IVF Diary Vol III: 14-16 Apr 16

Medication(s) administered and dosage(s). Transfer Day!!!!  PM Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.

The past few days Chris has been giving me my progesterone in oil injections because I have been too sore to turn around and attempt to give one to myself in the behind!  Last night I prepped the medication as per usual, I iced my backside, then usually I go lie on the bed face down ready for Chris to inject, but this time I decided to secretly attempt to inject it myself!  I stood with my side facing the bathroom mirror (which I didn’t actually use in the end). I held the needle like a dart, but it’s very difficult to get a true dart like action when doing this to myself! There was no hesitating this time (I must have tried this about 10 times last cycle).  Rather than ‘dart’ it in, I placed the needle on my skin and pushed a little – it didn’t break the skin! I couldn’t feel it because I had iced the area anyway, so I pushed harder.  You definitely have to push that thing in a whole lot harder than you might think!!!  Anyway, it went in and I started to inject the oil.  Chris walked into the bathroom as I was doing this and for a second ignored me…then realised what I was doing, I hadn’t told him I was going to do it!!!  He was super impressed!! After I took the needle out I realised that there was quite a lot of blood with this one – typical!!!  I hadn’t got the gauze ready.  I felt a little dizzy, but not too bad.  I put my heat pad on the injection site as usual and gave Chris a high five!  Can I give a high five to all my lovely supporters who have cheered me on with this injection!!!  You helped me do it! Thank you so much!!!

Medical procedures undertaken. 5 Day Embryo Transfer!!!!! I was very nervous that we would arrive and the procedure would be cancelled because I was still feeling the OHSS symptoms.  We arrived at 0700AM at the clinic and we were second in line – there were only two of us patients in the OR today.  Learning my lesson from previous transfers I did not drink anything when I woke up and ensured my bladder was as empty as it could be by the time I arrived at the clinic.  I started sipping my water about 40 mins before they took me in.  They recommend drinking 24oz, but seriously my bladder can barely hold 12oz and with the OHSS the past few days I have only been able to drink about 8oz at the most before needing to pee.  Once I was in the OR the doctor told us we had two beautiful embryos to transfer today and one potential to freeze.  Once I was in the stirrups, the doctor placed the speculum and the other doctor used the transabdominal ultrasound on my tummy. OH MY GOODNESS it hurt!  And this time not from a full bladder!  The Doctor exclaimed ‘Oh yes, you do have super enlarged ovaries!’ I just laughed out loud because I could tell him that without the ultrasound.  Anyway, the canula tube that the embryos would be transferred by was inserted into my uterus and we were ready to go!  The embryologist checked my identity, and went back into his lab and showed us the embryos on the TV screen, confirming they were ours – one of the blastocysts had started to hatch since he took the photo earlier in the morning (a new thing the clinic does!!!!  Very cool because before Chris would snap a pic of the TV screen with his phone!).  At this point I was crying because of the pain from the ultrasound!!! We watched the embryos on the ultrasound screen ‘arrive’ into my uterus 🙂  We had the same doctor do our transfer for our Positive result last year…not that this should make a difference…but….this is a good sign!!!!!

Any results?  The two embryos we transferred were graded 3BB and 3CB (Here is a useful link to find out more about blastocyst grading).  There is one blastocyst that might make it to the freezer (FINGERS CROSSED!!! This would be amazing so it can join our other frozen embryo!!!) Sadly the other 7 embryos are highly unlikely to make it to the freezer 😦

blastocyst 3BB blastocyst 3CB.jpg

The one on the right is the 3BB the one on the left is the 3CB –  we haven’t decided on a name for them yet!

