Where’s Waldo??

“Where’s Waldo? – Do you know who Waldo is?”

My doctor asked me as she used the vaginal ultrasound to search my uterus and fallopian tubes for a potential sac.  Today at my ultrasound appointment my doctor carefully searched as she discussed it with the more ‘junior’ doctor.  The ‘junior’ doctor also had a go with ultrasound wand.  But nothing was there – not even that black teeny dot from Tuesday was there anymore.

My hCG went up to 1066 from 686 (55% increase in 44 hrs).  This is not the direction my beta levels should be heading in right now.

My doctor helpfully told us today that her cut off is 7 weeks for a decision on whether to use methotrexate; in the mean time if my hCG continues to rise she will closely monitor me every 48 hours with ultrasound and beta blood tests until 7 weeks.  Today I am 6 weeks 2 days pregnant, so only 5 days left for me to miscarry naturally. She is now more confident that when I return on Saturday they will see the growing empty sac now that my beta hCG is above 1000.  The question remains – where will this empty sac be?  We are still hoping it will be in the uterus and not the fallopian tube.

So I’m still on ectopic watch for now.  I have no bleeding or spotting, the odd pain twinge here and there, today I woke up a bit more nauseous and I’m starting to pee a lot again, so my ‘pregnancy’ symptoms are now returning as my hCG levels continue to rise.  But overall I feel physically well, a little bit mentally drained.

Today I took a sick day which was a good idea because I am not sure my brain could have coped with work today, instead I spent some time doing adult colouring in.  Very therapeutic, but sometimes I can’t stop because I don’t like leaving things unfinished, and then it stops being therapeutic as I create a chore for myself!!!

Anyway, until Saturday…..we continue to wait.

Sad, but starting to feel mad

This afternoon I had my mobile (cell) phone with me on loud so I could hear the doctor ring with my results.  I get a lot of notifications and pings every 5 minutes so I am sure my colleagues were getting annoyed with me.  But anyway, I received three pings all at once, which I thought was odd, so I checked my email to find a notification from my clinic for a new appointment, with my doctor tomorrow morning (The three pings were from my email and app that tracks my appointments).  Well isn’t that just nice?  My eyes started to well up because I knew this had to be bad news – what a crappy way to find out?  After 20 minutes of consoling myself, I finally received the call from my doctor.  My hCG levels have continued to rise again to 686 (Tues) from 345 (Fri).  Not good news.  So my doctor starts talking more about this potentially being a tubal (ectopic) pregnancy…she didn’t really tell me anything new from yesterday, she stressed again that there is zero chance that I have a viable pregnancy (OK so I got that from yesterday when there was nothing on the ultrasound).

Tomorrow morning I will have another ultrasound to double check my uterus for a (non-viable) pregnancy and some blood tests to see if I am suitable candidate for the drug methotrexate.  I have done a bit more research into this drug, and I really want the doctor to explain all tomorrow – I will be using my 3 point guide to help me feel better informed!  The best guide I found is from the NHS:

“The use of methotrexate to treat pregnancy of unknown location and ectopic pregnancy” available here.

I have been having some random (but not sharp) short pains today, including pain on the left side.  I have also not passed any blood today.  The problem is with Irritable Bowel Syndrome for me is that stress causes pain, so I am having a hard time distinguishing between the two – I don’t feel stressed per se, but this rollercoaster surely can’t be good for my gut.

In the meantime I’m looking forward to tomorrow’s appointment as I move from feeling sad to feeling mad – mad that this feels really unfair and crappy.  I’m taking bets on how many med students/doctors/fellows/nurses they can squeeze this time in the room for my ultrasound tomorrow…..I have a feeling there will be some interest 😐

Nothing….

There was nothing there on the ultrasound screen, just my beautiful uterus – empty.  There was the teeniest tiniest black spot that may have been the beginning of a sac, but it was so small my Doctor was not certain.  She didn’t need to say anything for me to quickly realise that I was not one of the lucky 1%.  My doctor checked my ovaries: my right one is still hyperstimulated from the IVF and I had some VERY big follicles/cysts (but this is normal for after IVF and of no concern, but may explain any pain I may have here), my left ovary too was swollen, but not as bad as my right one.

