potatoes, Gouda cheese, jelly lollies and almost any red meat are in. I can handle tea, but that's it for hot drinks, cold drinks are fine as long as they aren't too fizzy or milk based. So, world's most boring diet. (Also, if you're going to serve me tomatoes, they'd better be fresh because I can taste when they're not)

Tiredness is my life at the moment. M. regularly wakes me up when I fall asleep on the couch, and some tasks leave me zombie like. Probably because this week the embryo has (hopefully) doubled in size. Then there's the time spent staring at my now noticeable breasts (exciting when you start with a small A cup)

Wednesday is the day for our first scan, and therefore the first hurdle for my anxiety to get over ( well after the anxiety of going for fertility treatment, choosing ivf, giving myself injections and going through the egg retrieval). If all is well then, we may be able to look at telling less immediate family for Christmas.

Meanwhile, my baby stash grows. Mostly because I'm leaving my job and people want to give me a gift while they can. I look at them as gifts of love, and know that even if something goes wrong, I'll out them aside for later, knowing they were given with love and will be used with love eventually.

Week Six: the search for a size comparison that isn't fruit . . .

A lot has happened since the last time I updated with our good news. (Well not that much, but it makes me feel like I'm more productive)

- I went to see the nurse at my fertility clinic. She moved me onto progesterone pessaries (1/3 the cost of crinone), told me that the horrific pain I was having (not to mention the five month pregnant bloating) was hyperstimlation rearing up again (yay!), and let me know how far along I was (5 weeks and 2 days at the time - it's now a week later so I'm 6 weeks and 2 days)

- The pessaries are . . . Different. (TMI alert) They're inserted like a tampon, twice daily, then I have to lie down for half an hour. In that time they melt and the progesterone gets in my system. The side effects seem less extreme then the crinone, but in combination with the heat, they're not the most comfortable things in the world.

-the hyperatimulation is more under control now I understand that I have it again. It's controlled through drinking water and Gatorade, and while it's still a problem, it's significantly improved.

-Nausea kicked in over the weekend. At first I thought it might be the tummy bug doing the rounds, but that was a 24 hour thing, and this has been 5 days, so not so much. No vomiting, but relatively strong nausea, particularly in relation to food. And it sticks around until early evening.

-Almost everyone knows. Which both comforts me and terrifies me in equal amounts. Some people picked it up through the massive, swollen belly I had last week.

-I am pretty terrified of something going wrong and I probably will be until we a) hear a heart beat, b) see a scan, c) get through the first trimester d) are holding the baby. Part of the problem is that symptom are changed by the progesterone, so I don't feel like I'm controlling my body, so I don't feel like I can trust it. I keep holding on to all the positives though - it was a strong positive result, I've had no spotting at all, I'm healthy . . .

-we have our first baby things. A cute singlet with planes on it (we're both plane enthusiasts, M. More than me, though I do intend to impart my love of Spitfires), two winter onesies, a pair of tiny red sneakers and two board books (including Where is the Green Sheep!) I also got a present of a bib and a singlet from a co worker who promises to hold a baby shower, even though I'm changing jobs at the end of the year.

- And our current due date is . . . 22 of July :)

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!

A different kind of two week wait

Well, only three more sleeps until my pregnancy test and I can honestly say that this has been a very different two week wait.

Some of the differences:

- I know almost all my symptoms can be attributed to the progesterone. Which actually stops a lot of fretting. Instead of worrying whether it's pms or pregnancy I just blame it on the progesterone.

- My breasts are definitely bigger. As in, my bra is getting rather small and hurting me. So, I need to go bra shopping or get a crop top of some sort.

- I know that the first part was already done.

-I'm very, very, very tired. Like fall asleep at work tired.

-I seem to get progressively sorer during the day. Especially in the stomach.

All in all, it's gone much quicker than I thought it would. Just a few more days and we might know something, one way or another . . .

Words I hate seeing

Whenever I've started a new drug during this cycle, I've done a bit of research of the side effects. Something that really irritates me is the number of time side effect information is proceeded with 'Most women experience no side effects'

Obviously, I'm in the minority because I've experienced a multitude of side effects with each of the drugs!

Synarel - tiredness, achiness, forgetfulness, mood swings (all to extreme levels)
Gonal-f - hyperstimulation, bloating, tiredness, cramping
Crinone - tiredness (yes, I've just been tired for the last 6 weeks!), sore breasts, depression

I realize they put the 'most women' in the information to calm worried women who are about to put all these hormones into their bodies, but when you're already the minority (infertile), the last thing you need is to know you're even more of a freak because you have side effects to everything!