What are my symptoms?  Still suffering with OHSS, but the important thing is that it is not getting worse.  Now we have to hope that it doesn’t get worse if I get pregnant (OHSS can either appear or get worse as hCG levels increases once you actually get pregnant)…so we are still on the watch.  I am really getting bored of not being able to do anything other than a gentle walk – and that is a short distance gentle walk too 😦

How do I feel today? I was feeling really anxious last night about today’s transfer and I did not sleep well at all.  I had awful nightmares about the Brussels attacks too.  I woke up from them and couldn’t stop thinking about it for about an hour or so before I fell back asleep.  Today I am feeling relieved that we had at least two to transfer and all those emotions came bubbling up in the form of tears as we left the clinic – a true mix of happy, scared and pained feelings!

BUT I am PUPO! (Pregnant Until Proven Otherwise) and for that I am truly grateful.  We will be over the moon if this one blastocyst also makes it to the freezer.

What’s next? The two week wait…..eeeeeeek!!! To pee or not to pee (on a stick)…..that is the question!!!!

The Final Countdown!!! 

160416_IVF3_Calendar_Countdown.jpg

 

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal), 5mg Melatonin at bed time and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF Diary Vol II: 29-30 Jan 16

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.  Remember I was taking baby steps with self injecting the progesterone?  Well, I have not progressed any further, in fact I probably regressed.  I am really struggling to pull back the needle to check for blood and keeping the needle still, then I freak out when the needle is moving around in my butt!!! I have yet to take the plunge with putting the needle in myself.  I am feeling pretty miserable with my lack of progress. I’m not going to give up, but I’m feeling frustrated at myself.

Medical procedures undertaken. 5 Day Embryo Transfer!  Our transfer was scheduled for 7AM on Saturday, so we were up super early again.  I learned my lesson from last time around.  No tea before the procedure.  Usually I am a real grump without my morning cup of tea, but as tea is a diuretic I decided to avoid it this time.  I also didn’t drink anything until I arrived at the clinic. For our first IVF cycle, in addition to tea, I also drank 3/4 of the recommended water to take 30 minutes before the procedure (24oz) and I was painfully busting to go to the toilet.  So, now knowing my bladder size a bit better, I decided to drink just a third of the 24oz recommended water (and no tea).  I was a little nervous it wouldn’t be enough, but the ultrasound clearly showed my uterus (Dr also commented on the severity of my retroverted uterus as if it was a surprise!).

As I got onto the table ready for the transfer procedure the Doctor gave us a run down on the status of our 11 embryos.  This time, she showed us the report (last time the Dr just told us we had 2 eight cell embies).  We had not been given an update since the fertilisation report so I was very nervous!!!  Amazingly, all 11 embryos were still alive.  We had three blastocysts, graded 5BB, 5BB and 5CC.  The other 8 embryos were still only 9-5 cells.  They were going to wait one more day to see if they would catch up.  When I said ‘so this means we will have at least one to freeze?’, she didn’t seem particularly confident that we would have any.  But I will remain hopeful that the rest will catch up!!  We were transferring the best two blastocysts we had, and I am happy with that!

We have named our embies Petrie and Spike…can you guess why we ended up naming them this?

ivf2_blasts

Introducing Petrie & Spike – our Day 5 Embryos – now on board!  (We think that weird stickie looking thing is a scratch on the petri dish – that or I will be giving birth to some stick man)

The Dr prepared me for the procedure, she washed out my ‘baby house’ as she called it, then practiced inserting the catheter, everything went smoothly!  Then the embryologist came to confirm my identity, he went back to the embryology lab to show on the TV screen in our room our name on the petri dish and then a zoomed in picture of our embryos.  Then he came back in the room with our embryos ready to be transferred.  The Dr quickly did the transfer as we watched on the ultrasound monitor the liquid with the embryos in it go up into my uterus.  Chris later described it looking like a ‘shooting star’.  I thought that was a lovely way to describe this!  I was wheeled back to the recovery room and I had to lie down for one hour before they would let me either pee or leave!!!

What are my symptoms?  I think the estrogen and progesterone are starting to kick in and I had a good old cry last night.  It wasn’t helped by my failure to do my own progesterone injection.

How do I feel today? I was pretty relaxed with the whole procedure today and I am feeling positive still. Woohoo!