What does this mean?  It was difficult for my doctor to say without knowing what my beta test results are.  If my hCG levels are continuing to rise, it is likely that I have a tubal pregnancy (ectopic pregnancy – a pregnancy that grows outside of the uterus).  If my hCG levels are falling, then it will be safe to assume that I have a chemical pregnancy* and the little black spot on the screen was indeed huckleberry.

My symptoms have been spotting dark brown blood since Friday, general abdominal pains all day Monday, my spotting surprisingly stopped today (Tuesday).  I have had some pains specifically on my left side, although not overly sharp pains, and I pointed out to the doctor (doctors – there were 2 others in the room with her) where this was….yeh, about where my ovary/fallopian tubes are.

If this is a chemical pregnancy then the doctor will prescribe me some medication (a vaginal pessary, I cannot remember the name of it) to help my body along with expelling the uterine pregnancy.  If this medication doesn’t work, or my hCG levels come back higher with a likelihood of a tubal pregnancy, then I will be prescribed Methotrexate (an intramuscular injection – YEY another injection, of course!!!).  I want to avoid taking this drug because it will mean we are not allowed to conceive for at least another 3 months because the chemical can stay in the body and harm a developing embryo.  But at the same time, we don’t want to wait and see for too long because there is a chance my tube could rupture and I would lose a fallopian tube.  I have read that even after being given the shot their tube still ruptured because it was left too late.

So I was asking you to hope with me that I didn’t bleed, but now I want to bleed….please, please body, just bleed!!!  I think this will be one of those times when I cry tears of happiness when I start to bleed full flow!  I know it will also be sad at the same time….choo choo, all aboard the emotional train wreck!!!

I mentioned that there were two other doctors in the room, one was ‘shadowing’, the other was a fellow (no not a chappie you silly Brits!!!).  The fellow interjected and answered some of our questions, he was clearly very knowledgeable, but there was a lot of bouncing around between them.  Chris was getting frustrated with the information we were receiving, they were talking to us as if we were medical professionals.  It took 5 minutes of Chris’s continued questioning to get the doctors to say that despite the miscarriage being bad (and sad), what we were seeing was ‘normal’ or ‘common’.  What they really needed to start out with was – don’t worry, there is nothing seriously wrong with you, chemical pregnancies happen frequently with IVF (because they are transferring 2 embryos).  I think I had a bit more knowledge than Chris and didn’t feel quite as frustrated because I had googled a lot on miscarriage, chemical pregnancy, blighted ovum and have read forums/blogs etc.  So my lesson here is to share more of my ‘google expert medical opinion’ knowledge with Chris before these types of appointments.

We also discussed my hCG levels (49, 110 and 345) and my doctor did admit that my first hCG result of 49 was borderline low- to non viable.  So why, oh why, did the other doctor (who did my IUIs) seem so happy and chirpy on the phone, proceed to tell me my progesterone and estrogen levels were excellent but fail to tell me my hCG level.  All it required was this:  “Congratulations Ms Dani, you are pregnant, but your levels were a little lower than average, we would like to see you again in 5 days just to make sure you levels are doubling nicely.  Your estrogen & progesterone levels are excellent, so this is a good thing.”  Expectation management is not a bad thing.

So – we have one big question answered, I feel a relief, albeit a sad relief – there is no viable pregnancy.  The next big question we wait for an answer is – is this a chemical pregnancy or a tubal pregnancy?

*A chemical pregnancy is a clinical term for a very early miscarriage. It happens before an ultrasound could even detect a heartbeat (before the 5th week of gestation). This occurs when an egg is fertilized but it does not implant on the uterine wall. Chemical pregnancies are actually quite common, occurring in 50 – 60% of first pregnancies.  There are many possible causes of chemical pregnancy – inadequate uterine lining, low hormone levels, luteal phase defect, infection, or other unknown reasons. The most common assumption is that they are due to chromosomal problems in the developing foetus. This can result from poor sperm or egg quality, genetic abnormalities from either mother or father, or abnormal cell division of the foetus.