(This post totally brought to you by a person trying to distract herself through the two week wait)

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.

Triggering It All

I had my last Gonal-f injection yesterday morning, and my last sniff of synarel at 7pm last night. Then at 2.30am this morning, I stumbled out of bed, along with M, to give the trigger injection. This injection will allow the eggs to mature ready for collection.

The injection is a premixed syringe, and just needs to be given pretty much like the Gonal-f injections. The instruction sheet was hilarious, though - a massive page full of statistics and side effects, with just a teeny tiny corner devoted to the actual instructions. The steps themselves also advised me to inject myself in a 'dart-like motion'. M suggested that meant he should stand at the other end of the room and throw the needle towards me. Needless to say, that was not the approach we finally took.

The injection all went fine, in the end, though I was extremely faint headed afterward. I think that was just a psychological side effect, since this needle looked more like a needle than others have. A bit of Gatorade and I was all fine.

Not taking the Synarel has felt very strange this morning. No longer is my life ruled by the alarm on my phone! (Well not until Wednesday when I start the crinone anyway) Also, the desperate thirst I had before has also died back a little, which makes it harder to drink the 3 litres of water I need to consume to avoid OSSH.

Tomorrow I get to have my thyroid tablet and have a small breakfast, along with lots of water before fasting for 6 hours. Then off to the hospital. Apparently I'll be in quite some pain afterward, so I'm not sure when I'll be able to update again. Hopefully there'll be good news about the number of eggs soon.

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 . . . :)

IVF injections - one week in

So, I've now had 7 Gonal-f injections to stimulate eggs. How are things going?

-the Gonal-f counteracts a lot of the emotional side effects of the Syneral. This means I have more concentration and less emotional turmoil. This is a Good Thing

-the general achiness is also gone

-the tiredness hasn't

-replacing the other side effects I now have massive bloating, achy ovaries and irritation at all the injection sites :(

-also, I need to drink at least 3ltrs of liquid a day, so I'm constantly heading for the toilets!

A blood test last week showed that hormone levels were good, now we're hoping tomorrows' scan goes as well. Then another week until the tentative egg pick up

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

Things I hate about Synarel

This is how I feel most of the time . . .

I've been on Synarel for 13 days now, which, in my mind at least, makes me perfectly qualified to talk about why it sucks (of course, this is the same mind that forgot how to do subtraction and needed help from a very kind 12 year old)

1. The taste. A friend asked me what it tasted like. I'm leaning between pesticide, an ashtray or the garbage bin after a week in the sun.

2. The fact the taste doesn't appear until about 15 minutes after the spray. So you're there thinking, that wasn't so bad. Then 'bang', aforementioned taste

3. The stupid song that is the alarm on my phone every 12 hours. (I know I can change it, but this is my stupid list.)

4. The fact I now seem to forget everything. Everything. Like simple words. And how to do subtraction. Today I brought a coffee with me into my study. Without any water or milk in it (but the teaspoon was still there)

5. The acne. Which turned out to really be my imminent period, but I'm blaming synarel

6. How hard it is to spell synarel

7. The mood swings. I feel like I'm harbouring seven dwarfs of moods in me at the moment - so far this last week I've had visits from Sleepy, Grumpy, Weepy, Snappy and Happy.

8. People who tell me that I shouldn't complain about synarel

9. Feeling like I'm not me anymore.

10. Insecurity over whether I'm doing it right or not. This morning, I pressed on the spray and got nothing - no sound, no spray, no liquid. So I did a check in the sink and repeated the dose successfully. But now I'm worried that maybe the first one did work and the second one is an overdose and I'm probably going to die . . .

11. The looks on people's faces every morning at work. The 'oh shit, what horror is she going to inflict on us today look'

The good thing about Synarel?

My period came on Thursday, so there now is an end in sight for the synarel

Image from Flickr

Cycle One: Starting with Synarel

The first part of my IVF routine is a nasal spray called Synarel, which I need to take twice a day. This starts before your actual cycle starts (day 21 of my previous cycle) and works to stop normal ovulation. (Ovulation needs to be stopped so we don't lose the eggs I'll be producing.)