Any results?  I am thinking of doing a home pregnancy test everyday from 7 days past the 5 day transfer – last time I tested the day before the beta.  But this time I am thinking of testing simply in the name of science.  I don’t know why, I’ll have a think about this – I’ve got a while anyway!  2 Week Wait here we come!!!

What’s next? Beta HcG test will be 13 days from now :-s

Weight. NSTR.

Waist. The Dr showed me my squished uterus today from my stimulated ovaries – there were some pretty big follicles still in there. I am not surprised I am still bloated as I am.  The Dr told me to keep up the drinking to help flush them out.

Boobs. Definitely growing.

Hours of Sunshine 🙂 Deleted from my diary…what’s the point?  The one sunny day at a weekend – I am on enforced bed rest!!!

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF Diary Vol II: 26-28 Jan 16

Medication(s) administered and dosage(s). Progesterone in Oil 1ml Intra-muscular injection, vivelle dot estrogen patches 0.1mg x2.  I am taking baby steps in learning how to inject the progesterone myself.  Last night I held the needle and hovered it above my skin but cried, well sobbed… and begged Chris to do it.  I realised that I had never actually watched this huge needle go in before because I have always been lying down on the bed face down.  So the first step was watching it break the skin.  He checked for blood, then I took over from Chris and injected the oil so I know what it feels like and I took the needle out.  There are definitely some challenges with injecting yourself and reaching round at the right angle – fortunately I am pretty flexible (thanks yoga!).  We will do the same again whilst I build my confidence up! baby steps….!!

Medical procedures undertaken. Nil

What are my symptoms?  My recovery from the Egg Retrieval surgery has been incredible!  Compared with last time when I was practically crippled with pain and constipation I am in a way better place.  The runny/dribbly/itchy nose and continuous sneezing has started to wear off.  I treated the symptoms with nose saline spray (with aloe) and antihistamines.   I was only constipated for about 1.5 days, and for someone who poos 3-5 times a day this wasn’t insignificant! But again, it was no where near as bad as last time when it was 3 days.  I don’t sleep well when taking the progesterone injections or the estrogen patches, I’m not sure which is the culprit.  I suspect it’s the progesterone because I remember being like that when I was only taking the progesterone suppositories for the IUIs.  I woke up very early this morning with some sharp tummy pains, the kind you get from being very hungry.  OK enough whinging, really, I am in a good place!

How do I feel today? I guess technically we are in the 2 Week Wait. I’m getting nervous that I am too positive now!!! Although last night I had a dream that I had to knit my embryos, and I dropped the last stitch, which meant I dropped an embryo on the floor and I had everyone looking for it!!! Don’t pscyho-analyse me too hard ;-p I went back to work on Wednesday and people were surprised to see me in good health because I had originally booked the whole week off as sick leave based on my experience last time.  But it wasn’t needed!

Any results?  Out of the 14 eggs that were retrieved, 11 of them were mature.  Out of the 11 mature eggs all 11 fertilised successfully!  This means an automatic go to Day 5 Transfer space!!!  Our clinic doesn’t provide updates on the embryo progress unless things are going badly.  We haven’t heard from the clinic and today is Day 3, so we are assuming things are all good.  Our next update on how many made it to blastocyst will be on Saturday morning when we go in for our Transfer!  It’s really strange because I know so many other clinics offer daily updates, but I’ve come to the conclusion that ignorance is bliss.

What’s next? Day 5 transfer is scheduled for 7AM this Saturday :-s who needs a lie-in when you can make a baby the good old test tube way!

Weight. Aghhhhh. I can’t even….

Waist. Seriously bloated and look pregnant.

Boobs. Getting bigger by the day – someone is happy about this! Not my bra, that’s for sure ;-p

Hours of Sunshine 🙂 The sun has been hiding.  I think that the whole sun thing has no bearing on my fertility considering the amount of sun I got in August last year when we went through IVF the first time!

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.