Creeping thoughts

I have had some spotting everyday since Friday – just the teeniest amount here and there.  Every time I go to the toilet I feel sick to my stomach as I wipe and check the tissue with apprehension.  I hold my pee just so I delay having to see the blood.  I can feel my stomach starting to bloat, with a feeling of emptiness.

My app tells me I am 5 weeks and 5 days pregnant today and huckleberry is the size of a chocolate chip.  But is huckleberry in there?  Perhaps huckleberry is no longer there, may be he never developed after implantation, or may be he is hanging on for us to see him once again on the ultrasound tomorrow…

Time is dragging and the fog creeps thick around us, we try to keep busy, but it’s impossible to hide our deepest thoughts.  I know that tomorrow is going to be a good day, whatever happens we will have some of the answers to many of our questions.

This post may sound depressive, but I promise you I am not – just sad and anxious, and I think it is OK to be feeling like this right now, it would probably be a bit weird if I didn’t.

Trying not to cry at work is HARD

On Tuesday, after my second beta test, I went home from work early so that I could receive the good or bad news in private.  But my results had not ‘come back in time’, so not knowing when I would receive my results, I went into work on Wednesday.  I was busy running around the office preparing for a one day workshop I was leading the next day when I received the phone call.  You may know already that the news was ‘not good’.  Receiving news like this whilst at work is difficult. My eyes were welling up when I dashed to the toilet quickly, passing one of my senior bosses and trying not to look him in the eye.   I called Chris and had a good old cry – lucky there are not many women at my work to gate crash my pity parade.  Chris said he would come to my work for a hug and he would be there in about 30 minutes.  So I collected myself, and headed back to my desk.  A colleague of mine who had promised to provide me some input to my project report for about 3 weeks decided to tell me he was not able to do it and he was going on leave the next day.  Let’s just say, this was the wrong time to be telling me this.  My attitude initially to him going on leave was….”and…..?????”.  I had waited some time for his input and my report was already late.  I said “No worries…..” in a very sarcastic and mean tone.  Then my friend walked past us happy and bubbly….realised she had just interrupted something and asked if she should go, to which I nodded.  Anyway, I was clearly in a grump.

After 40 minutes of being really pissy one minute, and on the verge of tears the next, Chris arrived at my work.  We had a big hug and cry together in my work car park (parking lot).  Chris stayed for a coffee, and we decided we would work from home for the rest of the day.  I went back to my desk to finish off my preparations for the next day when my colleague (who I had been grumpy to) asked if everything was OK?  So I told him about my phone call. I held back the tears as I said it, but said it was OK, I was going home for the afternoon, which he agreed I should do.  I felt a little bit bad for my pissyness, but I know he understood that it wasn’t personal against him.

Thursday….I kept myself super busy at my workshop all day, I hardly stopped to think about anything else other than work.  It was great!

Today, Friday, I had my third beta blood test.  It didn’t start out great as my appointment was already eating into some ‘compulsory training’ time at work…and of course, the clinic had a waiting room FULL of patients.  I was greeted by a nice enough nurse who I had never met before. I thought I had met them all!!!!  In fact, it was very bizarre, I noticed that the receptionist was someone I had never met before, and all the other nurses I saw wondering around were all new. I wondered briefly if they had done ‘swap staff with another clinic’ day.  V. weird.  Anyway, the nurse who took my blood was pretty distracted by another nurse who was ‘in training’ (who at my last beta test, I blamed for my late result 🙂 ).  They were gossiping, I did not appreciate a lack of attention when I was already upset with having to be there. Grrrr.

After I made into work this morning 40 minutes late, I sat in on about 1.5hrs of pointless training (I am actually already trained, and didn’t know they were going to be covering this same material).  You can tell it was going to be a good day for me….not.  The office was very quiet today, everyone was out on travel or on leave, which was probably a good thing, but I felt lonely.  So I took myself off to a quiet empty meeting room and typed up notes from Thursday’s workshop to keep me busy…but it was slow going, my mind kept wondering to my results.