The actual taking of it is pretty simple - remove cap and safety piece, stick it up your nose, squirt and sniff. I have to keep to a strict time table - every 12 hours (7am and 7pm in my case), and people have warned about forgetting to take the cap off - and when it's as expensive as it is, you don't want to lose any spray.

The taste is a) terrible and b) long lasting. This morning was actually better than yesterday to start with, because I had the sniff just after I had some coffee, but it's really kicking in now. Some people recommend peppermint to mask the taste, so I'm trying to decide if that means Minties or I'll just invest in Mint Slice biscuits. Also, as bad as it tastes, it's not as bad as the reflux tablets I had to have as a child (taken on their own they tasted like dentists cotton. Except I couldn't take them as tablets and mum had to smoosh them into a watery paste with water and I had to drink/lick it all out. I still want to vomit just thinking about it).

Side effect wise, some people don't seem to have any. Some people seem to get them by day 4. I seemed to start yesterday. Because the drug stops ovulation, they say the side effects are similar to menopause. Not sure if my side effects are like menopause, but I'm tired and achy, have tightness in my lower abdomen and I'm really irritable. (Apparently another side effect is shrinking breasts. I'm hoping this is a long term effect for those who take it for other issues. I have precious little breast to lose!) It's possible that some of these effects are pre-menstrual, but I'm definitely more irritable (I felt like I had something crawling under my skin this morning) and also having more trouble sleeping. So it seems like I got hit with the side-effect hammer!

I forced myself to get out for a walk yesterday, which seemed to work, plus I'm going to increase my water and see if that helps. Hopefully the side effects level soon, and they should definitely do so when I start the injections.

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

All systems going ahead . . .

Two of the bibs I crocheted for my best friend

This has truly been a week of ups and downs when it comes to everything fertility related (and in my mind at the moment, everything is fertility related).

Monday and Tuesday were relatively quiet, though not without their quirks. Wednesday morning brought my period with it, along with the first lot of work colleagues approaching me to make sure I was ok (no, not really).

Thursday was filled with more inquiries into my well-being (just tired, I tell them. Not sleeping well). Then I met up with my best friends for coffee. One of my friends is pregnant, and I had crocheted gifts for her, which once again made me realise how healthy the crocheting is for me. Seeing her joy at the unexpected gifts, knowing they're going to be loved and used, filled me with joy, something which I really needed at that point in time.

Then, within half an hour of giving her the gifts, there was the phone call from M. and a whole heap of new emotions, from anger and frustration, through to hope.

Since then, I've gone back and done some reading on hypothyroidism and how it affects health in general and fertility specifically. The general symptoms are well documented - tired, aching, weight gain and digestive issues are the most well known, but it can also show in slowing speech (which may explain the trouble I've had reading aloud this year?), hoarse voice (big problem this year, but may be because I've had to yell more), drooping eyelids, intolerable to cold (though it was cold in my state this winter!), coarse and dry skin (even the fertility doctor picked this one), dry hair and tingly hands. The problem is, of course, is that these things are relatively innocuous and can be explained by other things. However, if they are symptoms, I'm going to feel great when we adjust the medication dosage - and feeling great has to help fertility.

The information on hypothyroidism and fertility is less conclusive. I've seen information which suggests it makes ovulation less likely, while other information talks about problems with the luteal phase, making it difficult for a fertilized egg to implant - basically a chemical pregnancy. Either way, I'm going to wait until I see the specialist and ask him what his take on it is. I'm also going to ask what my levels were - good for fertility is 1.0, but acceptable range in Australia (for non-fertility) is up to 3.0, I believe. If it's close to that, I'm going to be adding that to the complaint I make about Stupid Doctor.

What comes next? Well I get a short week at work this week, because Friday I need to have a HSG (hysterosalpingogram) which is an x-ray of my uterus and fallopian tubes. The doctors describe this test as 'uncomfortable' which is a term they also used the last time I was recovering from surgery (bloody painful would have been a better description). Then the Monday after that we're back at the fertility specialist for our 'where to' update and a shiny prescription for some 'make me healthy again' tablets.

The baby blanket I crocheted

Well . . . That is 'Interesting' News

Today my husband M. contacted the fertility doctor's rooms in regards to the tests he had done on the weekend. In his discussion, he was able to find out quite a lot of information to be further discussed in our next appointment.