IVF round 2 – December/January 2016

We met for our follow-up appointment with our doctor yesterday.  There were no surprises.  Which is a good thing!  So the plan of attack is a fresh round of IVF…get a couple more embryos frozen:

  1. Schedule a Hysterosalpingogram (HSG – if you would like a refresher what this procedure entails, check out my post from last time here) – I will do this as soon as I start my period (who knows when that will be!!!).  It is very unlikely that my fallopian tubes will be blocked, but she wants to be sure.  Fair enough.  However, I am NOT looking forward to this test.  Last time I was completely naive to the potential pain ahead for this particular procedure, now that I know exactly how much it can hurt I’m a wee bit nervous!
  2. Plan to start Birth Control Pills to regulate my cycle in December with an egg retrieval date for early January 16.  There is a period of 3 weeks that the embryology lab is closed over the Christmas period.  Seriously – how unlucky am I?? Last time my cycle was delayed because the embryology lab was being refurbished.  Oh well – I guess everyone needs a holiday.

There is a potential chance we could start Birth Control Pills in November, and do a retrieval before Christmas, but I think it will be close to my 3 month period of ‘no baby making’ because of the methotrexate shot I had affecting fetus development.  I have been researching this, and I would be willing to go ahead a week or two earlier because doctors are overly cautious with this 3 month time stamp.  As long as I keep taking my folic acid I should have no problems.  However, this is something to be discussed once we have a better idea of a) when my period is likely to be and b) assuming my HSG test is all clear!!!

There will be no change to my protocol, perhaps a slight increase in some of the medication dosages to mature more of my eggs.  As a reminder from our first round we had 9 eggs retrieved, 6 of these eggs were mature, 4 of these eggs were successfully fertilised by ICSI, 2 good 8 cell embryos were transferred on day 3, and 1 of the 2 embryos made it to Day 5 blastocyst and was frozen.  Our doctor mentioned that she would consider waiting to Day 5 for the transfer this time around, especially as our frozen one is Day 5 – she wants them to be the same.  We like this plan!

This gives me some time to concentrate on work for a little while, get my body healthy and start growing some strong eggs!  What is amazing is what the horrrorscopes says for me next week…

horoscopes

I was already planning on going back on my sugar free, healthy diet next week! Freaky! Sooooo….which old friend should I Skype on Sunday next week and wants to reveal a long-held secret to me??!!!?!

How to get the most out of your doctor

It took me about 24hrs after it was confirmed that I am pregnant to realise I do not know how to be pregnant.  This might seem very weird considering we have been talking about this moment for more than two years now.  Once we started trying to conceive I just of buried my head in the sand.  I didn’t want to jinx our chances by buying a book about it, and I started to avoid all pregnancy related websites and apps after 6 months of failing to succeed in our quest to make a baby.  I know the basics, like smoking is a big no-no, drugs are dangerous, avoid raw meat and reduce caffeine, but really, that is the limits of my knowledge.  So yesterday we went to the book store and bought two books on pregnancy.  One was the standard text book “Great expectations: Your all in one resource for pregnancy”, and the second was “Expecting Better”, beautifully demonstrated in this picture by Sushi:

Sushi, my book keeper

Sushi, my book keeper

This second book interested me because I have always wondered whether Japanese women stop eating sushi, or French women stop eating brie when they are pregnant.  Really?  I don’t think so.  I hope that this book will enlighten me to what the conventional wisdom really means.  But when I started reading the first chapter I didn’t need to go much further with it to be completely satisfied with my purchase.  Why?  Well the author, Emily Oster, is not so different from me, she was not happy with what her doctor was telling her.  I realised that my experience with my fertility clinic’s doctors and the feeling I had that there was a poor lack of communication.  All of this was because I was not asking the right questions.  I didn’t know I needed to ask them.  And this is silly because all along I had the key questions in the back of my mind…I use them everyday at work!!!