At 2pm my phone rang, I was surprised because the results weren’t due back til 3pm.  It was the doctor who had done my egg retrieval and  transfer calling with the bad news.  He said my hCG levels were 395 (actually it turns out he was wrong, they were actually 345).  My first response was wow it went up again, OK – I wasn’t expecting that!  But he brought me back down to earth and said he did not believe this would be a normal pregnancy, he would expect an absolute minimum level of 800 by now, and I should stop taking my medications to prevent prolonging the pain (Emotional pain he meant), he did say that I could choose to stay on the meds if I wanted to be 110% sure, but he recommended to stop them. He also told me to arrange a follow up appointment with my doctor as soon as possible.  And that was it.  I actually did not cry, I was just confused.  Sad, but confused.  I stayed in my meeting room and focused on my task at hand, surprisingly I got a lot done in the next two hours.

It is so hard to not cry in front of work colleagues, but at the same time, being there has been a good thing when I needed to divert my mind’s wondering to sad things.

As I left work I received a phone call from my doctor, she started talking to me as if I did not know my results.  However, she was far more informative about my results and what she wanted to do next.  She told me that she agreed with the other doctor I should stop taking the medication, there is a very very small chance (about 1%) that this might be a viable pregnancy, but coming off the meds will not harm the developing foetus if in fact it is developing.  By stopping the medication my body will be allowed to do what it probably would ordinarily have done and let me bleed.  She wants to see me on Tuesday afternoon for an ultrasound and another beta test to be sure I do not have an ectopic pregnancy, although very unlikely, she wants to check.  It is normal if I don’t start bleeding for another 4-5 days, but in the mean time if I get any sharp sudden pains or difficulty breathing to call her immediately.  She also started talking about what we have in the freezer – we have just one blastocyst that was frozen on Day 5 stored away.  They won’t do a transfer with just one frozen, so we would have to do another round of IVF.  Can’t even think about that right now.

As soon as I got home I took off the estrogen patches from my stomach.  It feels good to not have anything stuck there, and we don’t need to think about doing an injection either.  I’m trying to think of the positives here!

I always say it’s never over ’til the fat lady sings….predicting a successful pregnancy outcome

fat_lady_singing

I always say it’s never over ’til the fat lady sings.  But that doesn’t mean I can’t see that fat lady getting ready to get on stage…I can also hear her warming up, running through a few scales too.

So, my suspicions were pretty much confirmed about why I didn’t get my results yesterday.  My results were not good.  And let me point out here that these are not my words, but the words of my nurse.

My hCG levels last Weds were 49 –  just a bit lower about where they should be, but were not overly worrisome…

My results from Tues this week, however, were 126.  They went up!!!! But those of you who are familiar with hCG levels and where they should be by now will know this is not a great number.  hCG levels should double every 2 to 3 days.  What does this mean?  Well my doctor wants me to keep taking my progesterone and estrogen, just in case – there is always a small chance this pregnancy is still viable!! But I have to go in for another beta test on Friday to double check that this pregnancy is, in fact, over.

I can safely say I am no longer feeling cautiously optimistic….I am feeling pessimistic as hell and sad.  If you would like to hold onto hope for us, I gratefully take your strength and thank you for helping to hold us up, but quite frankly when the nurse tells you it is not good, it’s not good.  I understand she is preparing us for the worst.

BUT!!!!! I decided to do a bit of research on what all this really means, what are MY chances?  You know I had to do it, as one of my colleagues told me today – GTS!  (Google That S#*% !!!).  OK, I’m going to get a bit technical here….hang in there if you have in interest in hCG levels (the beautiful pregnancy hormone!!)….


I found a very useful study* that looked at the predictive values of hCG levels for a viable pregnancy 13 days after a 3 day Embryo Transfer (I took my first beta test 14 days after my 3 day Embryo transfer).  My result of 49, according to their model, gives me the following chances of outcome: 45% successful singleton pregnancy, 31% miscarriage, 13% bio-chemical pregnancy, 9% ectopic pregnancy, 3% successful multiples pregnancy.  Well I am glad they didn’t tell me what my hCG levels were last week!