Most of the news was positive. M. is all 'normal', which is really wonderful news. Most of my tests came back great, including the one which measured the 'age' of my reproductive system - basically finding out if it's in the state it should be for a 29 year old. Just one test threw up a question . . .

The bloody thyroid test.

Remember Stupid Doctor? The one who told us to just go back and try a bit more? Well one of the things he did do was put me in for basic blood tests, including my thyroid. I've had Hashimoto's Thyroiditis for a couple of years now, which is controlled with a simple tablet every day. I'm not great at remembering to get my blood tested, but the last few times, both doctors who have tested it have expressed concern about the levels, and said if it continues they'll revisit the dosage. Stupid Doctor said no such thing, instead completely clearing me with the nurse (despite all the doctors being at the same practice and my file containing the notes of other doctors).

But the blood tests taken at the fertility clinic only a couple of weeks later are showing my levels to be right out. And one of the main symptoms of this . . .infertility.

The stupid bloody doctor has basically missed the easiest thing to diagnose about me. Thank goodness I went to another doctor. Thank goodness he referred me to a good doctor. But we've basically wasted at least two cycles and a huge amount of stress and energy for such a treatable thing.

The good news is, though, that this is a treatable thing. And the treatment makes me feel better, which is just a bonus. It'll probably combat the fatigue, headaches, digestive problems and about ten other things which are classic symptoms of my levels being out. And which I probably would have put together if the stupid doctor hadn't cleared me.

Stupid bloody doctor!

Unfortunately . . .

It seems that this month has also been a big fat unsuccessful.

The hardest part about an unsuccessful month at this stage? Dragging myself through the next day when I just want to curl up in bed and cry. Or the fact that I'll be probably having an 'uncomfortable' (usually doctor speak for bloody painful) procedure next week as the next step in finding out what's wrong. Or trying not to inhale whole family sized blocks of chocolate . . . :-)

On to the 21st cycle . . .

How to survive the two week wait

Every two week wait (and this one is my 20th!) is slightly different from the others. There are different 'symptoms' (all of which turn out to be pre-menstrual in my case), different obsessions, different distractions.

This month I'm distracting myself with crochet. One of my best friends is expecting her first child in February, so I've made her a big round blanket, as well as a range of bright, colourful cotton bibs. I like crochet because it keeps the mind busy, I feel like I'm actually producing something and it's easier on the eyes than endlessly playing Angry Birds.

As for symptoms, I keep going back and forward on them. I had a vivid dream last night (featuring Dr Karl from Neighbours . . . ) which obviously means I'm pregnant. Or it obviously means my period is coming. My husband's glass of wine hasn't made me turn up my nose this month, which means my period is coming. Or I'm pregnant. My breasts hurt. Which means I'm pregnant. Or my period is coming!

The very real problem is, that after all this time I really don't trust my body anymore. There have been months where I've been absolutely certain that this is the month. And then my period comes, and all those hopes I've worked up feel especially heavy. Before we started trying to conceive, I was definitely more comfortable with all the signals my body sent. Now I just feel confused!

The good news is, it'll all be over soon. One way or another, I should know something before the end of the week. Then the next step of planning can begin.

Photo from flickr

When Facebook Strikes: My Ranting Reactions to the 'Breast Cancer' meme

I'm a pretty regular Facebooker. I use it to keep in contact with family, share photos, make jokes with workmates current and past, and post links to news articles I'm pretty sure only two people other than me care about.

I understand the pitfalls, most of them related to people I went to high school with, and usually I just ignore and move on. Unfortunately, the latest one was a little like a hefty kick to the stomach, leaving me feeling depressed and then angry.

It's one of those ridiculous 'Breast Cancer Awareness' memes, that in actual fact have nothing to do with Breast Cancer or awareness. Like the colour of your bra or posting your shoe size in inches to make people cast aspersions on your partner's penis. This delightful little number gives you the sentence '_______ weeks and craving ________', and gets you to fill in the blanks with a little reference chart based on your birthday.

I saw this for the first time yesterday morning as the status of someone rather close to me. I had no idea that it was a meme, so was absolutely shattered when I saw it. Shattered that she was obviously pregnant, shattered that she had chosen Facebook to tell me and everyone else, shattered that I still had another week of the two week wait and in every single way I was over it. I cried before I went to work. I opened up to a colleague and almost cried some more. I spent the day in a deep funk.

I came home and found another message from her assuring everyone that she wasn't pregnant, it was just something else. It wasn't until later, when I saw another one, that I twigged to what it was about. Then the anger set in.