In my job I help leaders make decisions every day…I do this by presenting the evidence, the facts – for and against a decision – I do some analysis on the data that supports the decision, I try to be unbiased and objective in my analysis, and then I present a recommendation to the leader on the best course of action.  The leader doesn’t always go with my recommendation, but I have presented them with the facts and figures to make their own mind up.  Sometimes I feel a bit hurt, but then I remember, I am not the one taking the risk.  So when it comes to our healthcare and doctors, WE are the decision makers.  We need to be presented with the arguments for and against, and be told what the supporting evidence is.  WE are unique in many different ways and the decisions we make will be unique, blanket guidelines are not always appropriate for everyone.

I think a good example of this is when we were told we should do ‘ICSI’ because of our unexplained infertility.  We didn’t ask the questions:  What are the pros of ICSI?  What are the cons of ICSI?  What are the improved success rates with people like us? (i.e. what’s the supporting evidence/data?)   We were not armed to make a decision, we just went with what the doctor said, and in the back of my mind I felt like I had not been given a chance to make a decision.  I did actually do a lot of this research myself, but it would have been better if my doctor would have told me – after all I am not the medical professional, I just have the fortunate ability to interpret statistics from studies and experiments.  So although I was finally happy with the decision to do ICSI after my research, something inside me was niggling about our doctor’s communication.

Another example is when it came to our embryo transfer.  We were told that it is the standard practice at the clinic to transfer 2 embryos on day 3, unless there were over 6 fertilised embryos then maybe we would be a candidate for waiting to Day 5 to transfer 2 blastocysts.  We did not ask the questions: what are the pros of us waiting to Day 5? What are the cons of us waiting to Day 5?  What are our personal chance of success with 4 fertilised embryos compared to if we had had 6? (i.e. what’s the supporting evidence/data?).  Again, I did a lot of this research myself.

I could go on with other opportunities throughout our infertility treatment where I could have asked these three simple questions that would have revealed the knowledge I needed to feel like I was in control of making a decision.  We rely on doctors to make the decisions for us…and most of the time I am happy with that fact, but there were times that I felt like we should hold that responsibility for a decision.  When it comes to my pregnancy I want to be able to ask these questions to my doctors and nurses so I can take the responsibility for making some of the big decisions such as prenatal testing or birthing plans.

Emily Oster suggests reading the book “Our medical mind: How to decide what is right for you” by Jerome Groopman and Pamela Hartzband.  I think I might try it, and I’ll let you know how it goes.  Has anyone read this one?

In the meantime my friends, next time you are in a consult with your doctor, remember these three simple questions to help you make the best decision, for you, and get the most out of your doctor….

  • What are the pros (for me)?
  • What are the cons (for me)?
  • What is the evidence/what are the chances (for me in particular)?

IVF DIARY VOL I: 04 Aug 2015

IVF_Diary_Vol1fMedication(s) administered and dosage(s). 

Doxycycline to reduce chance of infection after the egg retrieval.

Acetaminophen/Codeine #3 300/30mg 1 every 4-6hrs as needed for pain – although I took one this morning, I’m afraid this is not helping with my constipation and I don’t think it is helping with the pain, so I’m not taking anymore.

Colace, to help counter my constipation.

Vivelle Dot Patches x2 (Estrogen usually administered to menopausal women).  These are super easy – they stick to my abdomen…now that is something I can do myself!!! I love the fact that they say on the box “Do not use if you are pregnant”. HA!!!

Progesterone in oil – 1mg.  Oh my goodness, this is an intra-muscular injection with a 1.5″ needle. I lay down on the bed on my front.  Using a cool pack I iced my buttock cheek in the top right hand quadrant where Chris injected it.  I hardly felt the needle going in as a result of the ice numbness, but I felt like Chris was pushing really hard so I said he doesn’t need to put pressure on it when it’s in me!  He told me that there was hardly an imprint of the needle on my skin, he wasn’t pushing! I guess that is just how a needle feels going into the muscle!  Afterwards we massaged the area and then I applied a heat pad to the injection area.  Owwww I feel like someone has kicked me in the butt cheek!! It’s really isn’t so bad, but I am not the one adminstering it, so I can look away!!