According to these researchers’ analysis, they decided that the cut-off level for predicting a viable pregnancy was an hCG level is 76 IU/I (80% sensitivity)….although this is considerably higher than some other researchers have reported (for example other studies have found the cut off at a similar sensitivity to be: 42 mIU/ml (Qasim et al., 1996); 55 IU/l (Bjercke et al., 1999); and 50 IU/l (Sugantha et al., 2000)).

Wow guys, 76 seems to be a whole lot higher than the others….so do they have credibility in their research?  Well from what I can ‘statistically understand’ and in understanding their research design, it looks solid; their sample size is excellent, some of the best I have seen in articles about artificial reproductive technologies….but I am not a medical professional, so I am totally relying on my knowledge of stats and may be there is something ‘medically awry’ that I cannot see.

If I use any of these models, and consider my hCG level of 49 from last week, these researchers would have told me my chances of a viable pregnancy were always going to be low.

However, there was one interesting point that came out from this study that caught my eye:

In subjects with unexplained infertility, ICSI may result in lower than expected HCG levels (Gold et al., 2000)….The explanation for this was not clear.  Although the early embryo cleavage is delayed in ICSI-derived embryos and the fragmentation of embryos is increased the implantation potential is comparable with IVF-derived embryos.

Even though my numbers have not multiplied nicely….in the back of my mind I am holding onto this slither of hope….holding on that we are the ones in that 5% extreme quantile who defy the norm, and it is because we are unexplained and our embryo was ‘ICSI-ed‘ that my hCG numbers are much lower.

Until Friday…………. :-s

*Pokkeus, P., Hiilesmaa, V. & Tiitinen, A. (2002) Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Human Reproduction 17(7):1901-1905. Available at: http://humrep.oxfordjournals.org/content/17/7/1901.full

No results today….

Before work this morning I went for my second beta test.

There was a new nurse helping out my favourite nurse.

My results have not materialised today.  The chief nurse called me at 1700 to tell me she has not seen them yet and she will make sure someone calls me tomorrow.

Coincidence?

I mean, how often does this happen???

My twisted mind thought of an alternative once it had gone past 4pm and the reason that I had not yet received a phone call, was that my results have come back not good and the doctor wasn’t there to give me the news with a way ahead.  Why am I so paranoid about this?  Well over the last few days my symptoms have pretty much disappeared.  OK so I know it is early still….but…..I took a test again last night because I was just not feeling right about it all…and the line looked much fainter than the other one BUT they are different brands so I probably shouldn’t really compare.  However it was pretty faint and I would have thought my line be darker by now?

Grrrrrrrrrrrrrrrrrrrrrrrrrrrr….I bet the new nurse messed it up and I am worrying all for NOTHING.

IVF DIARY VOL I: 05-06 Aug 2015

IVF_Diary_Vol1b.pngMedication(s) administered and dosage(s).  Progesterone 1ml, vivelle dot estrogen patches 0.1mg x2, colace x1

Medical procedures undertaken. We woke up nice and early for our 7AM appointment.  As we parked up our doctor also parked up, so there was this awkward moment of where I was walking very slowly (still constipated and sore from the egg retrieval) and she clearly had somewhere to be!  Of course Chris had lots of questions for her as he collared her on her way into work about me and my recovery.  Anyway, so we were called upstairs to the IVF surgery room and I was ushered to the same cubicle I was in on Monday.  The nurses immediately noticed I was waddling and I told them about my constipation and bloating.  They were very sympathetic and gave me advice on taking extra colace, prunes, prune juice and apricots to get things moving.  They did not want me straining myself to poo!!!  One nurse said that she sees so many patients like me and doesn’t understand what causes it.  The doctor said it was the progesterone, but I was constipated before I took the progesterone!  After I got changed into my gown and deli hat, I walked back to my cubicle and our doctor was looking over our chart, she said we had 2 beautiful strong embryos, but 2 not so strong that needed to be left in culture for longer to see if they survive to blastocysts on Day 5 for cryopreservation.  And then off she went….there was no discussion.  So I guess we are doing our transfer today then.  I turned to Chris and said is that OK?? And he shook his head in a manner that was like sure why not.