Not at the friend who posted it first. English is her recent second language, and there's a very real possibility she didn't understand the full meaning of what she posted. But at the sadistic bastard who came up with the self serving meme in the first place.

Pregnancy, just like breast cancer, is not a joke. Not something to 'keep men out of' (as the email that sets up the meme implores you to do), not something to play around with. Pregnancy is a deeply personal thing for so many women, who might be infertile, worrying about how they're going to afford to raise the child they're carrying, recovering from a miscarriage, unsure if they'll ever be in a position to carry a child safely, grieving for a stillborn child. Not to mention, the treatment for breast cancer can leave women infertile, making the whole thing even more nasty.

By turning the process into a joke, the meme basically says that it's okay to hurt people (and judging by the blog posts I read this morning, there is no way I am the only one who feels this way), okay to remind them of what they cannot have.

But what about real pregnancies? That was a comment that I saw on one forum this morning. A woman who was 'super fertile' (she complained that she had a hard time not getting pregnant because they couldn't afford protection all the time and loved each other too much not to have sex. I did not leap through the screen to kill her, but I'd be happy to send her some condoms) whinged that she was tired of having to be 'super careful' of whatever she said so she didn't upset people. The difference between real pregnancies and this, in my mind at least, is that real (wanted) pregnancies are wrapped in the most wonderful joy. You're so pleased for the friend or acquaintance who is having a baby that any kind of sting is immediately softened. A joke 'pregnancy' has no kind of joy attached, no balm to take the sting away.

There is so much we can do to raise awareness for cancer and other diseases. There are hundreds of support and research groups out there doing everything they can to find causes, support treatment and discover cures. If we want to raise awareness we can link to them, encourage people to have check ups, encourage people to get behind charities we're passionate about. We don't need to exclude and hurt to make a point.

Edited to add:
Here's a couple of links to people who have also blogged about this, sometimes much more eloquently than I can:
Regarding the Facebook "Breast Cancer Awareness Games" by C. G. Ward Photography
It Does Not Raise Any Awareness, I Swear by Tales From This Side of the Mamahood
Pretending You're Pregnant Isn't Cute  from Yolk

Photo from Flickr

So what next . . .

Last week we had our first Specialist Appointment. So far there have been three main repercussions from that appointment:

1. My arm developed the worst bruise ever from the blood tests. Honestly, it looked like someone had grabbed me quite violently every day for a week. It's finally faded to a yellow now.

2. M received a phone call from his GP to urgently discuss one of the blood tests taken at the specialist. It had turned up very high levels of potassium, which could mean he was at high risk of a heart attack. Thankfully the test was false and he's all healthy. We've had no other call about the blood tests which is a Good Thing because they generally only call when there's an issue.

3. It's been ovulation week (and a bit, to try to accommodate my slightly wonky cycle ATM) which has actually been a lot more fun than it has recently - probably because we know there's something happening.

Other than that, I've read a few more fertility books and talked with a couple of people at work who've also gone through the whole thing. Now, just to get through the rest of the Two Week Wait . . .

Book Review: The Inadequate Conception by Lori Green LeRoy

It seems that actually visiting the fertility specialist has turned me into a reader of infertility books. Luckily, this one was worth the read. This one also has a great long subtitle to share: From Barry White to Blastocytes: What your mom didn't tell you about getting pregnant.

The Inadequate Conception is not an autobiography, but it does tell us quite a lot about the author's attempts to get pregnant. It's also not a dry medical book, though there's a fair bit of that info in there too. It reads much more like a well organised and well written blog, and it's very clear that the author has spent a significant amount of time in the blogging world (which in my mind is a good thing, and led to an easily read and digested book).

At the time of writing the book, Lori Green LeRoy was a veteran of trying to make a baby, having gone through just about every procedure known. In the book she outlines some of them, plus the side effects, and other people's experiences, all while dosing it up with well timed humour. A lot of her expressions will probably stick with me, such as 'single line syndrome' to describe the feeling you get when you look at another negative pregnancy test. Then there's the bit about seeing the cervix as a Dungeons and Dragons gatekeeper refusing sperm entrance to the castle . . .

Although the tone of the book is relatively light-hearted, it's clear that there's a real story about real people going through real emotions underneath. There's the fear of the internal ultrasound wand, the worries about the costs, the clearly awful side effects of fertility drugs and the 'Case of the Bitters' which discusses a world where pregnancy is revered. But the author also cautions that there is a point when you need to move on.