Medical procedures undertaken. No procedures on me per se, but my mature eggs were “ICSI’d” yesterday afternoon and our fertilised eggs are being looked after by the embryologists so they develop into embryos.

What are my symptoms? I am massively bloated – my waist increased by 4cm and I put on 3lbs despite the fact that I hardly ate anything yesterday.  I am constipated, I poo usually 3 times a day and so far nothing.  I’ve taken some Colace which takes 12-36 hours to work – not soon enough.  My bowels and stomach also hurt whenever I pee and fart.  Farting releases a little bit of the pressure, but does not relieve me!  It hurts when I walk, the pain is not getting any better.  The nurse said I should call tomorrow if the pain continues to worsen or I put on anymore weight because I could be at risk from Ovarian Hyper Stimulation Syndrome.  They would need to do an ultrasound to check how my ovaries are doing.  I really really hope this starts to go away so I can go to work tomorrow plus I want to be better before my transfer.  In the meantime the nurse advised drinking liquids, not just water but juice, gator aid and soup.  Eat small portions….I am soooo hungry, but I can’t physically eat a whole meal right now!!

Day1

Day 1 – pronuclear stage: 1 cell with 2 dots in the middle.  This indicates a normally fertilized egg with each dot representing genetic materials from the mum and the dad.

Any results? This morning I received a phone call from the IVF nurse co-ordinator who gave me an update on egg/embryo status.  When I answered the phone she sounded so somber I thought she was going to tell me it had been a complete failure.  But here is what she told me.  Yesterday they retrieved 9 eggs, 6 were mature, this morning 4 had successfully fertilised, 2 had not, but they may be late developers and so they will call me if they do make it.  If they don’t call, they haven’t made it, and 4 will be the number.  (They didn’t call in the end 😦 ). I won’t get any more updates until I arrive on Thursday for my transfer procedure (3 days). I’m not sure I like the fact that we won’t receive any more updates, but at the same time, what can I do about it if I was told if they are progressing well?  Nothing, so I guess this way it stops us thinking too much about it.

How do I feel today? I am trying to stay positive, I won’t lie that I cried for a very brief while after I got off the phone from the nurse.    I was initially upset that less than 1 in 2 eggs made it through to fertilisation.  I couldn’t help but think how somehow this is my failure.  But I realise this is ridiculous, so I cried for only a minute.

How does Chris feel today? Poor Chris found the intra-muscular injection quite traumatic, I feel really bad.  But he did it!!!  I will let him tell you all about it in a separate post.  He is quite pragmatic about the number of fertilised eggs – 4 today seems like a good number to come away with.  However he feels confused, like me, about whether we should wait for a 5 day transfer.

What’s next?   I am not sure about the 3 versus 5 day transfer.  We do get to discuss things with the doctor on Thursday, but we haven’t talked about it since we started our IVF cycle.  I’ve read a lot about the fact that if an embryo doesn’t make it to blastocyst stage at 5 days then it is unlikely to have ever been a viable pregnancy anyway (I am not sure how they can really know that for sure).  So wouldn’t it be better to let them get to 5 days to see if they survive to blastocyst stage rather than having false hope with a day 3 transfer and waiting two weeks to see it fail;?  This seems like the worst kind of gambling!!!

Weight. I’ve gained 3lbs of whatever over night, it’s not food that’s for sure!!! I’ll keep an eye on it.

Waist.  My waist has bloated 4cm in the last 24hrs, which might not sound like much, but it sure is a significant gain for me over this time period!

Boobs. NSTR.

Hours of Sunshine 🙂 I’m not really allowed in the sun because I am taking doxycycline 😦 but I did sneak in a bit (wearing sun cream of course) this morning and had a slow waddle down to the beach.

150804_IVF1_Stats

*Notes.  I take First Response Reproductive Health multi vitamin gummies (pre-natal) and CoQ10 200mg gummies daily.  NSTR = Nothing Significant To Report.