The nurse took my vitals and I started to sip my bottle of water; she warned me not to drink too much because I wouldn’t be able to pee until an hour after the transfer :-s  I drank 3/4s of a bottle of water and that was plenty…in fact probably a little bit too much. Chris got changed into his ‘egg packing factory suit’ – he looked awesome!  He was going to come into the surgical room with me! Brucie bonus!  He was well trained by the nurse on when to take photos of the embryos and where he would sit for the procedure.

IVF1_Chris

Twit-twoo!!!!

IVF1_Both_of_Us

As we were waiting, I overheard the lady in the cubicle next to me begin to cry.  She was going in for her egg retrieval and had just had her Intra-venous drip inserted.  The nurse asked her what was making her sad (I like this nurse, she clearly has much experience with these kind of situations).  The lady said she was afraid of going to sleep.  As the nurse explained the process and how it was just like taking a strong sleeping pill, all I wanted to do was pull back the curtain and giver her the biggest hug ever and tell her it’s OK, it is no where near as bad as general anesthetic and you are going to be just fine – I know it’s scary but it’s going to be easy and won’t hurt.  But of course this is a big no-no, talking to other patients.

After about 30 minutes of waiting I was taken into the surgery room on the trolley (very lazy!!!) and I scooted onto the table.  I put my knees in stirrups this time and I was fully bare and exposed to the world.  Unpleasant.  Chris was sat behind me so he could hold my hand.

The surgery room

The surgery room

The doctor knocked on the embryology lab door to give the go-ahead to get the embryos prepared.  We watched on a TV screen to check that the embryos had our name on the petri-dish and then we saw our two embryos for about 5 seconds!

Our two little 8 cell embryos - AKA HuckleBERRY and HuckleBERINA (because they look like raspberries)

Our two little 8 cell embryos – AKA HuckleBERRY and HuckleBERINA (because they look like raspberries)

They did look pretty good!  They looked nice in shape and symmetry, the doctor was very complimentary about them.  Then two embryologists came into the surgery room, read my wrist band and asked me my name – this is performed by two people so absolutely no mistakes are ever made getting the wrong embryo in the wrong patient!!! The embryologists went away to prepare our embryos.  After this moment, the doctor checked my abdomen, both physically and using an ultrasound (not a transvaginal ultrasound for a change woohoo!!!) except my bladder was full, I was constipated and still sore from the egg retrieval –  I winced the whole way through.  Everything seemed good and he inserted the speculum  and washed out my uterus.  The nurse came and told me that from what she could see on the screen, my ovaries were super enlarged still and I have a mild case Ovarian Hyper stimulation syndrome that will go away soon, I just need to keep up my fluid intake.  Then the doctor knocked again on the embryo lab’s door.  This time the embryologist came in with a soft flexible catheter with the two embryos ready and loaded to be inserted into my uterus.  Using the ultrasound as a guide he inserted the catheter and we ‘watched’ the embryos be ‘puffed’ in by air into my uterus.  I say ‘watched’…I could barely see the screen from the angle I was at.  But I nodded my head not wanting to disappoint him that I missed it.  Before the speculum was removed the catheter was given back to the embryologist just to check under a microscope that the embryos were not still in the catheter.  A few moments later the speculum was removed which was a huge relief, it wasn’t painful, rather very uncomfortable I wanted to pee right there on the table.  I was scooted back onto the trolley and wheeled back to my cubicle where we were told not to go anywhere for 1hr…not even the toilet!!! Eeeek!!

We read a bit and then played a game of crib whilst we waited.   I won!  If I hadn’t have won, I am not sure Chris would have survived the rest of the day.  That made time fly by and then it was time to go!!! We were given a couple of souvenirs…the petri dish our embryos grew in and a little card with the results of our egg retrieval.  Chris took the deli hat too – I think he likes it a bit too much.