Particularly interesting was the section on the men's role in it all. Most books/information/websites I've read treat the semen sample with a sheepish grin and quickly move back to talking about injections and examinations. This book took the time to have a male perspective, and to point out that for many men it's not just a case of 'having a good time' while their partner gets poked and prodded.

I'd highly recommend this book. Because it's simply sharing the experiences of others, it never gets preachy or over involved. Instead it's just a nice way of laughing a bit at the problems and pointing out that we're never really alone in this.

Book Review: Bump and Grind by Genevieve Morton

The subtitle for this book is The A-Z survival guide for when you're trying to get pregnant and sick of being told to relax! which is a real mouthful, but probably what drew me in to buy the book in the first place. I then went on to have a pretty mixed reaction to it . . .

Positives

• It was easy to get through. The A-Z format broke it into easy parts
• It had some nice truths - the avoidance of the word 'relax' completely resonated with me. Can't tell you how many people have told me to relax/not think about it etc.
• There was good information on testing and keeping track

Things that annoyed me

• The book is pretty stereotypical - focusing on being married etc.
• Continual bashing of 'Smug Fertility Goddesses' (aka those who boast about getting pregnant when they just brush by the partners). I know they're out there, I hate that I let them annoy me, and I really didn't need constant reminder of them

Things that made me weepy (Great)

• Anything about how much this sucks or the idea of 'giving up' There were times when I needed to close the book and walk away from it.

Basically, a fairly decent book as long as you're able to dip into what you actually need, and able to walk away from it when you need to.

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

The Journey to Now: Part Two

It seems funny, now that I look back at it, how much energy and stress I put into not getting pregnant over the years. Because, despite being off the pill for over a year, despite reducing the amount of caffeine I drank and removing alcohol altogether, despite swallowing horse pill vitamins, we just couldn't manage to get pregnant.

At first it was a disappointment, but one you could deal with - no matter, we'll try again next month, almost no one gets pregnant in the first (second, third, fourth) month. Then you try to ignore it, put the due date for your period to the back of your mind and just pretend everything is okay. Then your period is late by one day and your hopes soar . . . before coming crashing down again.

You develop a really bad relationship with your period. Forget anything you felt in your pre-trying to conceive days when a period was a painful inconvenience. Now it's a burden, a nasty little reminder that you're still not pregnant, that the really good feeling you had this time was absolutely nothing. And you still have the cramps and inconvenience on top of it all.

After a year, you enter the select group. The 10 percent that can't get pregnant in 12 months and are technically infertile. And there is nothing nice or cheerful about that word. M and I made an appointment with my local GP, hoping to get some information, answers, or at the very least a referral. He gave me a form for a blood test for my thyroid (all in appropriate range apparently), some information we already knew, and told us to keep trying for six to nine months more before he would do anything. We left tired, disgruntled, and once I got the blood test results back, determined to go to another GP.

Luckily this one was more understanding, giving me some good information and, brilliantly, a referral to the best infertility specialist close to where we live. It was a real relief to be getting something done, an even better relief when an appointment was made for just four weeks later.

And now, this week, we'll have our appointment and step into the next phase of this story.

The Journey to Now: Part One

It's incredibly hard to work out how to start a blog like this. You type in a pithy opening, look at it for a few moments, and then delete it before you can quite come to terms with how bad it really is. Repeat until the need to have a decaf coffee over takes you and you can slink away from the computer having achieved nothing.

I suppose the best place to start is with some sort of brief introduction.

I'm M, married to M. We've been together for 10 years, married for three. We're both professionals, nearly 30, own our own house, and taking away that rather big amount, relatively debt free. And we've been ready to fall pregnant since 2009.

Which tells you everything and really nothing at all.

One month after we started trying, I discovered a small lump under the surface of my stomach. On most people that would cause a considerable amount of worry and panic. On me, a resigned sense of 'here we go again'. Sure enough, I was diagnosed with my second incisional hernia in four years and was told to stop trying as that kind of strain would not be a Good Thing.

The hernia was repaired in January 2010, and by April we were all systems go. We were sure it would just be a couple of months and we'd definitely fall pregnant. Because that was how it was supposed to work. Right?

Well, no. Not really.

To be continued . . .

Photo from Flickr