IVF1_souvenirs_blank

Souvenirs!!! Petri dish our embryos grew in, report card and a deli hat. Stash!!!!

How do I feel today? I had a terrible night’s sleep dreaming that we would turn up to the clinic with just 1 weak embryo to transfer 😦  But now we have done the transfer I feel like a weight has been lifted off my shoulders.  I feel like I can get on with life right now and enjoy this summer!

What are my symptoms? I woke up with similar pains from the egg retrieval, tender, hard bloated stomach (very hard) and constipated.  I was waddling.  When we got home I sent Chris out to get prune juice, prunes and apricots.  The prune juice worked it’s wonders about an hour or so later.  The nurse told me not to strain, so when it was time to go to the toilet I tried my hardest to just let it all come out, but seriously, once it did all come out, it was the BEST feeling.  I am no longer waddling in pain and my stomach is not so hard anymore.  So I think most of my problem with pain was constipation.  I have Irritable Bowel Syndrome (Diarrhea variant) so I am currently sat here with a gurgling tummy, and I am soooo pleased I am back to normal! (Fingers crossed anyway!!)

How does Chris feel today?  Feels good.  He looks forward to this 2 week wait being over. (He is a man of many words :-))

Any results? Two 8 cell embryos transferred and safely inside me – huckleberry and huckleberina because they look like raspberries and Chris always talks about calling his son Huckleberry.  So let’s just say this is a compromise!!  2 other embryos are growing in culture hopefully over the next couple of days, fingers crossed they survive and can be frozen. I’m  Pregnant until proven otherwise.

What’s next?  Enjoy the two week wait.  My mum is visiting so she has been brilliant so far putting up with everything tht is going on, so I’m hoping to take some time off to enjoy some local sights and sounds.  The pregnancy test will be the day my mum flies out in 13 days.

Weight. OK so I think I have actually lost weight, if you account for all the fluid I have taken on and my waist size.  This isn’t surprising considering I have reduced my intake of food because it won’t physically go in!!

Waist.  Still bloated, but hopefully it will improve tonight now I have relieved myself!!!

Boobs. Starting to feel tender from all the hormones!

Hours of Sunshine 🙂 Fat chance!  It’s miserable out. Plus I’m on bed rest so I’m pleased about this fact!

150806_IVF1_Stats

*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 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.

IVF DIARY VOL I: 02-03 Aug 2015


IVF_Diary_Vol1Medication(s) administered and dosage(s). 
 A whole bunch of anesthesia drugs…who knows what!  And some Acetaminophen/Codeine #3 300/30mg 1 every 4-6hrs as needed for pain.

Medical procedures undertaken. Oocyte (egg) retrieval!  I arrived at the clinic today nice and early for a 7AM start.  No one was in the waiting room, Chris and I literally sat down for 30 secs when we were taken upstairs to the IVF surgery room.  We were number 3 out of 4 for egg retrievals today, so we got to see what the deal was before it was my turn!!  I was immediately shown to my ‘bed’ area, a curtained off area, like in any hospital I guess.  There was a waiting room/small coffee room for partners to wait in, but Chris mostly sat with me.  The nurses I met were bright, bubbly and friendly who seem to love their job, but they seemed constantly busy managing four patients at a time, they did a great job!

I was given a hospital gown and ‘Deli Ham Hat’ i.e. a hair net to put on.  I was allowed to keep my socks on! Yey!!  We waited for about 15 minutes in the bed cubicle with a ‘hot water bottle’ placed on the back of my hands, then the nurse asked Chris to take a seat in the waiting room whilst she put my Intra-Veinous drip in to the back of my hand.  Mostly because the nurse wanted Chris’s seat in order to sit down to do her job!  But also so that she doesn’t need to worry about him passing out when watching.  Clearly this has happened to some poor person in the past!  The nurse apologised for not offering me a numbing cream initially, but I pointed out that another needle really wasn’t going to ruin my day after the past 10 days of injections and needles!!  She did a great job of getting the IV in and I hardly felt it (she told me about my great veins!), although I couldn’t watch her do it and had to look away.  Once I was attached to a the drip she switched it on and I felt a coldness run up my arm.  She went to call Chris back from the waiting room.

As we waited, we heard the other ladies come and go quite quickly.  My doctor popped her head in to say hello.  She is quite eccentrically introverted, so her bedside manner isn’t the greatest!  She asked us how our summer was going, quickly realising where we were, and she said ‘Oh yes, doing IVF, it’s probably quite stressful!’ and then she wondered off.  I wasn’t offended by her, she is lovely, but I am not sure she would be everyone’s cup of tea in this regard.  In fact the first couple up for retrieval had specifically requested for our doctor to do the egg retrieval procedure because they respect her so much.  I am not so sure I would want that.  Not because I don’t trust her, but because I’d rather have the surgeon who does it day in day out!

After 30 minutes or so of waiting it was my turn.  The anesthetist asked me a few questions, I went to try and empty my bladder – there wasn’t much left at this stage – then she injected something into my IV, I started to feel woosy, like I had had a few alcoholic drinks, my words were slurring as they pushed my bed to the theatre room.  They asked me to shuffle onto the operating table, which I just about managed, I put my legs in some stirrups and the anesthetist injected something else. The next thing I knew I was talking to the nurse back in my bed cubicle.  Oh the pain was like my worst period times two, I really wanted to just curl up with a hot water bottle and cry.  For some reason I had started talking to the nurse about my experience of American military hospitals in Kuwait….I have no idea why!  The next thing I knew, I had my eyes open and Chris was holding my hand next to my bed.

During my egg retrieval Chris provided his sperm sample.  All in all, I was in and out in 25 minutes.  After about 15 minutes of recovery I was up walking to the bathroom – slowly!!!  The nurses told me that they thought 9 eggs was the magic number,  Which was incidentally the same number of eggs for the two other ladies before me!!! What are the chances of that?  Chris and I made a bet, I said 9, he said 11.  We find out tomorrow morning how many fertilize successfully.  I was made to sit in a wheelchair and taken to the front door by the nurse where Chris picked me up.  The drive home wasn’t overly comfortable, I felt every bump.  It felt like I was balancing a couple of weights on my ovaries, particularly my right one.

How do I feel today? I’m feeling positive.  I also feel like there is absolutely nothing in my control right now, so there is no point in worrying.  My mum and Chris are taking care of me whilst I take some time out on the sofa.  I really really hope our embryos stay strong to make it to a 5 day transfer because a 3 day transfer would be on Thursday and a few months ago I bought front row tickets to see Cirque Du Soleil for Thursday evening!! Of course if a 3 day transfer is on the cards then I will have to give my ticket to someone else and go another time, just not front row 😦

What are my symptoms? Very tender after the egg retrieval, it feels like I have been punched in the stomach and have weights hanging down from my ovaries so moving slowly is a must!!! Also going to the toilet is quite painful at the moment 😦

How does Chris feel today? He is a soldier.  Chris came up with a couple of funny egg based jokes…e.g. Today I will have my eggs ‘poached’…how do you like them? Over ICSI…. (*sigh, groan).  But he kept us chipper!

Any results? The nurses said they thought we had 9 eggs retrieved, but tomorrow morning we find out how many eggs fertilise.  I’ve finally got all my estradiol results, so I have changed the plot below to show my follicle growth and estradiol together over time.

What’s next?  Apart from finding out how many eggs have fertilised, tomorrow I start taking the estrogen patches and Chris starts injecting the progesterone. Oh crap….not looking forward to that.

Weight. I’ve managed to keep the weight off.  The nurses said after I told them my weight that I’m the kind of person they dislike!  Obviously they were joking 🙂

Waist.  NSTR.

Boobs. NSTR

Hours of Sunshine 🙂 It’s 92F outside and I am stuck inside recovering 😦

150803_IVF1_Stats

150803_IVF1_Follie

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